Ae-Ngibise Kenneth Ayuurebobi, Akpalu Bright, Ngugi Anthony, Akpalu Albert, Agbokey Francis, Adjei Patrick, Punguyire Damien, Bottomley Christian, Newton Charles, Owusu-Agyei Seth
Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana ; Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana.
Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana ; KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research- Coast, Kilifi, Kenya ; Population Health Sciences/Research Support Unit, Faculty of Health Sciences, Aga Khan University- East Africa, Nairobi, Kenya.
Pan Afr Med J. 2015 May 13;21:29. doi: 10.11604/pamj.2015.21.29.6084. eCollection 2015.
Epilepsy is common in sub-Saharan Africa, but there is little data in West Africa, to develop public health measures for epilepsy in this region.
We conducted a three-stage cross-sectional survey to determine the prevalence and risk factors for active convulsive epilepsy (ACE), and estimated the treatment gap in Kintampo situated in the middle of Ghana.
249 people with ACE were identified in a study population of 113,796 individuals. After adjusting for attrition and the sensitivity of the screening method, the prevalence of ACE was 10.1/1000 (95% Confidence Interval (95% CI) 9.5-10.7). In children aged <18 years, risk factors for ACE were: family history of seizures (OR=3.31; 95% CI: 1.83-5.96), abnormal delivery (OR=2.99; 95% CI: 1.07-8.34), problems after birth (OR=3.51; 95% CI: 1.02-12.06), and exposure to Onchocerca volvulus (OR=2.32; 95% CI: 1.12-4.78). In adults, a family history of seizures (OR=1.83; 95% CI: 1.05-3.20), never attended school (OR=11.68; 95% CI: 4.80-28.40), cassava consumption (OR=3.92; 95% CI: 1.14-13.54), pork consumption (OR=1.68; 95% CI: 1.09-2.58), history of snoring at least 3 nights per week (OR=3.40: 95% CI: 1.56-7.41), exposure to Toxoplasma gondii (OR=1.99; 95% CI: 1.15-3.45) and Onchocerca volvulus (OR=2.09: 95% CI: 1.29-3.40) were significant risk factors for the development of ACE. The self-reported treatment gap was 86.9% (95% CI: 83.5%-90.3%).
ACE is common within the middle belt of Ghana and could be reduced with improved obstetric care and prevention of parasite infestations such as Onchocerca volvulus and Toxoplasma gondii.
癫痫在撒哈拉以南非洲地区很常见，但西非地区缺乏相关数据，难以制定该地区癫痫的公共卫生措施。
我们开展了一项三阶段横断面调查，以确定活动性惊厥性癫痫（ACE）的患病率和危险因素，并估算了位于加纳中部的金坦波的治疗缺口。
在113,796名研究对象中，共识别出249例ACE患者。在对损耗和筛查方法的敏感性进行校正后，ACE的患病率为10.1/1000（95%置信区间（95%CI）9.5-10.7）。在18岁以下儿童中，ACE的危险因素包括：癫痫家族史（比值比（OR）=3.31；95%CI：1.83-5.96）、分娩异常（OR=2.99；95%CI：1.07-8.34）、出生后问题（OR=3.51；95%CI：1.02-12.06）以及盘尾丝虫暴露（OR=2.32；95%CI：1.12-4.78）。在成年人中，癫痫家族史（OR=1.83；95%CI：1.05-3.20）、从未上学（OR=11.68；95%CI：4.80-28.40）、食用木薯（OR=3.92；95%CI：1.14-13.54）、食用猪肉（OR=1.68；95%CI：1.09-2.58）、每周至少打鼾3晚（OR=3.40：95%CI：1.56-7.41）、弓形虫暴露（OR=1.99；95%CI：1.15-3.45）以及盘尾丝虫暴露（OR=2.09：95%CI：1.29-3.40）是ACE发病的显著危险因素。自我报告的治疗缺口为86.9%（95%CI：83.5%-90.3%）。
ACE在加纳中部地区很常见，可通过改善产科护理以及预防盘尾丝虫和弓形虫等寄生虫感染来降低其发病率。
