Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya

Mung’ala‐Odera, V.; White, Steven M.; Meehan, R.; Otieno, G.; Njuguna, Patricia; Mturi, Neema; Edwards, Tansy; Neville, Brian; Newton, Charles R.

doi:10.1016/j.seizure.2007.11.028

Cited by 99 publications

(103 citation statements)

References 23 publications

(30 reference statements)

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“…22 Only 11% of these children were on antiepileptic drugs (phenobarbital, phenytoin, and carbamazepine). 22 In children from the same region, convulsive status epilepticus was typically related to central nervous system infections, especially malaria, 23 and was 8 times the incidence compared with in London. This ratio was considered an underestimation as many patients would have died before reaching health care facilities.…”

Section: Discussionmentioning

confidence: 99%

Child Neurology Services in Africa

et al. 2011

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The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Europe PMC Funders Group Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts challenges in children across the continent. The presentations highlighted key common themes, namely, the need to promote education, training, and research. Building on these areas will have a ripple effect of improving child health care, improving facilities, and retaining skilled specialists in Africa.The following text collates the data delivered at this meeting, specifically from Ghana, Nigeria, Malawi, and Uganda, and provides a broader summary of the overall services across the continent. Summary of Services Across Africa, Focusing on EpilepsyA survey of 23 countries across Africa (Algeria, Cameroun, Cote d'Ivoire, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, Kenya, Malawi, Mali, Mauritius, Mozambique, Namibia, Nigeria, Rwanda, Sénégal, South Africa, Sudan, Togo, Tanzania, Uganda, Zambia, Zimbabwe; Figure 1) focused broadly on child neurology capacity and needs (2008)(2009)(2010)(2011). Questionnaires were sent to key pediatric physicians known to be practicing in the country to provide information on the services.

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Section: Discussionmentioning

confidence: 99%

Child Neurology Services in Africa

et al. 2011

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“…Perinatal complications are common in Africa, where two thirds of women requiring emergency obstetric care are unable to receive it [10]. Obstructed labor is associated with an increased risk of hypoxic–ischemic encephalopathy and resultant seizure disorder in the infant [11]. Despite extensive knowledge of the increased prevalence of seizure disorders in LMICs, less than 40% of patients with seizure disorder in LMICs receive a specific diagnosis and adequate treatment due to limited availability of diagnostic testing and medication [12].…”

Section: Introductionmentioning

confidence: 99%

The Role of Seizure Disorders in Burn Injury and Outcome in Sub-Saharan Africa

Boschini

Tyson

Samuel

et al. 2014

Journal of Burn Care & Research

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OBJECTIVE Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. We compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. METHODS We conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. RESULTS Prevalence of seizure disorder was 10.7% in our population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. While mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days versus 21.6 days. CONCLUSION Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in sub Saharan Africa and must be included in an overall burn prevention strategy in our environment.

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“…Untreated adverse perinatal complications are associated with a increased risk of suffering a period of hypoxic–ischaemic encephalopathy and subsequently developing epilepsy [22,23]. …”

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confidence: 99%

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

et al. 2012

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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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Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya

Abstract: There is a considerable burden of epilepsy in older children living in this area of rural Kenya, with a family history of seizures and a history of febrile seizures identified as risk factors for developing epilepsy.

Cited by 99 publications

References 23 publications

Child Neurology Services in Africa

Child Neurology Services in Africa

The Role of Seizure Disorders in Burn Injury and Outcome in Sub-Saharan Africa

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

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