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 Feb;7(2):145-50.
doi: 10.1016/S1474-4422(07)70331-9.

Incidence and outcome of convulsive status epilepticus in Kenyan children: a cohort study

Manish Sadarangani  1 , Claire Seaton, J Anthony G Scott, Bernhards Ogutu, Tansy Edwards, Agnes Prins, Hellen Gatakaa, Richard Idro, James A Berkley, Norbert Peshu, Brian G Neville, Charles R Newton
Affiliations

Incidence and outcome of convulsive status epilepticus in Kenyan children: a cohort study

Manish Sadarangani et al. Lancet Neurol. 2008 Feb.

Abstract

Background: Convulsive status epilepticus (CSE) is the most common neurological emergency in childhood and is often associated with fever. In sub-Saharan Africa, the high incidence of febrile illnesses might influence the incidence and outcome of CSE. We aimed to provide data on the incidence, causes, and outcomes of childhood CSE in this region.

Methods: Between March, 2006, and June, 2006, we studied all children who had been admitted with CSE to a Kenyan rural district hospital in 2002 and 2003. Confirmed CSE had been observed directly; probable CSE was inferred from convulsions on arrival, requirement for phenobarbital or phenytoin, or coma with a recent history of seizures. We estimated the incidence with linked demographic surveillance, and risk factors for death and neurological sequelae were analysed by multivariable analysis.

Findings: Of 388 episodes of CSE, 155 (40%) were confirmed CSE and 274 (71%) were caused by an infection. The incidence of confirmed CSE was 35 (95% CI 27-46) per 100,000 children per year overall, and was 52 (21-107) and 85 (62-114) per 100,000 per year in children aged 1-11 months and 12-59 months, respectively. The incidence of all CSE was 268 (188-371) and 227 (189-272) per 100,000 per year in these age-groups. 59 (15%) children died in hospital, 81 (21%) died during long-term follow-up, and 46 (12%) developed neurological sequelae. Mortality of children with confirmed CSE while in hospital was associated with bacterial meningitis (adjusted relative risk [RR]=2.6; 95% CI 1.4-4.9) and focal onset seizures (adjusted RR=2.4; 1.1-5.4), whereas neurological sequelae were associated with hypoglycaemia (adjusted RR=3.5; 1.8-7.1) and age less than 12 months (adjusted RR=2.5; 1.2-5.1).

Interpretation: Prevention of infections and appropriate early management of seizures might reduce the incidence and improve the outcome of CSE in children in sub-Saharan Africa.

PubMed Disclaimer

Figures

Figure
Figure
Study design and profile *All 388 CSE cases were used for descriptive analysis. The 178 cases linked to the DSS database were used for incidence analysis, and the 155 confirmed CSE cases were used for risk factor analysis.
See this image and copyright information in PMC

References

    1. Leppik IE. Status epilepticus. Clin Ther. 1985;7:272–278. - PubMed
    1. DeLorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. J Clin Neurophysiol. 1995;12:316–325. - PubMed
    1. Chin RF, Neville BG, Peckham C, Bedford H, Wade A, Scott RC. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006;368:222–229. - PubMed
    1. Chin RF, Neville BG, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11:800–810. - PubMed
    1. Berkley JA, Mwangi I, Ngetsa CJ. Diagnosis of acute bacterial meningitis in children at a district hospital in sub-Saharan Africa. Lancet. 2001;357:1753–1757. - PubMed

Publication types

MeSH terms