title: Determinants of active convulsive epilepsy in rural Cameroon: a population based case-control study.
abstract: OBJECTIVE
  The aim of this study was to investigate the determinants of active convulsive epilepsy in rural Cameroon, in order to inform prevention and control strategies at the local and regional levels.
  
  
  METHODS
  This case-control study took  place in the rural health district of Bafut, North-West Region of Cameroon. People with epilepsy receiving care in local health facilities or identified in the community were matched with non-epileptic controls for age and sex. The Limoges questionnaire was used for case definitions and screening  for risk factors for epilepsy. Potential determinants were investigated through logistic regression models.
  
  
  RESULTS
  In all 170 participants (85 cases, with 85 controls) were included. Fewer cases than controls were married (27% vs. 58%; P<0·001) and more  cases than control were living with parents (56% vs. 28%; P<0·001). In final multivariable regression analyses, a family history of epilepsy (odd ratio 3·11; 95% confidence interval: 1·61-6·01; P<0·001) and a poor obstetrical  history (odd ratio: 4·34; 95% confidence interval: 1·29-14·58; P = 0·018) were significant determinants of active convulsive epilepsy.
  
  
  CONCLUSIONS
  In this rural area of Cameroon, the previously reported high prevalence of active  convulsive epilepsy could be explained by a positive family history and a poor obstetrical history. The later being a potentially modifiable determinant, there is a need for additional efforts into maternal and child health, and for integrated disease control programs to mitigate the social  impact of epilepsy.
authors.affiliation: Neurological and Neurosurgical Hospital and Claude Bernard University, Lyon, France. lekoub77@yahoo.com
authors.forename: Alain
authors.initials: A
authors.lastname: Lekoubou
authors.forename: André Pascal
authors.initials: AP
authors.lastname: Kengne
authors.forename: Leopold
authors.initials: L
authors.lastname: Fezeu
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Mbanya
mesh_terms: D017677:Age Distribution; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D004829:Epilepsy, Generalized / Q000453:epidemiology*; D006801:Humans; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution