Prevalence and Incidence of Epilepsy in Ulanga, a Rural Tanzanian District: A Community‐Based Study

Abstract

A random cluster sample survey of approximately 18,000 people in 11 villages was performed in Ulanga, a Tanzanian district with a population of approximately 139,000 people. Well-instructed fourth-year medical students and neurologic and psychiatry nurses identified persons with epilepsy using a screening questionnaire and sent them to a neurologist for detailed evaluation. Identified were 207 subjects (88 male, 119 female) with epilepsy; of these, 185 (89.4%) (80 male, 105 female) had active epilepsy. The prevalence of active epilepsy was 10.2 in 1,000. Prevalence among villages varied, ranging from 5.1 to 37.1 in 1,000 (age-adjusted 5.8-37.0). In a 10-year period (1979-1988) 122 subjects living in the 11 villages developed epilepsy, with an annual incidence of 73.3 in 100,000. Generalized tonic-clonic seizures (GTCS) accounted for 58% and partial seizures accounted for 31.9%, whereas in 10.1% seizures were unclassifiable. Of the partial seizures, secondarily generalized seizures were the most common. Possible etiologic or associated factors were identifiable in only 25.3% of cases. Febrile convulsions were associated in 13.4 of cases. Other associated factors included unspecified encephalitis (4.7%), cerebral malaria (1.9%), birth injury (1.4%), and other (3%). In 38% of the cases, there was a positive family history of epilepsy.

Epilepsy and neurocysticercosis in sub-Saharan Africa

“…Our findings confirm high prevalence rates of epileptic seizures/epilepsy in the hospital and the community, which agrees with the results of previous epidemiological studies of epilepsy in sub-Saharan Africa [5,6,9,[13][14][15][16][17][18][19]. Most studies conducted in parts of Africa and Latin America indicate higher prevalence rates of epilepsy than have been found in high-income countries, but these prevalence rates can vary within a single country, as shown in Benin, the Ivory Coast, Senegal and Tanzania [6,9,19].…”

“…Most studies conducted in parts of Africa and Latin America indicate higher prevalence rates of epilepsy than have been found in high-income countries, but these prevalence rates can vary within a single country, as shown in Benin, the Ivory Coast, Senegal and Tanzania [6,9,19]. In a recent large-scale study from Kenya, it was shown that the active prevalence was only 4.5/1000, and therefore in the range of prevalence rates of high-income countries, with a high heterogeneity of prevalence rates across different areas ranging from below 1.0/1000 to 12.9/1000 [3].…”

“…This is compared to high-income countries where the prevalence of active epilepsy is estimated to be about 4-8/1000 inhabitants [8]. Interestingly, hotspots of highly prevalent epilepsy have been reported in various African countries such as Benin, the Ivory Coast, Cameroon, Nigeria, Senegal and Tanzania [6,9]. Causes for these high prevalence rates have so far not been identified, but they are deemed to be partly genetic in nature, most likely with a consistent environmental factor that affects genetically predisposed individuals [6].…”

Morbus Sacer in Africa: Some Religious Aspects of Epilepsy in Traditional Cultures

“…Besides looking at seizure control and reevaluating the mental status of 260 patients, selected focus-group discussions were held with patient groups and controls, both in the clinic area of Mahenge and in Ruaha, a remote area where no epilepsy clinic has been established (29). The people in both areas belong to the same culturallinguistic group and show an unusual high prevalence of epilepsy (30). Five patient and five control groups of…”

A Review on Management of Epilepsy Complications in Health Care Practice

“…The whole body may lose muscle tone, and the person can suddenly fall. [41][42][43][44][45][46] Tonic or Clonic Seizures: In tonic seizures, the muscles contract and consciousness is altered for about 10 seconds. Clonic seizures, which are very rare, occur primarily in young children, who experience spasms of the muscles but not tonic rigidity.…”