TY - JOUR
T1 - Epidemiology of Epilepsy in Nigeria
T2 - A Community-Based Study From 3 Sites
AU - Watila, Musa M.
AU - Balarabe, Salisu A.
AU - Komolafe, Morenikeji A.
AU - Igwe, Stanley C.
AU - Fawale, Michael B.
AU - Otte, Willem M.
AU - Van Diessen, Eric
AU - Okunoye, Olaitan
AU - Mshelia, Anthony A.
AU - Abdullahi, Ibrahim
AU - Musa, Joseph
AU - Hedima, Erick W.
AU - Nyandaiti, Yakub W.
AU - Singh, Gagandeep
AU - Winkler, Andrea S.
AU - Sander, Josemir W.
N1 - Funding Information:
This work was carried out at the UCLH/UCL Comprehensive Biomedical Research Centre, which receives a proportion of funding from the UK Department of Health's National Institute for Health Research Biomedical Research Centre's funding scheme. J.W. Sander receives research support from the Marvin Weil Epilepsy Research Fund, the UK Epilepsy Society, and the Christelijke Vereniging voor de Verpleging van Lijdersaan Epilepsie, the Netherlands. The authors are grateful to Mark Keezer for his useful advice throughout the study. They acknowledge all the research assistants and health workers who were involved in the field work. M.M. Watila was a Commonwealth Scholar, funded by the UK government.
Funding Information:
Funding from the Commonwealth Scholarship Commission and the Epilepsy Society.
Publisher Copyright:
© American Academy of Neurology.
PY - 2021/8/17
Y1 - 2021/8/17
N2 - BackgroundWe determined the prevalence, incidence, and risk factors for epilepsy in Nigeria.MethodsWe conducted a door-to-door survey to identify cases of epilepsy in 3 regions. We estimated age-standardized prevalence adjusted for nonresponse and sensitivity and the 1-year retrospective incidence for active epilepsy. To assess potential risk factors, we conducted a case-control study by collecting sociodemographic and risk factor data. We estimated odds ratios using logistic regression analysis and corresponding population attributable fractions (PAFs).ResultsWe screened 42,427 persons (age ≥6 years), of whom 254 had confirmed active epilepsy. The pooled prevalence of active epilepsy per 1,000 was 9.8 (95% confidence interval [CI] 8.6-11.1), 17.7 (14.2-20.6) in Gwandu, 4.8 (3.4-6.6) in Afikpo, and 3.3 (2.0-5.1) in Ijebu-Jesa. The pooled incidence per 100,000 was 101.3 (95% CI 57.9-167.6), 201.2 (105.0-358.9) in Gwandu, 27.6 (3.3-128.0) in Afikpo, and 23.9 (3.2-157.0) in Ijebu-Jesa. Children's significant risk factors included febrile seizures, meningitis, poor perinatal care, open defecation, measles, and family history in first-degree relatives. In adults, head injury, poor perinatal care, febrile seizures, family history in second-degree relatives, and consanguinity were significant. Gwandu had more significant risk factors. The PAF for the important factors in children was 74.0% (71.0%-76.0%) and in adults was 79.0% (75.0%-81.0%).ConclusionThis work suggests varied epidemiologic numbers, which may be explained by differences in risk factors and population structure in the different regions. These variations should differentially determine and drive prevention and health care responses.
AB - BackgroundWe determined the prevalence, incidence, and risk factors for epilepsy in Nigeria.MethodsWe conducted a door-to-door survey to identify cases of epilepsy in 3 regions. We estimated age-standardized prevalence adjusted for nonresponse and sensitivity and the 1-year retrospective incidence for active epilepsy. To assess potential risk factors, we conducted a case-control study by collecting sociodemographic and risk factor data. We estimated odds ratios using logistic regression analysis and corresponding population attributable fractions (PAFs).ResultsWe screened 42,427 persons (age ≥6 years), of whom 254 had confirmed active epilepsy. The pooled prevalence of active epilepsy per 1,000 was 9.8 (95% confidence interval [CI] 8.6-11.1), 17.7 (14.2-20.6) in Gwandu, 4.8 (3.4-6.6) in Afikpo, and 3.3 (2.0-5.1) in Ijebu-Jesa. The pooled incidence per 100,000 was 101.3 (95% CI 57.9-167.6), 201.2 (105.0-358.9) in Gwandu, 27.6 (3.3-128.0) in Afikpo, and 23.9 (3.2-157.0) in Ijebu-Jesa. Children's significant risk factors included febrile seizures, meningitis, poor perinatal care, open defecation, measles, and family history in first-degree relatives. In adults, head injury, poor perinatal care, febrile seizures, family history in second-degree relatives, and consanguinity were significant. Gwandu had more significant risk factors. The PAF for the important factors in children was 74.0% (71.0%-76.0%) and in adults was 79.0% (75.0%-81.0%).ConclusionThis work suggests varied epidemiologic numbers, which may be explained by differences in risk factors and population structure in the different regions. These variations should differentially determine and drive prevention and health care responses.
UR - http://www.scopus.com/inward/record.url?scp=85114521822&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000012416
DO - 10.1212/WNL.0000000000012416
M3 - Article
C2 - 34253632
AN - SCOPUS:85114521822
SN - 0028-3878
VL - 97
SP - E728-E738
JO - Neurology
JF - Neurology
IS - 7
ER -