Prevalence of active epilepsy in rural Tanzania: A large community-based survey in an adult population
| Autor: | Ahmed Jusabani, Roger G. Whittaker, Jane Rogathi, Richard Walker, Simukai Chigudu, Margaret Jackson, Ahmed Iqbal, Richard J. Q. McNally, William K. Gray, Eric Aris, D Birchall, Ewan Hunter |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Rural Population Pediatrics medicine.medical_specialty Adolescent Epidemiology Population Psychological intervention Clinical Neurology Pilot Projects Tanzania Epilepsy Young Adult medicine Prevalence Humans Young adult education Aged Aged 80 and over education.field_of_study Standard Population Sub-Saharan Africa Treatment gap biology Seizure types business.industry Data Collection General Medicine Middle Aged Classification biology.organism_classification medicine.disease Neurology Population Surveillance Female Neurology (clinical) business |
| Zdroj: | Seizure. 21(9):691-698 |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2012.07.009 |
| Popis: | Purpose To estimate the prevalence of active epilepsy in adults in an established demographic surveillance site in rural Tanzania. To describe the clinical characteristics of epilepsy and to estimate the treatment gap in this population. Methods A pilot study established that a previously validated screening questionnaire was sensitive for detecting cases of epilepsy in a Kiswahili-speaking Tanzanian population. A door-to-door census of the adult population (total 103,026) used the screening questionnaire to identify possible cases of epilepsy, who were then assessed by a research doctor to establish a diagnosis of epilepsy or otherwise. The prevalence of active epilepsy in this population was estimated with age-standardisation to the WHO standard population. Seizure types and epilepsies were classified according to current recommendations of the International League Against Epilepsy. The treatment gap for epilepsy was estimated based on antiepileptic drug use as reported by cases. Results Two hundred and ninety-one cases of active epilepsy, all with convulsive seizures, were identified. The age-standardised prevalence was 2.91/1000 adults (95% CI 2.58–3.24); the crude prevalence adjusted for non-response was 3.84/1000 adults (95% CI 3.45–4.20). Focal-onset seizures accounted for 71.5% of all cases identified. The treatment gap was 68.4% (95% CI 63.0–73.7). Conclusions This is one of the largest community-based studies of the prevalence of epilepsy in adults conducted in sub-Saharan Africa to date. We identified a lower prevalence than has previously been described in this region. The high proportion of focal onset seizures points to a large burden of acquired, and possibly preventable, epilepsy in this population. A treatment gap of 68.4% confirms that interventions to raise awareness of the treatable nature of epilepsy are warranted in this and similar populations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect