1. Characteristics of people with epilepsy in three Eastern African countries – a pooled analysis.
- Author
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Stelzle, Dominik, Kaducu, Joyce, Schmidt, Veronika, Welte, Tamara M., Ngowi, Bernard J., Matuja, William, Escheu, Gabrielle, Hauke, Peter, Richter, Vivien, Ovuga, Emilio, Pfausler, Bettina, Schmutzhard, Erich, Amos, Action, Harrison, Wendy, Keller, Luise, and Winkler, Andrea S.
- Subjects
EPILEPSY ,PEOPLE with epilepsy ,SEIZURES (Medicine) ,COMPUTED tomography ,ISCHEMIC stroke ,ANTICONVULSANTS - Abstract
Background: Epilepsy is one of the most common neurological disorders worldwide. Yet, its treatment gap is large in some areas and especially in sub-Saharan Africa data on clinical, radiological and semiological characteristics, as well as on treatment of persons with epilepsy (PWE) are still scarce. Methods: We pooled data from four cross-sectional studies on epilepsy in eastern Africa. Two studies from Malawi and Uganda were community-based; two studies in Tanzania (urban Dar es Salaam and rural Haydom) were hospital-based. Clinical characteristics of PWE were assessed by the same questionnaire. Additionally, data on treatment were collected and computed tomography (CT) scans were performed. Results: Overall, 1179 PWE were included in our analysis (581 (49.3%) female, median age 22 years (IQR 15–32 years)). Up to 25% of the patients had focal onset seizures. Those showed a higher rate of remarkable CT scan findings, with especially post-ischaemic and neurocysticercosis-associated lesions, compared to PWE with generalized onset seizures (35.1% vs. 20%). The majority of the patients experienced tonic–clonic seizures (70–85%). Only 67–78% of PWE received anti-seizure medication (ASM) treatment in the community-based studies, mostly monotherapy with phenobarbital, phenytoin or carbamazepine. Yet, underdosage was frequent and a large proportion of PWE received alternative non-ASM treatment consisting of herbal treatment (up to 83%) and/or scarification (up to 20%). Conclusions: Epilepsy is common in sub-Saharan Africa, often caused by neurocysticercosis or ischaemic strokes. PWE suffer from high seizure rates and subsequent injuries, as well as from socio-economic consequences due to insufficient ASM treatment. This pooled analysis illustrates the need for structural programmes for adequate identification, education, assessment and treatment of PWE in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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