Prevalence of epilepsy and seizures in the Navajo Nation 1998-2002.
OBJECTIVE
To determine the prevalence of epilepsy and seizures in the Navajo.


METHODS
We studied 226,496 Navajo residing in the Navajo Reservation who had at least one medical encounter between October 1, 1998 and September 30, 2002. We ascertained and confirmed cases in two phases. First, we identified patients with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes signifying epilepsy or seizures using Indian Health Service (IHS) administrative data. Second, we reviewed medical charts of a geographic subpopulation of identified patients to confirm diagnoses and assess the positive predictive value of the ICD-9-CM codes in identifying patients with active epilepsy.


RESULTS
Two percent of Navajo receiving IHS care were found to have an ICD-9-CM code consistent with epilepsy or seizures. Based on confirmed cases, the crude prevalence for the occurrence of any seizure (including febrile seizures and recurrent seizures that may have been provoked) in the geographic subpopulation was 13.5 per 1,000 and the crude prevalence of active epilepsy was 9.2 per 1,000. Prevalence was higher among males, children under 5 years of age, and older adults.


CONCLUSIONS
The estimated prevalence of active epilepsy in the Navajo Nation is above the upper limit of the range of reported estimates from other comparable studies of U.S. communities.
Parko
Karen
K
Department of Neurology, University of California, San Francisco, California, USA. Karen.Parko@ucsf.edu
Thurman
David J
DJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data*; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology*; D003294:Seizures, Febrile / Q000175:diagnosis / Q000453:epidemiology; D012737:Sex Factors; D015206:Southwestern United States / Q000453:epidemiology; D014481:United States; D016549:United States Indian Health Service / Q000706:statistics & numerical data*