脑型疟疾与继发性癫痫：加蓬的首例配对病例对照研究。

Cerebral malaria and sequelar epilepsy: first matched case-control study in Gabon.

作者信息

Ngoungou Edgard Brice, Koko Jean, Druet-Cabanac Michel, Assengone-Zeh-Nguema Yvonne, Launay Marylène Ndong, Engohang Edouard, Moubeka-Mounguengui Martine, Kouna-Ndouongo Philomène, Loembe Paul-Marie, Preux Pierre-Marie, Kombila Maryvonne

机构信息

Institute of Neuroepidemiology and Tropical Neurology (EA 3174), Limoges, France.

出版信息

Epilepsia. 2006 Dec;47(12):2147-53. doi: 10.1111/j.1528-1167.2006.00890.x.

DOI:10.1111/j.1528-1167.2006.00890.x

PMID:17201716

Abstract

PURPOSE

Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon.

METHODS

A matched case-control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria.

RESULTS

In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7-8.9], p<0.001. Additional risk factors were identified: family history of epilepsy: aOR=6.0 [95% CI: 2.6-14.1], p<0.0001, and febrile convulsions: aOR=9.2 [95% CI 4.0-21.1], p<0.0001.

CONCLUSIONS

This first case-control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.

摘要

目的

脑型疟疾（CM）被怀疑是热带地区癫痫的一个潜在病因。本文的目的是评估加蓬脑型疟疾与癫痫之间的关系。

方法

在加蓬利伯维尔的三家医院对1990年至2004年间住院的6个月至25岁的受试者样本进行了一项匹配病例对照研究。病例定义为患有癫痫并经神经科医生确诊的患者。对照定义为无癫痫的患者。根据世界卫生组织标准，感兴趣的暴露因素是脑型疟疾。

结果

总共纳入了296例病例和296例对照。其中，36例（26例病例和10例对照）有脑型疟疾病史。脑型疟疾后发生癫痫的调整优势比（aOR）为3.9 [95%可信区间：1.7 - 8.9]，p<0.001。还确定了其他危险因素：癫痫家族史：aOR = 6.0 [95%可信区间：2.6 - 14.1]，p<0.0001；热性惊厥：aOR = 9.2 [95%可信区间4.0 - 21.1]，p<0.0001。