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Epilepsy in Tanzanian children: Association with perinatal events and other risk factors
Author(s) -
Burton Kathryn J.,
Rogathe Jane,
Whittaker Roger,
Mankad Kshitij,
Hunter Ewan,
Burton Matthew J.,
Todd Jim,
Neville Brian G. R.,
Walker Richard,
Newton Charles R. J. C.
Publication year - 2012
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2011.03395.x
Subject(s) - epilepsy , odds ratio , medicine , pediatrics , confidence interval , electroencephalography , tanzania , family history , cross sectional study , case control study , psychiatry , pathology , environmental science , environmental planning
Summary 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.