High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
| Autor: | Sylvestre Mutungirehe, Peter Dedeken, Frank Van Steenkiste, Dirk E. Teuwen, Ieme Garrez, Fidele Sebera, Josiane Umwiringirwa, Paul Boon |
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| Rok vydání: | 2021 |
| Předmět: |
AFRICA
Adult Male prevalence door-to-door CHILDREN Neurosciences. Biological psychiatry. Neuropsychiatry Newly diagnosed REFERRAL CENTER Behavioral Neuroscience Epilepsy Young Adult Sex Factors Female preponderance door‐to‐door Medicine and Health Sciences EPIDEMIOLOGY Medicine Humans ACTIVE CONVULSIVE EPILEPSY Aged High prevalence business.industry OPERATIONAL CLASSIFICATION Rwanda gender gap Original Articles medicine.disease First seizure Cross-Sectional Studies TREATMENT GAP HEALTH-CARE Etiology epilepsy Female Original Article Gender gap Rural area business RURAL AREA RC321-571 Demography |
| Zdroj: | Brain and Behavior Brain and Behavior, Vol 11, Iss 11, Pp n/a-n/a (2021) BRAIN AND BEHAVIOR |
| ISSN: | 2162-3279 |
| Popis: | Introduction In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ reported in 2005 in Rwanda. We report a confirmatory prevalence study focused on gender‐specific observations. Methods A cross‐sectional door‐to‐door approach was used in three rural villages. First, epilepsy screening using the Kinyarwanda version of the Limoges questionnaire was performed. Second, confirmation of epilepsy diagnosis was completed by trained physicians. Results In total, 2681 persons (56.14% female) were screened. Of 168 positively screened, 128 persons were diagnosed with epilepsy confirming the prevalence of lifetime epilepsy of 47.7‰ (CI 39.8–56.8). The diagnosis gap was 62.5% with 80 newly diagnosed. The overall female:male ratio was 1.61:1.00. A male preponderance below 9 years of age inverted to a female preponderance above 20 years of age. Female PwE had an older age at first seizure, reported different reasons for not seeking care, and differed from male PwE in possible etiology. For previously diagnosed PwE, the treatment gap was more than 77%. Conclusion A high prevalence in rural areas was confirmed, with an observed female/male ratio among the highest of published door‐to‐door surveys in SSA. Gender differences in associated co‐morbidities and age at first seizure warrant future research of underlying etiologies and possible survival bias. A better understanding and focus on gender‐associated care‐seeking patterns, education, and specific needs are recommended. We confirmed the high prevalence of epilepsy in Rwanda and observed gender differences. Of 2681 screened persons, 168 were positively screened and 128 were diagnosed with epilepsy resulting in an epilepsy prevalence of 47.7‰. Female patients with epilepsy had an older age at first seizure and reported different reasons for not seeking care. This results in a need for further epilepsy etiology research and informs on gender‐specific needs for public health programs. |
| Databáze: | OpenAIRE |
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