Family Medicine Commons^™

Incidence, Remission And Mortality Of Convulsive Epilepsy In Rural Northeast South Africa, Ryan G. Wagner, Christian Bottomley, Anthony Ngugi, Fredrick Ibinda, F. Xavier Gómez-Olivé, Kathleen Kahn, Stephen Tollman, Charles R. Newton

Family Medicine, East Africa

Background: Epilepsy is one of the most common neurological conditions globally, estimated to constitute 0.75% of the global burden of disease, with the majority of this burden found in low- and middle- income countries (LMICs). Few studies from LMICs, including much of sub-Saharan Africa, have described the incidence, remission or mortality rates due to epilepsy, which are needed to quantify the burden and inform policy. This study investigates the epidemiological parameters of convulsive epilepsy within a context of high HIV prevalence and an emerging burden of cardiovascular disease.

Methods: A cross-sectional population survey of 82,818 individuals, in the Agincourt Health …

Burden Of Epilepsy In Rural Kenya Measured In Disability-Adjusted Life Years, Fredrick Ibinda, Ryan Wagner, Melanie Bertram, Anthony Ngugi, Evasius Bauni, Theo Vos, Josemir Sander, Charles Newton

Family Medicine, East Africa

Objectives: The burden of epilepsy, in terms of both morbidity and mortality, is likely to vary depending on the etiology (primary [genetic/unknown] vs. secondary [structural/metabolic]) and with the use of antiepileptic drugs (AEDs). We estimated the disability-adjusted life years (DALYs) and modeled the remission rates of active convulsive epilepsy (ACE) using epidemiologic data collected over the last decade in rural Kilifi, Kenya.

Methods: We used measures of prevalence, incidence, and mortality to model the remission of epilepsy using disease-modeling software (DisMod II). DALYs were calculated as the sum of Years Lost to Disability (YLD) and Years of Life Lost (YLL) …

Exposure To Multiple Parasites Is Associated With The Prevalence Of Active Convulsive Epilepsy In Sub-Saharan Africa, Gathoni Kamuyu, Christian Bottomley, James Mageto, Brett Lowe, Patricia Wilkins, John C. Noh, Thomas B. Nutman, Anthony Ngugi, Rachael Odhiambo, Ryan Wagner, Angelina Kakooza-Mwesige, Seth Owusu-Agyei, Kenneth Ae-Ngibise, Honorati Masanja, Faith Osier, Peter Odermatt, Charles Newton

Family Medicine, East Africa

Background: Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa.

Methods and Findings: A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52-2.58, p

Conclusion: This study investigates how …

Premature Mortality In Active Convulsive Epilepsy In Rural Kenya: Causes And Associated Factors, Anthony Ngugi, Christian Bottomley, Gregory Fegan, Eddie Chengo, Rachael Odhiambo, Evasius Bauni, Brian Neville, Immo Kleinschmidt, Josemir W. Sander, Charles R. Newton

Family Medicine, East Africa

Objective: We estimated premature mortality and identified causes of death and associated factors in people with active convulsive epilepsy (ACE) in rural Kenya.

Methods: In this prospective population-based study, people with ACE were identified in a crosssectional survey and followed up regularly for 3 years, during which information on deaths and associated factors was collected. We used a validated verbal autopsy tool to establish putative causes of death. Age-specific rate ratios and standardized mortality ratios were estimated. Poisson regression was used to identify mortality risk factors.

Results: There were 61 deaths among 754 people with ACE, yielding a rate of …