Bruno Elisa, Quattrocchi Graziella, Crespo Gómes Elizabeth Blanca, Sofia Vito, Padilla Sandra, Camargo Mario, Zappia Mario, Bartoloni Alessandro, Nicoletti Alessandra
Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.
Servicio departamental de Salud, Santa Cruz, Camiri, Bolivia.
PLoS One. 2015 Oct 1;10(10):e0139108. doi: 10.1371/journal.pone.0139108. eCollection 2015.
we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy associated with convulsive seizures (EACS) in a rural area of Bolivia.
the study was carried out in the Cordillera Province, southern-eastern Bolivia. One hundred fourteen rural communities with a total population of 18,907 inhabitants were included in the survey. In order to identify subjects with EACS, trained fieldworkers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II) that, in case of positive answer, underwent a complete neurological examination to confirm the diagnosis (stage III). We estimated age and sex specific life-time and active EACS prevalence at the prevalence day (30th June 2010). Incidence risk was evaluated for the 10-year period between January 2000 and December 2010.
on prevalence day we identified 136 subjects with EACS, 124 of whom had active epilepsy. The life-time prevalence of EACS was 7.2/1,000 (7.6/1,000 age-adjusted to the world standard population) while the prevalence of active EACS was 6.6/1,000 (6.7/1,000 age-adjusted to the world standard population). Both life-time and active prevalence showed a peak (10.3/1,000) in the 15-24 years age group and, overall, were higher among women. During the incidence study period, 105 patients living in the study area had the onset of EACS. The crude incidence risk was 55.4/100,000 (49.5/100,000 age-adjusted to the world standard population). Incidence was slightly but not significantly higher among women (58.9/100,000 versus 51.9/100,000).
the present study demonstrated a considerable burden of EACS in the Bolivian Chaco, showing prevalence and incidence estimates close to those reported for low and middle- income countries and underlying the need of treatment programs.
我们开展了一项三阶段的挨家挨户调查，以估算玻利维亚一个农村地区惊厥性癫痫发作相关癫痫（EACS）的发病率和患病率。
该研究在玻利维亚东南部的科迪勒拉省进行。调查纳入了114个农村社区，总人口为18907名居民。为了识别患有EACS的受试者，经过培训的现场工作人员向住户提出了一个经过验证的单一筛查问题（第一阶段）。对每个阳性受试者进行了第二次面对面问卷调查（第二阶段），如果回答为阳性，则对其进行全面的神经系统检查以确诊（第三阶段）。我们估算了在患病率调查日（2010年6月30日）按年龄和性别划分的终生及活动性EACS患病率。评估了2000年1月至2010年12月这10年期间的发病风险。
在患病率调查日，我们识别出136名患有EACS的受试者，其中124人患有活动性癫痫。EACS的终生患病率为7.2/1000（根据世界标准人口年龄调整后为7.6/1000），而活动性EACS的患病率为6.6/1000（根据世界标准人口年龄调整后为6.7/1000）。终生患病率和活动性患病率在15 - 24岁年龄组均出现峰值（10.3/1000），总体而言，女性患病率更高。在发病率研究期间，研究区域内有105名患者出现了EACS发作。粗发病率风险为55.4/100000（根据世界标准人口年龄调整后为49.5/100000）。女性的发病率略高，但差异不显著（58.9/100000对51.9/100000）。
本研究表明玻利维亚查科地区EACS负担较重，其患病率和发病率估算值与低收入和中等收入国家报告的相近，凸显了治疗项目的必要性。
