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
. 2022 Aug 26;22(1):321.
doi: 10.1186/s12883-022-02813-z.

Characteristics of people with epilepsy in three Eastern African countries - a pooled analysis

Dominik Stelzle  1 , Joyce Kaducu  2 , Veronika Schmidt  1   3 , Tamara M Welte  1   4 , Bernard J Ngowi  5   6 , William Matuja  7 , Gabrielle Escheu  8 , Peter Hauke  8 , Vivien Richter  9 , Emilio Ovuga  10 , Bettina Pfausler  11 , Erich Schmutzhard  11 , Action Amos  12 , Wendy Harrison  13 , Luise Keller  14 , Andrea S Winkler  15   16
Affiliations

Characteristics of people with epilepsy in three Eastern African countries - a pooled analysis

Dominik Stelzle et al. BMC Neurol. .

Erratum in

Abstract

Background: Epilepsy is one of the most common neurological disorders worldwide. Yet, its treatment gap is large in some areas and especially in sub-Saharan Africa data on clinical, radiological and semiological characteristics, as well as on treatment of persons with epilepsy (PWE) are still scarce.

Methods: We pooled data from four cross-sectional studies on epilepsy in eastern Africa. Two studies from Malawi and Uganda were community-based; two studies in Tanzania (urban Dar es Salaam and rural Haydom) were hospital-based. Clinical characteristics of PWE were assessed by the same questionnaire. Additionally, data on treatment were collected and computed tomography (CT) scans were performed.

Results: Overall, 1179 PWE were included in our analysis (581 (49.3%) female, median age 22 years (IQR 15-32 years)). Up to 25% of the patients had focal onset seizures. Those showed a higher rate of remarkable CT scan findings, with especially post-ischaemic and neurocysticercosis-associated lesions, compared to PWE with generalized onset seizures (35.1% vs. 20%). The majority of the patients experienced tonic-clonic seizures (70-85%). Only 67-78% of PWE received anti-seizure medication (ASM) treatment in the community-based studies, mostly monotherapy with phenobarbital, phenytoin or carbamazepine. Yet, underdosage was frequent and a large proportion of PWE received alternative non-ASM treatment consisting of herbal treatment (up to 83%) and/or scarification (up to 20%).

Conclusions: Epilepsy is common in sub-Saharan Africa, often caused by neurocysticercosis or ischaemic strokes. PWE suffer from high seizure rates and subsequent injuries, as well as from socio-economic consequences due to insufficient ASM treatment. This pooled analysis illustrates the need for structural programmes for adequate identification, education, assessment and treatment of PWE in sub-Saharan Africa.

Keywords: Epilepsy; Global health; Sub-Saharan Africa; Treatment gap.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the patient selection by site
See this image and copyright information in PMC

References

    1. Global, regional, and national burden of epilepsy, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 357–75. 10.1016/s1474-4422(18)30454-x. - PMC - PubMed
    1. Institute for Health Metrics and Evaluation (IHME) University of Washington. Global Burden of Disease Results Tool. https://vizhub.healthdata.org/gbd-results/. Accessed 5 Feb 2020.
    1. Winkler AS, Blocher J, Auer H, Gotwald T, Matuja W, Schmutzhard E. Epilepsy and neurocysticercosis in rural Tanzania-An imaging study. Epilepsia. 2009;50:987–993. doi: 10.1111/j.1528-1167.2008.01867.x. - DOI - PubMed
    1. Kellinghaus C, Engbring C, Kovac S, et al. Frequency of seizures and epilepsy in neurological HIV-infected patients. Seizure. 2008;17:27–33. doi: 10.1016/j.seizure.2007.05.017. - DOI - PubMed
    1. Annegers JF, Hauser WA, Beghi E, Nicolosi A, Kurland LT. The risk of unprovoked seizures after encephalitis and meningitis. Neurology. 1988;38:1407–1410. doi: 10.1212/wnl.38.9.1407. - DOI - PubMed