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. 2012 Dec;2(2):020405.
doi: 10.7189/jogh.02.020405.

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

Abigail Paul  1 , Davies Adeloye, Rhiannon George-Carey, Ivana Kolčić, Liz Grant, Kit Yee Chan
Affiliations

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

Abigail Paul et al. J Glob Health. 2012 Dec.

Abstract

Background: Epilepsy 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.

Methods: A 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.

Results: Active 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.

Conclusion: The 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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Figures

Figure 1
Figure 1
Search strategy.
Figure 2
Figure 2
Map showing the prevalence of epilepsy by country in Sub–Saharan Africa (adapted from http://www.worldatlas.com/webimage/countrys/africa/afoutl.htm).
Figure 3
Figure 3
The distribution of studies according to the year of publication.
Figure 4
Figure 4
Prevalence of active epilepsy by age: the size of the bubble is determined by the size of the sample for which the prevalence was calculated in original data, while the solid red data points represent the weighted mean of the prevalence for each 10–year age group, along with the error bars representing the 95% confidence intervals.
Figure 5
Figure 5
Prevalence of lifetime epilepsy by age: the size of the bubble is determined by the size of the sample for which the prevalence was calculated in original data, while the solid orange data points represent the weighted mean of the prevalence for each 10–year age group, along with the error bars representing the 95% confidence intervals.
Figure 6
Figure 6
Weighted mean of the prevalence of active epilepsy per age group for men and women.
Figure 7
Figure 7
Weighted mean of the prevalence of lifetime epilepsy by sex and age group.
See this image and copyright information in PMC

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