Incidence of Epilepsy in Rural Central Ethiopia

• Published in: Epilepsia (Copenhagen) 1997-05, Vol.38 (5), p.541-546
• Main Authors: Tekle‐Haimanot, Redda, Forsgren, Lars, Ekstedt, Jan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Africa; Age Distribution; Aged; Anticonvulsants - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Delivery of Health Care - standards; Developing Countries - statistics & numerical data; Electroencephalography; Epidemiology; Epilepsy; Epilepsy - diagnosis; Epilepsy - drug therapy; Epilepsy - epidemiology; Ethiopia - epidemiology; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Incidence; Infant; Infant, Newborn; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Prevalence; Random Allocation; Rural Population - statistics & numerical data; Sampling Studies; Seizures; Sex Distribution
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1157.1997.tb01138.x

Purpose: To study the incidence of epilepsy in a rural area of Ethiopia. Methods: A community‐based study was performed in a random sample of villages with 61,686 inhabitants in a rural area of central Ethiopia. In a door‐to‐door survey, all inhabitants in the study area were interviewed about seizures. A standardized protocol was used. All new cases with epilepsy that had occurred since a previous study was made 3.5 years earlier were included. Fifty‐three of the subjects were investigated with EEG. Results: One‐hundred thirty‐nine incident cases were identified, corresponding to an annual incidence of 64 in 100,000 inhabitants [95% confidence interval (CI) 44–84]. The corresponding rate for males was 72 (CI 42–102); for females, it was 57 (CI 31–84). The highest age‐specific incidence occurred in the youngest age groups (0–9 years); the next highest was in the group aged 10–19 years. Generalized convulsive seizures occurred in 69%, partial seizures occurred in 20%, and unclassifiable seizures occurred in 11%. Seizures occurred daily in 10% and weekly in another 14%; 33% had monthly seizures. Twenty‐two percent had a family history of epilepsy. A history of head trauma was ascertained in 5.7% and was the most common possible etiologic factor identified. Thirteen percent were treated with antiepileptic drugs (AEDs). Conclusions: The incidence of epilepsy in Ethiopia is high. A high incidence in combination with a prevalence of epilepsy in the study area comparable to that in the rest of the world may be explained by a high degree of spontaneous remission of epilepsy and/or a high mortality due to epilepsy. Despite health education on epilepsy given to the community, a minority of subjects were treated with AEDs, which may reflect the inadequacies of the health services and transportation difficulties faced by the patients.