Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association

Owolabi, Lukman; Adamu, Bappa; Jibo, Abubakar Mohammed; Owolabi, Shakirah Desola; Imam, Adamu Isa; Alhaji, Ibrahim Daiyyabu

doi:10.1016/j.seizure.2020.01.005

Cited by 24 publications

(31 citation statements)

References 49 publications

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“…Over three-fourths of persons having epilepsy live in the LMICs, and about two-thirds of these cases have unknown etiology (167,170). Although some reports suggest a relationship between epilepsy and CNS infections in Africa (168,172), the etiology of most epilepsy remains unknown. This emphasizes the role of genetics and an urgent need for genetic investigations.…”

Section: Limitations Of This Studymentioning

confidence: 99%

Voltage Gated Sodium Channel Genes in Epilepsy: Mutations, Functional Studies, and Treatment Dimensions

et al. 2021

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Genetic epilepsy occurs as a result of mutations in either a single gene or an interplay of different genes. These mutations have been detected in ion channel and non-ion channel genes. A noteworthy class of ion channel genes are the voltage gated sodium channels (VGSCs) that play key roles in the depolarization phase of action potentials in neurons. Of huge significance are SCN1A, SCN1B, SCN2A, SCN3A, and SCN8A genes that are highly expressed in the brain. Genomic studies have revealed inherited and de novo mutations in sodium channels that are linked to different forms of epilepsies. Due to the high frequency of sodium channel mutations in epilepsy, this review discusses the pathogenic mutations in the sodium channel genes that lead to epilepsy. In addition, it explores the functional studies on some known mutations and the clinical significance of VGSC mutations in the medical management of epilepsy. The understanding of these channel mutations may serve as a strong guide in making effective treatment decisions in patient management.

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Section: Limitations Of This Studymentioning

confidence: 99%

Voltage Gated Sodium Channel Genes in Epilepsy: Mutations, Functional Studies, and Treatment Dimensions

et al. 2021

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“…Nevertheless, clinical assessment of PWE in our study population of Balaka district, yielded a rather low prevalence of NCC (less than 6%). Other studies in endemic areas including sub-Saharan Africa reported significantly higher prevalence estimates of symptomatic NCC in PWE ranging up to 20–40%, varying with geographic regions and the method of diagnosis [ 4 , 13 , 34 ]. Reasons for this low prevalence may be that the Muslim population in the district was higher than anticipated and pork consumption was lower than anticipated.…”

Section: Discussionmentioning

confidence: 99%

“…However, in sub-Saharan Africa, access to modern anti-seizure medicine is limited for many people and a lack of awareness and education concerning epileptic seizures and epilepsy combined with traditional beliefs and subsequent social stigma lead to underdiagnosis and a large treatment gap of the disease [ 13 , 14 ]. Hence, before implementing MDA, it is important to estimate what proportion of PWE are associated with NCC, which could indicate the extent to which a relatively large number of people are likely to have asymptomatic undiagnosed active NCC.…”

Section: Introductionmentioning

confidence: 99%

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

et al. 2022

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Background Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the proportion of NCC among people with epilepsy (PWE) in a large cross-sectional study in a rural district of southern Malawi. Methods We conducted a community-based door-to-door screening study for epileptic seizures in Balaka, Malawi between October and December 2012. Past epileptic seizures were reported through a 15-item questionnaire answered by at least one person per household generating five major criteria. People who screened positive were further examined by a neurologist to establish diagnosis. Patients diagnosed with epilepsy were examined and offered Taenia solium cyst antigen and antibody serological tests, and a CT scan for the diagnosis of NCC. Results In total, screening information on 69,595 individuals was obtained for lifetime occurrence of epileptic seizures. 3,100 (4.5%) participants screened positive, of whom 1,913 (62%) could be followed-up and underwent further assessment. Lifetime prevalence was 3.0% (95% Bayesian credible interval [CI] 2.8 to 3.1%) and 1.2% (95%BCI 0.9 to 1.6%) for epileptic seizures and epilepsy, respectively. NCC prevalence among PWE was estimated to be 4.4% (95%BCI 0.8 to 8.5%). A diagnosis of epilepsy was ultimately reached for 455 participants. Conclusion The results of this large community-based study contribute to the evaluation and understanding of the burden of epilepsy in the population and of NCC among PWE in sub-Saharan Africa.

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“…1,2 Over 80% of the global burden of epilepsy is in low-and middle-income countries (LMICs), where secondary causes of epilepsy such as neurocysticercosis and traumatic brain injuries are highly prevalent. 1,3 Epilepsy has for long been misunderstood as a disease of the young, however, both the incidence and prevalence of epilepsy increase throughout adulthood. 4,5 In fact, the incidence of seizures and epilepsy in the elderly population is increasingly being recognized and constitutes a significant proportion of the global burden of the disease.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epilepsy in Older People in Sub-Saharan Africa: A Systematic Review

Bongomin¹,

Katabira²,

Sajatovic³

et al. 2021

NDT

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Background: Over one-fourth of new onset epilepsy occurs after age 60. However, the burden of epilepsy and other seizure disorders among this special population in Africa is largely unknown, despite a growingnumber of elderly persons on the continent. This study aimed to assess the prevalence and risk factors for epilepsy among persons aged 60 years or older in Africa. Methods: We conducted a systematic review by searching MEDLINE (via) and EMBASE databases from inception to 30th October 2020. Primary researches reporting prevalence or incidence of seizures or epilepsy in older persons (≥60 years) were included. Review articles were excluded. Results: We retrieved 107 citations from which 4 studies, recruiting 10, 334 participants were eligible. The studies were conducted between 1999 and 2018 and published between 2005 and 2019. Two of the studies were conducted in the West African countries of Niger and Senegal; meanwhile, the remaining 2 were conducted in East African country of Tanzania. Regarding study design, three were either hospital-based or community-based cross-sectional studies. Meanwhile, 1 was a retrospective hospital-based study. Of the 10,334 participants, 81 (0.78%) had a seizure disorder. The prevalence of seizure ranged from 0.02% to 3.2%. Conclusion:There are limited data on the prevalence of epilepsy in older persons in older adults in most countries in sub-Saharan Africa. Epilepsy among the older adults remains a challenge in Africa and more information is needed to understand the burden to improve care.

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Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association

Cited by 24 publications

References 49 publications

Voltage Gated Sodium Channel Genes in Epilepsy: Mutations, Functional Studies, and Treatment Dimensions

Voltage Gated Sodium Channel Genes in Epilepsy: Mutations, Functional Studies, and Treatment Dimensions

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

Epilepsy in Older People in Sub-Saharan Africa: A Systematic Review

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