Mavabyi ya ku wa: the prevalence of and risk factors for epilepsy in a rural South African surveillance site
Date
2011-10-10
Authors
Wagner, Ryan Gregory
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Abstract
Epilepsy, a chronic, often treatable condition, is one of the most common neurological
conditions globally, with the prevalence of epilepsy significantly higher in developing
regions of the world. In 2008, a household survey was undertaken within the
Agincourt Health and Demographic Surveillance System (AHDSS) in rural,
northeastern South Africa to identify the prevalence of and risk factors for active
convulsive epilepsy. A single question was administered as part of the annual census
to each household head. This single question sought to identify people with
convulsions, while a random sample of 4,500 individuals was drawn from the
Agincourt HDSS population as a way to validate the Stage One screening tool.
During initial piloting of the Stage One screening question, the question was found to
be adequately sensitive and significant (98.3% and 93.1%, respectively). A more
specific questionnaire was administered in Stage Two, while a clinical exam and
history was performed in Stage Three to conclusively diagnose epilepsy. The
adjusted prevalence of active convulsive epilepsy in the three-stage study was 3.26
per 1,000, while the adjusted prevalence in the population sample was 7.72 per 1,000
individuals highlighting a significant difference due to possible methodological or
cultural issues. Furthermore, a heterogeneous, random distribution of active
convulsive epilepsy was found across the site, with the identification of possible
familial clustering in a number of households. By utilizing univariate and
multivariate analysis, this study found sex and a family history of seizures to be
significant risk factors for developing epilepsy in rural South Africa. Abnormal
deliveries and problems after delivery were found to be significant in the bivariate
analysis, but not the multivariate analysis. These findings highlight the need for
additional research exploring epilepsy in rural South Africa.
Description
M.Sc. (Med.), Faculty of Health Sciences, University of the Witwatersrand, 2011
Keywords
epilepsy, Agincourt, South Africa, convulsive epilepsy