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High prevalence of epilepsy in Northern Rwanda: Exploring gender differences

INTRODUCTION: In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ re...

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Autores principales: Dedeken, Peter, Sebera, Fidele, Mutungirehe, Sylvestre, Garrez, Ieme, Umwiringirwa, Josiane, Van Steenkiste, Frank, Boon, Paul A. J. M., Teuwen, Dirk E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613444/
https://www.ncbi.nlm.nih.gov/pubmed/34661989
http://dx.doi.org/10.1002/brb3.2377
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author Dedeken, Peter
Sebera, Fidele
Mutungirehe, Sylvestre
Garrez, Ieme
Umwiringirwa, Josiane
Van Steenkiste, Frank
Boon, Paul A. J. M.
Teuwen, Dirk E.
author_facet Dedeken, Peter
Sebera, Fidele
Mutungirehe, Sylvestre
Garrez, Ieme
Umwiringirwa, Josiane
Van Steenkiste, Frank
Boon, Paul A. J. M.
Teuwen, Dirk E.
author_sort Dedeken, Peter
collection PubMed
description INTRODUCTION: In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ reported in 2005 in Rwanda. We report a confirmatory prevalence study focused on gender‐specific observations. METHODS: A cross‐sectional door‐to‐door approach was used in three rural villages. First, epilepsy screening using the Kinyarwanda version of the Limoges questionnaire was performed. Second, confirmation of epilepsy diagnosis was completed by trained physicians. RESULTS: In total, 2681 persons (56.14% female) were screened. Of 168 positively screened, 128 persons were diagnosed with epilepsy confirming the prevalence of lifetime epilepsy of 47.7‰ (CI 39.8–56.8). The diagnosis gap was 62.5% with 80 newly diagnosed. The overall female:male ratio was 1.61:1.00. A male preponderance below 9 years of age inverted to a female preponderance above 20 years of age. Female PwE had an older age at first seizure, reported different reasons for not seeking care, and differed from male PwE in possible etiology. For previously diagnosed PwE, the treatment gap was more than 77%. CONCLUSION: A high prevalence in rural areas was confirmed, with an observed female/male ratio among the highest of published door‐to‐door surveys in SSA. Gender differences in associated co‐morbidities and age at first seizure warrant future research of underlying etiologies and possible survival bias. A better understanding and focus on gender‐associated care‐seeking patterns, education, and specific needs are recommended.
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spelling pubmed-86134442021-11-30 High prevalence of epilepsy in Northern Rwanda: Exploring gender differences Dedeken, Peter Sebera, Fidele Mutungirehe, Sylvestre Garrez, Ieme Umwiringirwa, Josiane Van Steenkiste, Frank Boon, Paul A. J. M. Teuwen, Dirk E. Brain Behav Original Articles INTRODUCTION: In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ reported in 2005 in Rwanda. We report a confirmatory prevalence study focused on gender‐specific observations. METHODS: A cross‐sectional door‐to‐door approach was used in three rural villages. First, epilepsy screening using the Kinyarwanda version of the Limoges questionnaire was performed. Second, confirmation of epilepsy diagnosis was completed by trained physicians. RESULTS: In total, 2681 persons (56.14% female) were screened. Of 168 positively screened, 128 persons were diagnosed with epilepsy confirming the prevalence of lifetime epilepsy of 47.7‰ (CI 39.8–56.8). The diagnosis gap was 62.5% with 80 newly diagnosed. The overall female:male ratio was 1.61:1.00. A male preponderance below 9 years of age inverted to a female preponderance above 20 years of age. Female PwE had an older age at first seizure, reported different reasons for not seeking care, and differed from male PwE in possible etiology. For previously diagnosed PwE, the treatment gap was more than 77%. CONCLUSION: A high prevalence in rural areas was confirmed, with an observed female/male ratio among the highest of published door‐to‐door surveys in SSA. Gender differences in associated co‐morbidities and age at first seizure warrant future research of underlying etiologies and possible survival bias. A better understanding and focus on gender‐associated care‐seeking patterns, education, and specific needs are recommended. John Wiley and Sons Inc. 2021-10-17 /pmc/articles/PMC8613444/ /pubmed/34661989 http://dx.doi.org/10.1002/brb3.2377 Text en © 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Dedeken, Peter
Sebera, Fidele
Mutungirehe, Sylvestre
Garrez, Ieme
Umwiringirwa, Josiane
Van Steenkiste, Frank
Boon, Paul A. J. M.
Teuwen, Dirk E.
High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_full High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_fullStr High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_full_unstemmed High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_short High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_sort high prevalence of epilepsy in northern rwanda: exploring gender differences
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613444/
https://www.ncbi.nlm.nih.gov/pubmed/34661989
http://dx.doi.org/10.1002/brb3.2377
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