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Epidemiology of epilepsy in rural Benin: prevalence, incidence, mortality, and follow-up.

Abstract：

PURPOSE:Epilepsy is a major clinical and social issue in Africa. This study was conducted to estimate the prevalence, incidence, mortality, and therapeutic outcome in rural Djidja in Benin. METHODS:This was a two-phase study with a cross-sectional phase and 18 months of follow-up. In the first phase, information was obtained using door-to-door surveys, reports from key informants, and medical sources. People were interviewed using a validated screening questionnaire for epilepsy in tropical regions. The diagnosis of epilepsy was confirmed by a neurologist. We used a capture-recapture method to estimate the number of people with epilepsy (PWE). PWE were followed every month for 18 months after the cross-sectional survey. We asked the health services, the general population, and village leaders in the study area to identify suspected cases of epilepsy occurring during the follow-up. New cases were updated every month after confirmation. Antiepileptic drugs were prescribed to PWE. KEY FINDINGS:We surveyed 11,668 subjects (male-to-female ratio 0.9) and identified 123 PWE, yielding a prevalence of 10.5 per 1,000 (95% confidence interval (CI) 8.8-12.6/1,000). Combining the three sources, we found 148 PWE and a prevalence of 12.7 per 1,000 (95% CI 10.7-14.9/1,000). After application of the capture-recapture method, the prevalence was estimated to be as high as 38.4 per 1,000 (95% CI 34.9-41.9/1,000). The cumulative incidence was 104.2 per 100,000 and the mean annual incidence was 69.4 per 100,000. The mean annual mortality was 20.8 per 1,000. After treatment, 45% of PWE had total seizure remission and 35% had a decrease in the number of seizures. SIGNIFICANCE:This study shows that door-to-door survey findings could be improved by using information from other sources. The follow-up suggests that epilepsy could be controlled. Continuous drug delivery and regular follow-up are key.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Houinato D,Yemadje LP,Glitho G,Adjien C,Avode G,Druet-Cabanac M,Preux PM

doi

10.1111/epi.12082

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

757-63

issue

eissn

0013-9580

issn

1528-1167

journal_volume

pub_type

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Epidemiology of epilepsy in rural Benin: prevalence, incidence, mortality, and follow-up.