Christianson A L, Zwane M E, Manga P, Rosen E, Venter A, Kromberg J G
Department of Human Genetics and Developmental Biology, University of Pretoria.
S Afr Med J. 2000 Mar;90(3):262-6.
To determine the prevalence of epilepsy and its associated disabilities in rural South African children aged 2-9 years.
Eight villages in the district of Bushbuckridge, Northern Province, South Africa.
A two-phase design was used. The first phase involved screening children on a house-to-house basis by interviewing mothers or caregivers using an internationally validated questionnaire for detecting childhood disability in developing countries. The second phase consisted of a paediatric/neurodevelopmental assessment of the children who screened positive.
A total of 6,692 children were screened; 722 (10.8%) had a paediatric evaluation and 49 (0.73%) had epilepsy. The lifetime and active prevalences of epilepsy in these children were 7.3/1,000 and 6.7/1,000 respectively. Associated developmental disability was recorded in 35 affected children (71.4%), including 8 (16.3%) in whom this was moderate to severe. More than a half of the children with epilepsy (57.1%) did not receive anticonvulsant medication.
The prevalence of epilepsy in the rural childhood population investigated is higher than that recorded in most similar studies from sub-Saharan Africa, and the poor utilisation of appropriate anticonvulsant treatment is cause for concern. This study highlights the paucity of relevant information on the epidemiology of epilepsy in South Africa and that the system available for its management, especially in rural areas, appears to have functional deficiencies. Appropriate research is needed to identify the problems in service delivery and to enable the planning and implementation of an appropriate primary health care-based system for the diagnosis and management of epilepsy in children.
确定南非北部省份布什巴克里奇地区2至9岁农村儿童癫痫及其相关残疾的患病率。
南非北部省份布什巴克里奇地区的8个村庄。
采用两阶段设计。第一阶段通过使用国际认可的用于在发展中国家检测儿童残疾的问卷对母亲或照料者进行逐户访谈来筛查儿童。第二阶段包括对筛查呈阳性的儿童进行儿科/神经发育评估。
共筛查了6692名儿童；722名（10.8%）接受了儿科评估，49名（0.73%）患有癫痫。这些儿童癫痫的终生患病率和现患率分别为7.3/1000和6.7/1000。35名患病儿童（71.4%）有相关发育残疾记录，其中8名（16.3%）为中度至重度。超过一半的癫痫儿童（57.1%）未接受抗惊厥药物治疗。
在所调查的农村儿童人群中，癫痫患病率高于撒哈拉以南非洲大多数类似研究记录的水平，抗惊厥药物治疗的低利用率令人担忧。本研究凸显了南非癫痫流行病学相关信息的匮乏，以及现有的癫痫管理系统，尤其是农村地区的系统，似乎存在功能缺陷。需要进行适当研究以确定服务提供中的问题，并为规划和实施基于初级卫生保健的儿童癫痫诊断和管理适当系统提供支持。
