Adverse Perinatal Events, Treatment Gap, and Positive Family History Linked to the High Burden of Active Convulsive Epilepsy in Uganda: A Population-Based Study

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dc.contributor.authorMwesige, Angelina Kakooza
dc.contributor.authorNdyomugyenyi, Donald
dc.contributor.authorPariyo, George
dc.contributor.authorPeterson, Stefan Swartling
dc.contributor.authorWaiswa, Paul Michael
dc.contributor.authorGaliwango, Edward
dc.contributor.authorChengo, Eddie
dc.contributor.authorOdhiambo, Rachael
dc.contributor.authorSsewanyana, Derrick
dc.contributor.authorBottomley, Christian
dc.contributor.authorNgugi, Anthony K.
dc.contributor.authorNewton, Charles R. J. C.
dc.date.accessioned2022-03-01T05:07:52Z
dc.date.available2022-03-01T05:07:52Z
dc.date.issued2017
dc.description.abstractTo determine the prevalence of active convulsive epilepsy (ACE) and describe the clinical characteristics and associated factors among a rural Ugandan population.The entire population in Iganga/Mayuge Health Demographic Surveillance Site (IM-HDSS) was screened using two questions about seizures during a door-to-door census exercise. Those who screened positive were assessed by a clinician to confirm diagnosis of epilepsy. A case control study with the patients diagnosed with ACE as the cases and age/sex-matched controls in a ratio of 1:1 was conducted.A total of 64,172 (92.8%) IM-HDSS residents, with a median age of 15.0 years (interquartile range [IQR]: 8.0–29.0), were screened for epilepsy. There were 152 confirmed ACE cases, with a prevalence of 10.3/1,000 (95% confidence interval [CI]: 9.5–11.1) adjusted for nonresponse and screening sensitivity. Prevalence declined with age, with the highest prevalence in the 0–5 years age group. In an analysis of n = 241 that included cases not identified in the survey, nearly 70% were unaware of their diagnosis. Seizures were mostly of focal onset in 193 (80%), with poor electroencephalogram (EEG) agreement with seizure semiology. Antiepileptic drug use was rare, noted in 21.2% (95% CI: 16.5–25.8), and 119 (49.3%) reported using traditional medicines. History of an abnormal antenatal period (adjusted odds ratio [aOR] 10.28; 95%CI 1.26–83.45; p = 0.029) and difficulties in feeding, crying, breathing in the perinatal period (aOR 10.07; 95%CI 1.24–81.97; p = 0.031) were associated with ACE in children. In adults a family history of epilepsy (aOR 4.38 95%CI 1.77–10.81; p = 0.001) was the only factor associated with ACE.There is a considerable burden of epilepsy, low awareness, and a large treatment gap in this population of rural sub-Saharan Africa. The identification of adverse perinatal events as a risk factor for developing epilepsy in children suggests that epilepsy burden may be decreased by improving obstetric and postnatal care.en_US
dc.identifier.citationKakooza‐Mwesige, A., Ndyomugyenyi, D., Pariyo, G., Peterson, S. S., Waiswa, P. M., Galiwango, E., ... & Noh, J. (2017). Adverse perinatal events, treatment gap, and positive family history linked to the high burden of active convulsive epilepsy in Uganda: a population‐based study. Epilepsia Open, 2(2), 188-198.https://doi.org/10.1002/epi4.12048en_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2350
dc.language.isoenen_US
dc.publisherEpilepsia Openen_US
dc.subjectAdverse perinatal events, Population study of epilepsy, Risk factors, Treatment gap, Uganda.en_US
dc.titleAdverse Perinatal Events, Treatment Gap, and Positive Family History Linked to the High Burden of Active Convulsive Epilepsy in Uganda: A Population-Based Studyen_US
dc.typeArticleen_US
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