Prevalence, risk factors and behavioural and emotional comorbidity of acute seizures in young Kenyan children: a population-based study

Kariuki, Symon M.; Abubakar, Amina; Kombe, Martha; Kazungu, Michael; Stein, Alan; Newton, Charles R.

doi:10.1186/s12916-018-1021-y

Cited by 12 publications

(14 citation statements)

References 33 publications

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“…Infections were common. Studies from Kilifi identified falciparum malaria as the primary diagnosis in up to 65.4% children with acute symptomatic seizures,5,6,15–21 while respiratory tract infections were the primary diagnosis in up to 27.8%5,6,22 and any infection identified in 80% of children with acute symptomatic seizures 5,6,15. Five percent of children admitted to hospital with acute symptomatic seizures hadepilepsy,14 a significant association (HR 1.53, 95% CI 1.10–2.14).…”

Section: Resultsmentioning

confidence: 99%

“…In a retrospective review of 6,639 pediatric EEGs performed for suspected epilepsy and reviewed at Kenyatta National Tertiary Referral Hospital, 3 Hz spike-wave activity, a feature of childhood absence epilepsy, was seen in 7.4% (163 of 2,216) of abnormal EEGs and hypsarrhythmia, seen with infantile spasms, in 2.8% (62 of 2,216) of abnormal EEGs 23. One Kilifi study6 assessed children presenting with acute seizures and found complex (focal, prolonged, or recurrent) seizures in 84%, generalized seizures in 85%, and EEG abnormalities in 27%. Another reported convulsive status epilepticus in 35.4% children with acute seizures 13…”

Section: Resultsmentioning

confidence: 99%

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<p>Epilepsy diagnosis and management of children in Kenya: review of current literature</p>

Samia¹,

Hassell²,

Hudson³

et al. 2019

RRTM

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Introduction: The growing impact of non-communicable diseases in low- to middle-income countries makes epilepsy a key research priority. We evaluated peer-reviewed published literature on childhood epilepsy specific to Kenya to identify knowledge gaps and inform future priorities. Methodology: A literature search utilizing the terms “epilepsy” OR “seizure” as exploded subject headings AND “Kenya” was conducted. Relevant databases were searched, generating 908 articles. After initial screening to remove duplications, irrelevant articles, and publications older than 15 years, 154 papers remained for full-article review, which identified 35 publications containing relevant information. Data were extracted from these reports on epidemiology, etiology, clinical features, management, and outcomes. Results: The estimated prevalence of lifetime epilepsy in children was 21–41 per 1,000, while the incidence of active convulsive epilepsy was 39–187 cases per 100,000 children per year. The incidence of acute seizures was 312–879 per 100,000 children per year and neonatal seizures 3,950 per 100,000 live births per year. Common risk factors for both epilepsy and acute seizures included adverse perinatal events, meningitis, malaria, febrile seizures, and family history of epilepsy. Electroencephalography abnormalities were documented in 20%–41% and neurocognitive comorbidities in more than half. Mortality in children admitted with acute seizures was 3%–6%, and neurological sequelae were identified in 31% following convulsive status epilepticus. Only 7%–29% children with epilepsy were on antiseizure medication. Conclusion: Active convulsive epilepsy is a common condition among Kenyan children, remains largely untreated, and leads to extremely poor outcomes. The high proportion of epilepsy attributable to preventable causes, in particular neonatal morbidity, contributes significantly to the lifetime burden of the condition. This review reaffirms the ongoing need for better public awareness of epilepsy as a treatable disease and for national-level action that targets both prevention and management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

<p>Epilepsy diagnosis and management of children in Kenya: review of current literature</p>

Samia¹,

Hassell²,

Hudson³

et al. 2019

RRTM

View full text Add to dashboard Cite

show abstract

“…The 2001 Neurological Impairment Survey was conducted when malaria transmission was high 13,14 and the reduced prevalence of epilepsy may be attributed to a decline in seizures attributable to malaria and meningitis, which subsequently increased the risk for epilepsy 15,16 . The decline in the prevalence of epilepsy may also be attributed to sensitizations and prompt management of acute seizures, which reduced the risk of subsequent unprovoked seizures 28 …”

Section: Discussionmentioning

confidence: 99%

Neurological impairment and disability in children in rural Kenya

Abuga

Kariuki

Abubakar

et al. 2021

Develop Med Child Neuro

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Aim To investigate geographical change over time in the burden of neurological impairments in school‐aged children in a demographic surveillance area. Method We investigated changes in neurological impairment prevalence in five domains (epilepsy and cognitive, hearing, vision, and motor impairments) using similar two‐phase surveys conducted in 2001 (n=10 218) and 2015 (n=11 223) and determined changes in location‐level prevalence, geographical clustering, and significant risk factors for children aged 6 to 9 years (mean 7y 6mo, SD 1y) of whom 50.4% were males. Admission trends for preterm birth, low birthweight (LBW), and encephalopathy were determined using admission data to a local hospital. Results Overall prevalence for any neurological impairment decreased from 61 per 1000 (95% confidence interval [CI] 48.0–74.0) in 2001 to 44.7 per 1000 (95% CI 40.9–48.6) in 2015 (p<0.001). There was little evidence of geographical variation in the prevalence of neurological impairments in either survey. The association between neurological impairments and some risk factors changed significantly with year of survey; for example, the increased association of adverse perinatal events with hearing impairments (exponentiated coefficient for the interaction=5.94, p=0.03). Annual admission rates with preterm birth (rate ratio 1.08, range 1.07–1.09), LBW (rate ratio 1.08, range 1.06–1.10), and encephalopathy (rate ratio 1.08, range 1.06–1.09) significantly increased between 2005 and 2016 (p<0.001). Interpretation There was a significant decline in the prevalence of neurological impairments and differential changes in the associations of some risk factors with neurological impairments over the study period. Limited geographical variation suggests that similar interventions are appropriate across the defined area.

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“…The high proportion of non-convulsive seizures may indicate childhood absence epilepsy or temporal lobe epilepsy are common in this area [30]. Temporal lobe epilepsy syndromes may be a consequence of acute seizures, malaria-associated seizures or status epilepticus, which are common in this area [31].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and mortality of epilepsies with convulsive and non-convulsive seizures in Kilifi, Kenya

Kariuki

Ngugi

Kombe

et al. 2021

Seizure

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The prevalence of all epilepsies (both convulsive and non-convulsive seizures) in Low-and Middle-Income Countries (LMIC), particularly sub-Saharan Africa is unknown. Under estimation of non-convulsive epilepsies in data from these countries may lead to inadequate and sub-optimal allocation of resources to control and prevent epilepsy. We determined the prevalence of all types of epilepsies and compared the mortality between convulsive seizures and non-convulsive seizures in a resource limited rural area in Kenya. Methods: Trained clinicians identified cases of epilepsy in a randomly selected sample of 4,441 residents in the Kilifi Health and Demographic Surveillance System site using a cross-sectional survey design. Seizure types were classified by epileptologists using the current guidelines of the International League Against Epilepsy (ILAE). We estimated prevalence for epilepsy with convulsive seizures and non-convulsive seizures and for epilepsy with non-convulsive seizures only and compared premature mortality between these groups of seizures. Results: Of the 4441 people visited, 141 had lifetime epilepsy and 96 active epilepsy, which is a crude prevalence of 31.7/1,000 persons (95% CI: 26.6-36.9) and 21.6/1,000 (95% CI: 17.3-25.9), respectively. Both convulsive and non-convulsive seizures occurred in 7% people with epilepsy (PWE), only convulsive seizures in 52% and only non-convulsive seizures in 35% PWE; there was insufficient information to classify epilepsy in the remainder 6%. The age-and sex-adjusted prevalence of lifetime people was 23.5/1,000 (95% CI: 11.0-36.0), with the adjusted prevalence of epilepsy with non-convulsive seizures only estimated at 8.2/1,000 (95%CI:3.9-12.6). The mortality rate in PWE was 6.3/1,000 (95%CI: 3.4-11.8), compared to 2.8/1,000 (2.3-3.3) in those without epilepsy; hazard ratio (HR) =2. 31 (1.22-4.39; p=0.011). The annual mortality rate was 11.2/1,000 (95%CI: 5.3-23.4) in PWE with convulsive and non-convulsive seizures and none died in PWE with non-convulsive seizures alone. Conclusions: Our study shows that epilepsy with non-convulsive seizures is common and adds to the prevalence of previously reported estimates of active convulsive epilepsy. Both epilepsy with convulsive seizures and that with non-convulsive seizures should be identified for optimising treatment and for planning resource allocation.

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Prevalence, risk factors and behavioural and emotional comorbidity of acute seizures in young Kenyan children: a population-based study

Cited by 12 publications

References 33 publications

<p>Epilepsy diagnosis and management of children in Kenya: review of current literature</p>

<p>Epilepsy diagnosis and management of children in Kenya: review of current literature</p>

Neurological impairment and disability in children in rural Kenya

Prevalence and mortality of epilepsies with convulsive and non-convulsive seizures in Kilifi, Kenya

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