Prevalence of active epilepsy, lifetime epilepsy prevalence, and burden of epilepsy in Sub-Saharan Africa from meta-analysis of door-to-door population-based surveys

Owolabi, Lukman; Adamu, Bappa; Jibo, Abubakar Mohammed; Owolabi, Shakirah Desola; Isa, Adamu; Alhaji, Ibrahim Daiyyabu; Enwere, Okezie Oguamanam

doi:10.1016/j.yebeh.2019.106846

Cited by 44 publications

(44 citation statements)

References 57 publications

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“…In this large community-based door-to-door survey in Dar-es-Salaam, Tanzania, we found a community lifetime prevalence for any type of epileptic seizure that was comparable to other studies in similar settings [ 7 , 21 , 22 ]. After adjusting for inaccuracy of our screening questionnaire, the lifetime prevalences of epilepsy were within similar range yet mostly higher than previously reported [ 5 , 6 ]. Reason for the higher prevalence in our study is likely the inclusion of questions for focal seizures.…”

Section: Discussionsupporting

confidence: 77%

“…Great variation of prevalences was observed between African sub-regions with the highest rates in Central Africa and lowest rates in Eastern Africa. Furthermore, prevalence of epilepsy was higher in rural African areas (0.98% vs 0.49%) [ 6 ]. The estimate for urban areas, however, is based on only three studies, all from Nigeria [ [7] , [8] , [9] ].…”

Section: Introductionmentioning

confidence: 99%

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Lifetime prevalence of epilepsy in urban Tanzania – A door-to-door random cluster survey

et al. 2021

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Objectives Epileptic seizures and epilepsy in urban settings of low-income and middle-income countries (LMIC) are largely under-researched, but their prevalence is necessary for good healthcare planning. This study aimed to determine the lifetime prevalence of epileptic seizures and epilepsy in urban Dar es Salaam. Methods Nearly 50,000 people in former Kinondoni district, Dar es Salaam, were screened for epileptic seizures using a set of nine questions. Answers to these nine questions were categorized into generalized, focal, and unspecified seizures. Screening positivity rates were adjusted for questionnaire inaccuracy using two scenarios to analyse true epilepsy prevalences. Results Overall, 1085 (2.23%) people fulfilled the criteria for ever having had at least one type of epileptic seizure. Two-hundred-ninety-six (0.60%) people screened positive for generalized seizures, 986 (2.02%) for focal seizures, and 32 (0.07%) for unspecified seizures. Women more commonly screened positive than men (2.61% versus 1.72%, p < 0.001), particularly for focal seizures (p < 0.001). Adjusting for different degrees of accuracy of the screening questionnaire yielded true lifetime prevalences for epilepsy of any type between 1.59% and 2.41%. We furthermore observed a considerable variation of screening positivity rates between wards in Kinondoni district ( p < 0.001). Conclusion The prevalence of epilepsy, based on a questionnaire survey in urban Tanzania, was higher than previously observed, probably due to the screening questionnaire, which contained questions specifically designed to identify focal seizures. Further studies on epileptic seizures/epilepsy are needed for urban settings in LMIC, preferably with an integrated follow-up of positive cases.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Lifetime prevalence of epilepsy in urban Tanzania – A door-to-door random cluster survey

et al. 2021

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“…The disease has a huge burden in the developing countries as over 80% of cases occurring in low-and middle-income countries [2] [3]. In Sub-Saharan Africa including Sudan, the prevalence of epilepsy was estimated to be 9 per 1000 persons [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Current Medical Practice in a Group of Sudanese Patients with Epilepsy: A Cross Sectional Hospital Based-Study

Elsayed¹,

Issa²,

Mahmoud³

et al. 2021

CRCM

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Introduction: The epilepsy classification in under developed countries faces many difficulties in reporting, work-up and management strategies. Exploring local practice in general hospitals will positively add to the welfare of patients with epilepsy. The objectives of this study were to assess the current medical practice in epilepsy work up and to study the selection of AEDs as per ILAE guidelines. Methods: This was a cross sectional-retrospective hospital based study, conducted between April and September 2016 in Omdurman Teaching Hospital, Khartoum, Sudan. Patients aged 18 years old and above were enrolled. Epilepsy was defined as having at least two non-provoked seizures in the least 6 months in a patient who was assessed by clinical review and electroencephalogram (EEG). Epilepsy was classified as generalized, focal or unclassified. Medications refer to all internationally licensed antiepileptic medications (AEDs) in 2016. Results: One hundred adult Sudanese patients were enrolled for this study. The most common event described during the ictal phase was tongue biting in 50% of participants followed by body stiffness in 46%. Epilepsy was classified as generalized in 84%, focal in 11% and unclassified in 5% patients. In generalized epilepsy, the MRI detected 23.3% abnormal findings higher than the CT which detected 14.8% (4/27), p value = 0.032. In focal epilepsy, the CT detected 75% abnormal findings higher than the MRI which detected 33.3%, p value = 0.02. The AEDs used were as follows: Carbamazepine (CBZ) 48%, Na valproate (VP) 33%, Lamotrigine

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“…In 2016, it was estimated that 45.9 million PwE worldwide had active epilepsy and 70 million had lifetime epilepsy [ 2 ]. In sub-Saharan Africa (SSA), there is an overall prevalence estimate of active epilepsy and lifetime epilepsy of 9‰ and 16‰, respectively, with modest variation from one subregion to another [ 3 ]. Prevalence is twice as high in rural areas as it is in urban settings [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Mortality of all causes and sudden unexplained death in epilepsy (SUDEP) in a cohort of 235 persons living with epilepsy in Rwanda using WHO Verbal Autopsy Questionnaire

Sebera

Uwacu²,

Nsanzabaganwa³

et al. 2020

Epilepsy & Behavior Reports

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Introduction Mortality in persons living with epilepsy (PwE) is 1.6–9.3-fold higher than in the general population. Mortality from definite/probable Sudden Unexpected Death in EPilepsy (SUDEP) is estimated at 1.2 per 1000 person-years. We report mortality and SUDEP rate in a cohort of Rwandan PwE. Methods PwE presenting for a first visit at the Ndera epilepsy center between January and June 2016 were followed-up prospectively. For PwE who did not attend their follow-up visit, home visits were organized. Deaths were assessed using World Health Organization Verbal Autopsy Standards age-specific questionnaires. Results Of 235 PwE enrolled, home visits were organized for 81 (34.4%) PwE who did not return for their follow-up consultation. Seven fatalities (mortality 16.7/1000 patient-years [CI 6.7–34.3]) were recorded (aged 2–80 years). Four had an identified cause. Three were classified as probable SUDEP, resulting in a probable SUDEP rate of 7.1/1000 patient-years (CI 1.47–20.86). Probable SUDEP occurred in PwE (age: 2, 21, 34 years) showing no symptoms of illness while receiving antiepileptic treatment; in two cases, death occurred during sleep. Conclusion Although autopsies were absent, the high mortality and probable SUDEP rates warrant future studies to establish causes of epilepsy-related deaths in Rwanda and sub-Saharan Africa.

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Prevalence of active epilepsy, lifetime epilepsy prevalence, and burden of epilepsy in Sub-Saharan Africa from meta-analysis of door-to-door population-based surveys

Cited by 44 publications

References 57 publications

Lifetime prevalence of epilepsy in urban Tanzania – A door-to-door random cluster survey

Lifetime prevalence of epilepsy in urban Tanzania – A door-to-door random cluster survey

Clinical Characteristics and Current Medical Practice in a Group of Sudanese Patients with Epilepsy: A Cross Sectional Hospital Based-Study

Mortality of all causes and sudden unexplained death in epilepsy (SUDEP) in a cohort of 235 persons living with epilepsy in Rwanda using WHO Verbal Autopsy Questionnaire

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