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Burden of epilepsy in rural Kenya measured in disability-adjusted life years
OBJECTIVES: [Image: see text] 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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BlackWell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238788/ https://www.ncbi.nlm.nih.gov/pubmed/25131901 http://dx.doi.org/10.1111/epi.12741 |
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author | Ibinda, Fredrick Wagner, Ryan G Bertram, Melanie Y Ngugi, Anthony K Bauni, Evasius Vos, Theo Sander, Josemir W Newton, Charles R |
author_facet | Ibinda, Fredrick Wagner, Ryan G Bertram, Melanie Y Ngugi, Anthony K Bauni, Evasius Vos, Theo Sander, Josemir W Newton, Charles R |
author_sort | Ibinda, Fredrick |
collection | PubMed |
description | OBJECTIVES: [Image: see text] 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) due to premature death using the prevalence approach, with disability weights (DWs) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals (UIs) computed by bootstrapping. RESULTS: A total of 1,005 (95% UI 797–1,213) DALYs were lost to ACE, which is 433 (95% UI 393–469) DALYs lost per 100,000 people. Twenty-six percent (113/100,000/year, 95% UI 106–117) of the DALYs were due to YLD and 74% (320/100,000/year, 95% UI 248–416) to YLL. Primary epilepsy accounted for fewer DALYs than secondary epilepsy (98 vs. 334 DALYs per 100,000 people). Those taking AEDs contributed fewer DALYs than those not taking AEDs (167 vs. 266 DALYs per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0–5 year age group. SIGNIFICANCE: The DALYs for ACE are high in rural Kenya, but less than the estimates of 2010 GBD study. Three-fourths of DALYs resulted from secondary epilepsy. Use of AEDs was associated with 40% reduction of DALYs. Improving adherence to AEDs may reduce the burden of epilepsy in this area. |
format | Online Article Text |
id | pubmed-4238788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BlackWell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-42387882014-11-28 Burden of epilepsy in rural Kenya measured in disability-adjusted life years Ibinda, Fredrick Wagner, Ryan G Bertram, Melanie Y Ngugi, Anthony K Bauni, Evasius Vos, Theo Sander, Josemir W Newton, Charles R Epilepsia Full-Length Original Research OBJECTIVES: [Image: see text] 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) due to premature death using the prevalence approach, with disability weights (DWs) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals (UIs) computed by bootstrapping. RESULTS: A total of 1,005 (95% UI 797–1,213) DALYs were lost to ACE, which is 433 (95% UI 393–469) DALYs lost per 100,000 people. Twenty-six percent (113/100,000/year, 95% UI 106–117) of the DALYs were due to YLD and 74% (320/100,000/year, 95% UI 248–416) to YLL. Primary epilepsy accounted for fewer DALYs than secondary epilepsy (98 vs. 334 DALYs per 100,000 people). Those taking AEDs contributed fewer DALYs than those not taking AEDs (167 vs. 266 DALYs per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0–5 year age group. SIGNIFICANCE: The DALYs for ACE are high in rural Kenya, but less than the estimates of 2010 GBD study. Three-fourths of DALYs resulted from secondary epilepsy. Use of AEDs was associated with 40% reduction of DALYs. Improving adherence to AEDs may reduce the burden of epilepsy in this area. BlackWell Publishing Ltd 2014-10 2014-07-31 /pmc/articles/PMC4238788/ /pubmed/25131901 http://dx.doi.org/10.1111/epi.12741 Text en © 2014 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy. http://creativecommons.org/licenses/by/3.0/ This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Full-Length Original Research Ibinda, Fredrick Wagner, Ryan G Bertram, Melanie Y Ngugi, Anthony K Bauni, Evasius Vos, Theo Sander, Josemir W Newton, Charles R Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title | Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title_full | Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title_fullStr | Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title_full_unstemmed | Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title_short | Burden of epilepsy in rural Kenya measured in disability-adjusted life years |
title_sort | burden of epilepsy in rural kenya measured in disability-adjusted life years |
topic | Full-Length Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238788/ https://www.ncbi.nlm.nih.gov/pubmed/25131901 http://dx.doi.org/10.1111/epi.12741 |
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