title: Prevalence of active epilepsy in a rural area in South Tanzania: a door-to-door survey.
abstract: OBJECTIVE
  A door-to-door survey was carried out to assess the prevalence of active epilepsy in the rural population within the catchment area of the Mnero Diocesan Hospital in Southern Tanzania.
  
  
  METHODS
  A total of 4,905 individuals living in 1,047 households were enrolled in a study, consisting of a screening dialogue with a representative family member followed by a face-to-face interview with the affected subject. The diagnosis of epilepsy followed clinical guidelines proposed by the International League Against Epilepsy (ILAE).
  
  
  RESULTS
  We detected 42 cases (21 males and 21 females) of active epilepsy (8.6/1,000; 95% CI: 6.0/1,000-11.1/1,000; age-adjusted prevalence ratio: 7.4/1,000). Thirty of them met the case definitions of generalized seizures, whereas 12 patients reported partial seizures. The peak prevalence was found in both sexes in the second decade of life (f: 16.9/1,000; m: 15.8/1,000; t: 16.4/1,000), with a second peak in the group aged 30-39 years (f: 10.4/1,000; m: 8.8/1,000; t: 9.7/1,000). Eleven patients (26.2%) were classified as "strongly suspected of symptomatic" epilepsy, the remaining 31 patients (73.8%) as possibly being idiopathic, symptomatic, or cryptogenic epilepsy cases.
  
  
  CONCLUSIONS
  This study provides baseline data about the active epilepsy prevalence in a rural African population. Compared to western countries, our study confirmed a pattern toward higher prevalence of epilepsy in tropical countries. As shown in previous studies, we observed a higher prevalence of epilepsy in children and adolescents, followed by a steady decline with increasing age. Reasons for this type of frequency could be ascribed to malnutrition, trauma, genetic conditions, antenatal and prenatal care, diseases resulting in febrile convulsions, cerebral infections and may even result in death in specifically diseased individuals.
authors.affiliation: Department of Neurology, Medical University Innsbruck, Innsbruck, Austria. Wolfgang.Dent@macnews.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dent
authors.forename: Raimund
authors.initials: R
authors.lastname: Helbok
authors.forename: William Bahati Pungu
authors.initials: WB
authors.lastname: Matuja
authors.forename: Sönke
authors.initials: S
authors.lastname: Scheunemann
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D002648:Child; D016001:Confidence Intervals; D004828:Epilepsies, Partial / Q000453:epidemiology; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D004829:Epilepsy, Generalized / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013636:Tanzania / Q000453:epidemiology