An estimate of the prevalence of epilepsy in Sub–Saharan Africa: A systematic analysis

Abstract

BackgroundEpilepsy is a leading serious neurological condition worldwide and has particularly significant physical, economic and social consequences in Sub–Saharan Africa. This paper aims to contribute to the understanding of epilepsy prevalence in this region and how this varies by age and sex so as to inform understanding of the disease characteristics as well as the development of infrastructure, services and policies.MethodsA parallel systematic analysis of Medline, Embase and Global Health returned 32 studies that satisfied pre–defined quality criteria. Relevant data was extracted, tabulated and analyzed. We modelled the available information and used the UN population figures for Africa to determine the age–specific and overall burden of epilepsy.ResultsActive epilepsy was estimated to affect 4.4 million people in Sub–Saharan Africa, whilst lifetime epilepsy was estimated to affect 5.4 million. The prevalence of active epilepsy peaks in the 20–29 age group at 11.5/1000 and again in the 40–49 age group at 8.2/1000. The lowest prevalence value of 3.1/1000 is seen in the 60+ age group. This binomial pattern is also seen in both men and women, with the second peak more pronounced in women at 14.6/1000.ConclusionThe high prevalence of epilepsy, especially in young adults, has important consequences for both the workforce and community structures. An estimation of disease burden would be a beneficial outcome of further research, as would research into appropriate methods of improving health care for and tackling discrimination against people with epilepsy.

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“…1 The prevalence of active convulsive epilepsy in subSaharan Africa (SSA) is high and ranges from 2.2 to 58 per 1000 affecting an estimated 4.4 million people. 2 Preux and DruetCabanac 3 estimated that the median prevalence of epilepsy in SSA to be 15/1000 ranging between 0/1000 and 33.5/1000. The prevalence of epilepsy in SE Nigeria is 4.3 per 1000.…”

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“…A systematic analysis study on the prevalence of epilepsy in sub-Saharan Africa showed that active epilepsy was estimated to affect 4.4 million people, while lifetime epilepsy was estimated to affect 5.4 million 5. Another meta-analysis showed that the median incidence of epilepsy was 50.4/100,000/year (33.6–75.6), while it was 45.0 (30.3–66.7) for high-income countries and 81.7 (28.0–239.5) for low- and middle-income countries 6.…”

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“…In contrast, the lifetime prevalence of epilepsy in the developed world is 5.8 per 1000 [6]. In sub-Saharan Africa, an estimated 4.4 million people have active epilepsy, defined as one or more seizures over the past five years [7]. …”