Epilepsy in rural Ugandan children: seizure pattern, age of onset and associated findings

M.B Duggan

Abstract

Introduction: Much information on childhood epilepsy in sub Saharan Africa is hospital based. A survey was considered necessary before integrating epilepsy management into a Ugandan community programme.

Method: Using an ‘outreach’ method, children with recurrent seizures were offered assessment at 19 sites in Rukungiri District. A brief history and neurological and developmental assessment was carried out on each child. A clinical diagnosis of epilepsy, including seizure type, was given to 440 of 618 children <18 years with 178 exclusions.

Results: The age-specific prevalence of epilepsy in children < 15 years was 2.04% ( 95% CI 1.94 % to 2.24 %) based on 395 cases in an <15 years population of 193,126 . Percentage distribution by seizure type was:-generalised tonic-clonic (53%), complex partial seizures CPS (27%), simple partial and miscellaneous seizures (6% each), with some diagnostic overlap between seizure types. Cerebral palsy, evident or evolving, was most strongly associated with CPS. A positive perinatal or infantile history was noted in 12 and 6% respectively, and 50.2% of seizures began in infancy.

Conclusions: The prevalence of epilepsy is similar in Gambian children. The high contribution from early-onset CPS, resembles Kenyan reports of malaria- associated CPS, suggesting a causal association with malaria.

Key words: seizure type, associated findings, age-specific prevalence, possible malaria association