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. 2012 Apr;53(4):752-60.
doi: 10.1111/j.1528-1167.2011.03395.x. Epub 2012 Feb 6.

Epilepsy in Tanzanian children: association with perinatal events and other risk factors

Kathryn J Burton  1 , Jane Rogathe, Roger Whittaker, Kshitij Mankad, Ewan Hunter, Matthew J Burton, Jim Todd, Brian G R Neville, Richard Walker, Charles R J C Newton
Affiliations
Free PMC article

Epilepsy in Tanzanian children: association with perinatal events and other risk factors

Kathryn J Burton et al. Epilepsia. 2012 Apr.
Free PMC article

Abstract

Purpose: To define the prevalence and risk factors for epilepsy in children in a rural district of Tanzania by conducting a community-based case-control study.

Methods: Children aged 6-14 years with active epilepsy (at least two unprovoked seizures in the last 5 years) were identified in a cross-sectional survey in Tanzania. Cases were compared with age-matched controls.

Key findings: Overall 112 children with epilepsy (CWE) were identified; the unadjusted prevalence of epilepsy was 2.91 per 1,000 (95% confidence interval [95% CI] 2.4-3.5). The main seizure types were focal motor with secondary generalization in 73 (65.2%) of 112 and generalized convulsive seizures in 19 (16.9%) of 112. Adverse perinatal events were present in 16 (14%) of 112 cases but in no controls. In multivariate analysis, epilepsy was associated with number of parents who were resident at home (odds ratio [OR] 6.2 for none vs. both resident, 95% CI 1.5-25.5), history of adverse perinatal events (OR 14.9, 95% CI 1.4-151.3), family history of afebrile seizures (OR 5.7, 95% CI 1.0-27.5), and poor scholastic attainment (OR 8.6, 95% CI 4.0-18.4). Electroencephalography (EEG) and computed tomography (CT) scans were abnormal in 44 (44%) of 101 and 26 (29%) of 90 cases, respectively. Overall, 98 (88%) of 112 cases had focal features on assessment.

Significance: In this study from sub-Saharan Africa, CWE predominantly had focal features that support the suggestion that most epilepsy in this region has a symptomatic etiology. Adverse perinatal events were strongly associated with epilepsy. Genetic and social factors may also be important. Epilepsy may be preventable in a significant proportion of children with better antenatal and perinatal care.

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Figures

Figure 1
Figure 1
Flow chart of case ascertainment and recruitment.
Figure 2
Figure 2
Diagram of focal features on clinical history and examination compared to focal abnormalities on EEG and CT scan.
See this image and copyright information in PMC

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