Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.
Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
Trop Med Int Health. 2021 Apr;26(4):492-502. doi: 10.1111/tmi.13548. Epub 2021 Feb 18.
To analyse the cumulative incidence of febrile seizures, to evaluate the accuracy of our screening questionnaire and to describe clinical characteristics of children with febrile seizure in an urban population in Tanzania.
A large random cluster sampled population was screened for a febrile seizure history as part of a larger epilepsy study using a standardised questionnaire in a two-stage door-to-door survey in Tanzania. A subset of screen positive participants was further examined for confirmation of diagnosis and evaluation of clinical characteristics.
Overall, 49 697 people were screened for a febrile seizure history of whom 184 (0.4%) screened positive. Women more commonly screened positive than men (112 [0.4%] vs. 72 [0.3%]). There was no marked difference between age groups or education. The positive predictive value of the screening tool was 37% (95% CI 24-51%) but its accuracy varied with the age of interviewed individuals. Cumulative incidence rates were estimated between 1.1% and 2.0% after adjusting for the inaccuracy of the screening tool. Most febrile seizures occurred before the age of two (65%) and most children had more than one episode (80%). A large proportion of children had complex febrile seizure (65%), often caused by malaria or respiratory infections.
The community-based cumulative incidence of a febrile seizure history in an urban Tanzanian population was similar to rates reported from other rural populations after adjusting for the inaccuracy of our screening tool. Based on the integrated nature of the febrile seizure questionnaire, screening positivity rates may have been too low. This has implications for the design of future studies. The majority of cases had complex febrile seizures often associated with malaria. This has implications for clinical case management.
分析热性惊厥的累积发病率，评估我们的筛查问卷的准确性，并描述坦桑尼亚城市人群中热性惊厥患儿的临床特征。
作为一项更大的癫痫研究的一部分，我们采用标准化问卷，通过两阶段上门调查，对坦桑尼亚的一个大型随机聚类抽样人群进行了热性惊厥病史筛查。对筛查阳性的部分参与者进行了进一步检查，以确认诊断并评估临床特征。
总体而言，对 49697 人进行了热性惊厥病史筛查，其中 184 人（0.4%）筛查阳性。女性筛查阳性的比例高于男性（112[0.4%]比 72[0.3%]）。年龄组和受教育程度之间没有明显差异。筛查工具的阳性预测值为 37%（95%CI 24-51%），但其准确性随被访者年龄的不同而变化。在调整筛查工具的不准确性后，估计累积发病率在 1.1%-2.0%之间。大多数热性惊厥发生在 2 岁之前（65%），大多数儿童有多次发作（80%）。很大一部分儿童有复杂的热性惊厥（65%），通常由疟疾或呼吸道感染引起。
在调整了我们的筛查工具的不准确性后，坦桑尼亚城市人群中热性惊厥病史的基于社区的累积发病率与其他农村人群报告的发病率相似。基于热性惊厥问卷的综合性，筛查阳性率可能过低。这对未来研究的设计有影响。大多数病例为复杂热性惊厥，常与疟疾有关。这对临床病例管理有影响。
