title: Behavioural comorbidity in Tanzanian children with epilepsy: a community-based case-control study.
abstract: OBJECTIVE
  The aim of this study was to define the prevalence of and risk factors for behavioural disorders in children with epilepsy from a rural district of Tanzania by conducting a community-based case-control study.
  
  
  METHODS
  One hundred and twelve children aged 6 to 14 years (55 males, 57 females; median age 12 y) with active epilepsy (at least two unprovoked seizures in the last 5 y) were identified in a cross-sectional survey and included in this study. Children who were younger than 6 years were excluded in order to eliminate febrile seizures. Behaviour was assessed using the Rutter scale; children who scored 13 or more were considered to have disordered behaviour. A comparison group was made up of age- and sex-matched children without epilepsy (n = 113; 57 males, 56 females; median age 12 y).
  
  
  RESULTS
  Behavioural disorders were diagnosed in 68 of 103 (66%) children with epilepsy and in 19 of 99 (19%) controls. Disordered behaviour was significantly more common in children with epilepsy than in the comparison group (univariate odds ratio 8.2; 95% confidence interval [CI] 4.3-15.6; p < 0.001) and frequent seizures and poor scholastic attainment were associated in children with epilepsy. Behavioural disorders were not associated with antiepileptic drug usage. Attention problems were present in 48 of 91 (53%) children with epilepsy and 16 of 97 (17%) controls (univariate odds ratio 5.7; 95% CI 2.9-11.1; p < 0.001). In children with epilepsy, attention problems were significantly more common in males and were associated with frequent seizures.
  
  
  CONCLUSIONS
  Children with epilepsy in a rural area of sub-Saharan Africa have a high prevalence of behavioural disorders and attention problems, both of which are associated with frequent seizures. Providing behaviour assessment and appropriate intervention programmes for children with epilepsy may reduce the burden of behaviour disorders in this setting.
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania. kjburton@doctors.org.uk
authors.forename: Kathryn
authors.initials: K
authors.lastname: Burton
authors.forename: Jane
authors.initials: J
authors.lastname: Rogathe
authors.forename: Ewan
authors.initials: E
authors.lastname: Hunter
authors.forename: Matthew
authors.initials: M
authors.lastname: Burton
authors.forename: Mark
authors.initials: M
authors.lastname: Swai
authors.forename: Jim
authors.initials: J
authors.lastname: Todd
authors.forename: Brian
authors.initials: B
authors.lastname: Neville
authors.forename: Richard
authors.initials: R
authors.lastname: Walker
authors.forename: Charles
authors.initials: C
authors.lastname: Newton
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants
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