Journal article
Prevalence and factors associated with convulsive status epilepticus in Africans with epilepsy
- Abstract:
-
Objective:
We conducted a community survey to estimate the prevalence and describe the features, risk factors, and consequences of convulsive status epilepticus (CSE) among people with active convulsive epilepsy (ACE) identified in a multisite survey in Africa.
Methods:We obtained clinical histories of CSE and neurologic examination data among 1,196 people with ACE identified from a population of 379,166 people in 3 sites: Agincourt, South Africa; Iganga-Mayuge, Uganda; and Kilifi, Kenya. We performed serologic assessment for the presence of antibodies to parasitic infections and HIV and determined adherence to antiepileptic drugs. Consequences of CSE were assessed using a questionnaire. Logistic regression was used to identify risk factors.
Results:The adjusted prevalence of CSE in ACE among the general population across the 3 sites was 2.3 per 1,000, and differed with site (p < 0.0001). Over half (55%) of CSE occurred in febrile illnesses and focal seizures were present in 61%. Risk factors for CSE in ACE were neurologic impairments, acute encephalopathy, previous hospitalization, and presence of antibody titers to falciparum malaria and HIV; these differed across sites. Burns (15%), lack of education (49%), being single (77%), and unemployment (78%) were common in CSE; these differed across the 3 sites. Nine percent with and 10% without CSE died.
Conclusions:CSE is common in people with ACE in Africa; most occurs with febrile illnesses, is untreated, and has focal features suggesting preventable risk factors. Effective prevention and the management of infections and neurologic impairments may reduce the burden of CSE in ACE.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 309.0KB, Terms of use)
-
- Publisher copy:
- 10.1212/wnl.0000000000001542
Authors
- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 092654/Z/10/A
- 083744/B/07/C
- 099782/Z/12/Z
- Funder identifier:
- https://ror.org/03x94j517
- Grant:
- MR/K012126/1
- Publisher:
- Lippincott, Williams and Wilkins
- Journal:
- Neurology More from this journal
- Volume:
- 84
- Issue:
- 18
- Pages:
- 1838-1845
- Place of publication:
- United States
- Publication date:
- 2015-04-03
- Acceptance date:
- 2015-01-09
- DOI:
- EISSN:
-
1526-632X
- ISSN:
-
0028-3878
- Pmid:
-
25841025
- Language:
-
English
- Pubs id:
-
517114
- Local pid:
-
pubs:517114
- Deposit date:
-
2024-11-23
- ARK identifier:
Terms of use
- Copyright holder:
- American Academy of Neurology
- Copyright date:
- 2015
- Rights statement:
- © 2015 American Academy of Neurology. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
If you are the owner of this record, you can report an update to it here: Report update to this record