Burden of epilepsy in rural K enya measured in disability‐adjusted life years

Summary Objectives The burden of epilepsy, in terms of both morbidity and mortality, is likely to vary depending on the etiology (primary [genetic/unknown] vs. secondary [structural/metabolic]) and with the use of antiepileptic drugs ( AED s). We estimated the disability‐adjusted life years ( DALY s) and modeled the remission rates of active convulsive epilepsy ( ACE ) using epidemiologic data collected over the last decade in rural K ilifi, K enya. Methods We used measures of prevalence, incidence, and mortality to model the remission of epilepsy using disease‐modeling software ( D is M od II ). DALY s were calculated as the sum of Years Lost to Disability ( YLD ) and Years of Life Lost ( YLL ) due to premature death using the prevalence approach, with disability weights ( DW s) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals ( UI s) computed by bootstrapping. Results A total of 1,005 (95% UI 797–1,213) DALY s were lost to ACE , which is 433 (95% UI 393–469) DALY s lost per 100,000 people. Twenty‐six percent (113/100,000/year, 95% UI 106–117) of the DALY s were due to YLD and 74% (320/100,000/year, 95% UI 248–416) to YLL . Primary epilepsy accounted for fewer DALY s than secondary epilepsy (98 vs. 334 DALY s per 100,000 people). Those taking AED s contributed fewer DALY s than those not taking AED s (167 vs. 266 DALY s per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0–5 year age group. Significance The DALY s for ACE are high in rural K enya, but less than the estimates of 2010 GBD study. Three‐fourths of DALY s resulted from secondary epilepsy. Use of AED s was associated with 40% reduction of DALY s. Improving adherence to AED s may reduce the burden of epilepsy in this area.