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Incidence, causes and phenotypes of acute seizures in Kenyan children post the malaria-decline period

Abstract:

Background: Acute seizures are a common cause of paediatric admissions to hospitals in Africa, and malaria is an important cause of seizures in endemic areas. Malaria has declined in the past decade whilst neonatal admissions have increased, both which may affect the incidence and phenotypes of acute seizures in African children.

Methods: We examined the effect of recent decline in malaria and the increasing burden of neonatal admissions on the incidence, causes and phenotypes of acute seizures admitted to hospital from 2009–2013. We used logistic regression to measure associations and Poisson regression to calculate the incidence and rate ratios.

Results: The overall incidence of acute seizures over the 5-year period was 312 per 100,000/year (95 % CI, 295–329): 116 per 100,000/year (95 % CI, 106–127) for complex seizures and 443 per 100,000 live births (95 % CI, 383–512) for neonatal seizures. Over the period, there was an increase in incidence of seizures-attributable to malaria (SAM) (incidence rate ratio (IRR) = 1.25; p < 0.001), but neither non-SAM (IRR = 1.03; p = 0.569) nor neonatal seizures (IRR = 0.99; p = 0.905). Important causes of acute seizures were malaria (33 %) and respiratory tract infections (19 %); and for neonatal seizures were neonatal sepsis (51 %), hypoglycemia (41 %) and hypoxic-ischemic encephalopathy (21 %). Mortality occurred in 6 % of all acute seizures, being more common in complex seizures (8 %) and neonatal seizures (10 %) than other seizures (p < 0.001 for both comparisons).

Conclusions: Acute seizures remain common in children despite a decline in the incidence of malaria; suggesting that causes for these seizures need to be prevented in the community.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1186/s12883-015-0444-8

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Oxford college:
St John's College
Role:
Author
ORCID:
0000-0002-6999-5507
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
ORCID:
0000-0002-3934-5132


More from this funder
Funder identifier:
https://ror.org/029chgv08
Grant:
092654/Z/10/A
083744/B/07/C
099782/Z/12/Z


Publisher:
BioMed Central
Journal:
BMC Neurology More from this journal
Volume:
15
Issue:
1
Article number:
180
Publication date:
2015-10-06
Acceptance date:
2015-09-29
DOI:
EISSN:
1471-2377
Pmid:
26444670


Language:
English
Keywords:
Pubs id:
575278
Local pid:
pubs:575278
Deposit date:
2024-11-23

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