TY - JOUR
T1 - Prevalence and risk factors for active convulsive epilepsy in rural northeast South Africa
AU - Wagner, Ryan G.
AU - Ngugi, Anthony K.
AU - Twine, Rhian
AU - Bottomley, Christian
AU - Kamuyu, Gathoni
AU - Gómez-Olivé, F. Xavier
AU - Connor, Myles D.
AU - Collinson, Mark A.
AU - Kahn, Kathleen
AU - Tollman, Stephen
AU - Newton, Charles R.
N1 - Funding Information:
Ryan Wagner acknowledges the Rotary International Foundation and the Ambassadorial Scholar Program that funded his graduate work, which forms part of this publication. This study was funded by the Wellcome Trust, UK through a Senior Clinical Fellowship awarded to Charles Newton ( 083744 ). The Agincourt HDSS is funded by the Wellcome Trust, UK (grants 058893/Z/99/A ; 069683/Z/02/Z ; 085477/Z/08/Z ), with important contributions from the University of the Witwatersrand , the South African Medical Research Council , and the William and Flora Hewlett Foundation, National Institute on Aging (NIA) of the NIH , and Andrew W Mellon Foundation, USA . The authors wish to acknowledge Ms. Rachael Odhiambo for developing and overseeing the study's database, Eddie Chengo for assisting in the clinical examination and diagnosis of people with epilepsy, Ferella Kirkham for his suggestion to investigate snoring as a risk factor and Paul Mee for his assistance in producing the maps for this article. Thanks to the fieldworkers and supervisors of the MRC/Wits Rural Public Health and Health Transitions Research Unit involved in the SEEDS study as well as the Agincourt sub-district population.
PY - 2014/5
Y1 - 2014/5
N2 - Rationale: Epilepsy is among the most common neurological disorders worldwide. However, there are few large, population-based studies of the prevalence and risk factors for epilepsy in southern Africa. Methods: From August 2008 to February 2009, as part of a multi-site study, we undertook a three-stage, population-based study, embedded within the Agincourt health and socio-demographic surveillance system, to estimate the prevalence and identify risk factors of active convulsive epilepsy (ACE) in a rural South African population. Results: The crude prevalence of ACE, after adjusting for non-response and the sensitivity of the screening method, was 7.0/1,000 individuals (95%CI 6.4-7.6) with significant geographic heterogeneity across the study area. Being male (OR = 2.3; 95%CI 1.6-3.2), family history of seizures (OR = 4.0; 95%CI 2.0-8.1), a sibling with seizures (OR = 7.0; 95%CI 1.6-31.7), problems after delivery (OR = 5.9; 95%CI 1.2-24.6), and history of snoring (OR = 6.5; 95%CI 4.5-9.5) were significantly associated with ACE. For children, their mother's exposure to some formal schooling was protective (OR = 0.30; 95%CI 0.11-0.84) after controlling for age and sex. Human immunodeficiency virus was not found to be associated with ACE. Conclusions: ACE is less frequent in this part of rural South Africa than other parts of sub-Saharan Africa. Improving obstetric services could prevent epilepsy. The relationship between snoring and ACE requires further investigation, as does the relative contribution of genetic and environmental factors to examine the increased risk in those with a family history of epilepsy.
AB - Rationale: Epilepsy is among the most common neurological disorders worldwide. However, there are few large, population-based studies of the prevalence and risk factors for epilepsy in southern Africa. Methods: From August 2008 to February 2009, as part of a multi-site study, we undertook a three-stage, population-based study, embedded within the Agincourt health and socio-demographic surveillance system, to estimate the prevalence and identify risk factors of active convulsive epilepsy (ACE) in a rural South African population. Results: The crude prevalence of ACE, after adjusting for non-response and the sensitivity of the screening method, was 7.0/1,000 individuals (95%CI 6.4-7.6) with significant geographic heterogeneity across the study area. Being male (OR = 2.3; 95%CI 1.6-3.2), family history of seizures (OR = 4.0; 95%CI 2.0-8.1), a sibling with seizures (OR = 7.0; 95%CI 1.6-31.7), problems after delivery (OR = 5.9; 95%CI 1.2-24.6), and history of snoring (OR = 6.5; 95%CI 4.5-9.5) were significantly associated with ACE. For children, their mother's exposure to some formal schooling was protective (OR = 0.30; 95%CI 0.11-0.84) after controlling for age and sex. Human immunodeficiency virus was not found to be associated with ACE. Conclusions: ACE is less frequent in this part of rural South Africa than other parts of sub-Saharan Africa. Improving obstetric services could prevent epilepsy. The relationship between snoring and ACE requires further investigation, as does the relative contribution of genetic and environmental factors to examine the increased risk in those with a family history of epilepsy.
KW - Case-control
KW - Epilepsy
KW - Population-based
KW - Prevalence
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=84898046568&partnerID=8YFLogxK
U2 - 10.1016/j.eplepsyres.2014.01.004
DO - 10.1016/j.eplepsyres.2014.01.004
M3 - Article
C2 - 24582322
AN - SCOPUS:84898046568
SN - 0920-1211
VL - 108
SP - 782
EP - 791
JO - Epilepsy Research
JF - Epilepsy Research
IS - 4
ER -
