Determining the disability adjusted life years lost to childhood and adolescence epilepsy in southeast Nigeria: An exploratory study

• Published in: Epilepsy research 2016-09, Vol.125, p.37-41
• Main Authors: Ughasoro, Maduka D, Onwujekwe, Obinna E, Ojinnaka, Ngozi C
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Burden of disease; Child; Child, Preschool; Childhood epilepsy; Cost of Illness; Disability adjusted life years; Disability Evaluation; Epilepsy - classification; Epilepsy - epidemiology; Epilepsy - psychology; Epilepsy - therapy; Female; Humans; Infant; Male; Neurology; Nigeria - epidemiology; Prevalence; Quality-Adjusted Life Years; Surveys and Questionnaires; Young Adult
• ISSN: 0920-1211; 1872-6844
• DOI: 10.1016/j.eplepsyres.2016.05.006

Abstract Objectives Disease burden has always been based on associated mortality. An accurate measurement of the burden of epilepsy should rely on both morbidity and mortality. This will close any existing gap in knowledge and provide useful information to aid evidence-based decision-making. In this study, burden of epilepsy was estimated, using disability-adjusted-life-years (DALYs), using disability weights for epilepsy that were part of the Global Burden of Disease 2010 work. Methods The study was conducted at the University of Nigeria Teaching Hospital, Enugu. Interviewer-administered questionnaire was used to collect information from patients with epilepsy who presented to neurology clinic. The prevalence of epilepsy, and case-fatality were obtained from previous publications. The DALYs were estimated by adding together the years lost to disability (YLDs) and years lost to life (YLLs) to epilepsy (DALYs = YLD + YLL). DALYs were dis-aggregated by age group and by whether or not epilepsy was treated. Results A total of 134 children with epilepsy-interviews were conducted. Some 56% and 44% of the subjects had primary and secondary epilepsy, respectively. The childhood epilepsy caused 1.63 YLLs per 1,000 population, 0.45 YLDs per 1,000 population and 2.08 DALY per 1,000 population. The highest burden was in children within the age group of 5–14 years at 2.18 DALY per 1,000 people. The YLDs was higher (0.63/1,000 population) among the untreated group, compared with the YLDs (0.27/1,000 population) among the treated group. The YLLs lost for children with secondary epilepsy (2.23/1,000 population) was higher than primary epilepsy YLLs of 1.07/1,000 population. Significance The DALYs due to childhood epilepsy was high. The YLDs was high among children with epilepsy who were not on treatment. The YLLs were found to be the same in all children with epilepsy, irrespective of their treatment status. This imperatively necessitates the de-emphasis on just mortality as an indicator of the burden of childhood epilepsy but rather a holistic approach should be adopted in considering both the mortality and disability in monitoring the outcome of health interventions.