Stelzle Dominik, Schmidt Veronika, Ngowi Bernard J, Matuja William, Schmutzhard Erich, Winkler Andrea S
Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Germany.
Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Germany.
eNeurologicalSci. 2021 Jun 15;24:100352. doi: 10.1016/j.ensci.2021.100352. eCollection 2021 Sep.
Epileptic seizures and epilepsy in urban settings of low-income and middle-income countries (LMIC) are largely under-researched, but their prevalence is necessary for good healthcare planning. This study aimed to determine the lifetime prevalence of epileptic seizures and epilepsy in urban Dar es Salaam.
Nearly 50,000 people in former Kinondoni district, Dar es Salaam, were screened for epileptic seizures using a set of nine questions. Answers to these nine questions were categorized into generalized, focal, and unspecified seizures. Screening positivity rates were adjusted for questionnaire inaccuracy using two scenarios to analyse true epilepsy prevalences.
Overall, 1085 (2.23%) people fulfilled the criteria for ever having had at least one type of epileptic seizure. Two-hundred-ninety-six (0.60%) people screened positive for generalized seizures, 986 (2.02%) for focal seizures, and 32 (0.07%) for unspecified seizures. Women more commonly screened positive than men (2.61% versus 1.72%, < 0.001), particularly for focal seizures (p < 0.001). Adjusting for different degrees of accuracy of the screening questionnaire yielded true lifetime prevalences for epilepsy of any type between 1.59% and 2.41%. We furthermore observed a considerable variation of screening positivity rates between wards in Kinondoni district ( < 0.001).
The prevalence of epilepsy, based on a questionnaire survey in urban Tanzania, was higher than previously observed, probably due to the screening questionnaire, which contained questions specifically designed to identify focal seizures. Further studies on epileptic seizures/epilepsy are needed for urban settings in LMIC, preferably with an integrated follow-up of positive cases.
在低收入和中等收入国家（LMIC）的城市地区，癫痫发作和癫痫在很大程度上研究不足，但它们的患病率对于良好的医疗保健规划是必要的。本研究旨在确定达累斯萨拉姆市癫痫发作和癫痫的终生患病率。
使用一组九个问题对达累斯萨拉姆市前基农多尼区近50,000人进行癫痫发作筛查。这九个问题的答案被分类为全身性、局灶性和未明确类型的发作。使用两种情况对筛查阳性率进行问卷不准确因素调整，以分析真正的癫痫患病率。
总体而言，1085人（2.23%）符合曾至少有过一种癫痫发作类型的标准。296人（0.60%）全身性发作筛查呈阳性，986人（2.02%）局灶性发作筛查呈阳性，32人（0.07%）未明确类型发作筛查呈阳性。女性筛查呈阳性的情况比男性更常见（2.61%对1.72%，<0.001），尤其是局灶性发作（p<0.001）。对筛查问卷不同程度的准确性进行调整后，任何类型癫痫的真正终生患病率在1.59%至2.41%之间。我们还观察到基农多尼区各病房之间的筛查阳性率存在相当大的差异（<0.001）。
基于坦桑尼亚城市地区的问卷调查，癫痫患病率高于先前观察到的水平，这可能归因于筛查问卷，该问卷包含专门设计用于识别局灶性发作的问题。对于LMIC的城市地区，需要对癫痫发作/癫痫进行进一步研究，最好对阳性病例进行综合随访。
