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Co-morbidity of epilepsy in Tanzanian children: A community-based case-control study

Lookup NU author(s): Professor Roger Whittaker, Dr Ewan Hunter, Professor Richard Walker

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Abstract

Purpose: To define the prevalence and associations of co-morbidity and school attendance in older children with epilepsy (CWE) from a rural district of Tanzania by conducting a community-based case-control study.Methods: Children aged 6-14 years old with active epilepsy (at least two unprovoked seizures in the last five years) were identified in a cross-sectional survey in Tanzania. Co-morbidities were assessed and cases were compared with age-matched controls.Results: Co-morbidity was very common amongst cases (95/112, 85%), with 62/112 (55%) having multiple co-morbidities. Co-morbidities consisted of cognitive impairment (72/112, 64%), behaviour disorder 68/112(61%), motor difficulties 29/112(26%), burns and other previous injuries (29/112,26%). These complications were significantly more common in cases than in controls (odds ratio 14.8, 95%CI 7.6-28.6, p<0.001). Co-morbidity in CWE was associated with structural cause, abnormal electroencephalogram and early onset seizures. Cognitive impairment was very common in CWE (64%) and was not associated with Phenobarbital use but was associated with motor difficulties, early onset and recurrent seizures. Poor school attendance was found in 56/112(50%) of CWE, but not in the controls: it was associated with the presence of multiple co-morbidities, especially with motor difficulties in CWE.Conclusion: Children with epilepsy in a rural area of sub-Saharan Africa had a high level of co-morbidity. Cognitive impairment and poor school attendance were very common. These associated difficulties in CWE in the region need to be addressed to reduce the negative impact of epilepsy on these children. Crown Copyright (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.


Publication metadata

Author(s): Burton K, Rogathe J, Whittaker RG, Mankad K, Hunter E, Burton MJ, Todd J, Neville BGR, Walker R, Newton CRJC

Publication type: Article

Publication status: Published

Journal: Seizure: European Journal fo Epliepsy

Year: 2012

Volume: 21

Issue: 3

Pages: 169-174

Print publication date: 01/04/2012

Online publication date: 29/11/2011

Acceptance date: 31/10/2011

ISSN (print): 1059-1311

ISSN (electronic): 1532-2688

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.seizure.2011.10.011

DOI: 10.1016/j.seizure.2011.10.011


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Funding

Funder referenceFunder name
BMA Charities
Kilimanjaro Christian Medical Centre
Helen H Lawson Grant
Northumbria Healthcare NHS Foundation Trust
083744Wellcome Trust

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