Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jan;7(1):50-6.
doi: 10.1016/S1474-4422(07)70292-2.

Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors

Tansy Edwards  1 , Anthony G Scott, Gilbert Munyoki, Victor Mung'ala Odera, Edward Chengo, Evasius Bauni, Thomas Kwasa, Ley W Sander, Brian G Neville, Charles R Newton
Affiliations

Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors

Tansy Edwards et al. Lancet Neurol. 2008 Jan.

Abstract

Background: Few large-scale studies of epilepsy have been done in sub-Saharan Africa. We aimed to estimate the prevalence of, treatment gap in, and possible risk factors for active convulsive epilepsy in Kenyan people aged 6 years or older living in a rural area.

Methods: We undertook a three-phase screening survey of 151,408 individuals followed by a nested community case-control study. Treatment gap was defined as the proportion of cases of active convulsive epilepsy without detectable amounts of antiepileptic drugs in blood.

Findings: Overall prevalence of active convulsive epilepsy was 2.9 per 1000 (95% CI 2.6-3.2); after adjustment for non-response and sensitivity, prevalence was 4.5 per 1000 (4.1-4.9). Substantial heterogeneity was noted in prevalence, with evidence of clustering. Treatment gap was 70.3% (65.9-74.5), with weak evidence of a difference by sex and area. Adjusted odds of active convulsive epilepsy for all individuals were increased with a family history of non-febrile convulsions (odds ratio 3.3, 95% CI 2.4-4.7; p<0.0001), family history of febrile convulsions (14.6, 6.3-34.1; p<0.0001), history of both seizure types (7.3, 3.3-16.4; p<0.0001), and previous head injury (4.1, 2.1-8.1; p<0.0001). Findings of multivariable analyses in children showed that adverse perinatal events (5.7, 2.6-12.7; p<0.0001) and the child's mother being a widow (5.1, 2.4-11.0; p<0.0001) raised the odds of active convulsive epilepsy.

Interpretation: Substantial heterogeneity exists in prevalence of active convulsive epilepsy in this rural area in Kenya. Assessment of prevalence, treatment use, and demographic variation in screening response helped to identify groups for targeted interventions. Adverse perinatal events, febrile illness, and head injury are potentially preventable associated factors for epilepsy in this region.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Screening Survey Flow
* Individuals aged 6 years and over resident during the previous census round † ACE = Active Convulsive Epilepsy defined as 2 or more unprovoked seizures with the most recent within last 12 months ‡ History of epileptic seizures. ¶ AED = Anti-epileptic drugs. Confirmed by testing of blood sample
Figure 2
Figure 2. Prevalence (per 1000) of Active Convulsive Epilepsy by enumeration zone and boundaries of administrative divisions within the study area in Kilifi District, adjusted for age and sex
See this image and copyright information in PMC

Comment in

References

    1. WHO . The World Health Report: 2001: Mental health: new understanding, new hope. 2001.
    1. Preux PM, Druet-Cabanac M. Epidemiology and aetiology of epilepsy in sub-Saharan Africa. Lancet Neurol. 2005;4(1):21–31. - PubMed
    1. Sander JW. The epidemiology of epilepsy revisited. Curr.Opin.Neurol. 2003;16(2):165–70. - PubMed
    1. Ndoye NF, Sow AD, Diop AG, Sessouma B, Séne-Diouf F, Boissy L, Wone I, Touré K, Ndiaye M, Ndiaye P, de Boer H, Engel J, Mandlhate C, Meinardi H, Prilipko L, Sander JWAS. Prevalence of epilepsy its treatment gap and knowledge, attitude and practice of its population in sub-urban Senegal an ILAE/IBE/WHO study. Seizure. 2005;14:106–111. - PubMed
    1. Central Bureau of Statistics . Vol. 64. Kenya Government; Nairobi: 2000.

Publication types