Demographic impact of epilepsy in Africa: results of a 10-year cohort study in a rural area of Cameroon.
OBJECTIVE
To evaluate the demographic impact of epilepsy a rural area of Africa.


METHODS
A cohort study was conducted between 1991 and 2001 in the Mbam Valley (Cameroon) on two groups of subjects (one of persons with epilepsy, and the other of control individuals matched for sex, age, and village of residence). At the end of the follow-up, information on mortality, marital status, and numbers of offspring was obtained from 128 pairs of subjects.


RESULTS
Thirty-seven (28.9%) persons with epilepsy and six (4.7%) controls died between 1991 and 2001. The relative risk of dying during the follow-up among the group of people with epilepsy, compared with the controls, was 6.2 (95% CI, 2.7-14.1). The most frequent causes of death in the persons with epilepsy were status epilepticus, sudden unexpected death in epilepsy (SUDEP), and drowning. Of the 90 pairs, of which both members were still alive in 2001, 15 (16.7%) persons with epilepsy were married as compared with 53 (58.9%) controls. The mean number of children was 0.9 in the subjects with epilepsy, and 1.7 in the controls (p < 0.0001).


CONCLUSIONS
Health personnel should be trained and sensitized about the devastating effect of this neglected disease in developing countries. In those areas where onchocerciasis control programs are organized by using the community-directed-treatment approach, the possibility that the ivermectin distributors could also be responsible for distributing antiepileptic drugs should be considered.
Kamgno
Joseph
J
Laboratoire mixte IRD/CPC d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroon.
Pion
Sébastien D S
SD
Boussinesq
Michel
M
D000293:Adolescent; D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003645:Death, Sudden / Q000453:epidemiology; D003906:Developing Countries; D004827:Epilepsy / Q000401:mortality*; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D012016:Reference Values; D012424:Rural Population / Q000706:statistics & numerical data*; D013226:Status Epilepticus / Q000401:mortality