title: Long-term survival and outcome in children admitted to kilifi district hospital with convulsive status epilepticus.
abstract: Objectives. The incidence of convulsive status epilepticus (CSE) is high in Africa but the long-term outcome is unknown. We examined the neurocognitive outcome and survival of children treated for CSE in a Kenyan hospital 3 to 4 years after discharge. Methods. The frequency and nature of neurological deficits among this group of children were determined and compared to a control group. The children were screened with the Ten Questions Questionnaire for neurodevelopmental impairment if alive and those that screened positive were invited for further assessment to determine the pattern and extent of their impairment. A verbal autopsy was performed to determine the cause of death in those that died. Results. In the 119 cases followed-up, 9 (8%) died after discharge, with the majority having seizures during their fatal illness. The 110 survivors (median age 5 years) had significantly more neurological impairments on the screening compared to 282 controls (34/110 (30.9%) versus 11/282 (3.9%), OR = 11.0, 95% CI 5.3-22.8). Fifteen percent of the cases had active epilepsy. Conclusions. This study demonstrates the considerable burden of CSE in African children. Strategies to manage children with CSE that are acceptable to the community need to be explored to improve the longer-term outcome.
authors.affiliation: Centre for Geographic Medicine Research-Coast (CGMRC), Kenya Medical Research Institute (KEMRI), P.O. Box 230, Kilifi 80108, Kenya.
authors.forename: Agnes
authors.identifier: 0000-0003-2527-9450
authors.initials: A
authors.lastname: Prins
authors.affiliation: Centre for Geographic Medicine Research-Coast (CGMRC), Kenya Medical Research Institute (KEMRI), P.O. Box 230, Kilifi 80108, Kenya.
authors.forename: Eddie
authors.identifier: 0000-0001-9258-0361
authors.initials: E
authors.lastname: Chengo
authors.affiliation: Centre for Geographic Medicine Research-Coast (CGMRC), Kenya Medical Research Institute (KEMRI), P.O. Box 230, Kilifi 80108, Kenya.
authors.forename: Victor
authors.initials: V
authors.lastname: Mung'ala Odera
authors.affiliation: Department of Paediatrics, University of Oxford, Level 2, Children's Hospital, Oxford OX3 9DU, UK ; Department of Paediatrics, University of British Columbia & BC Children's Hospital, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4.
authors.forename: Manish
authors.identifier: 0000-0002-9985-6452
authors.initials: M
authors.lastname: Sadarangani
authors.affiliation: Department of Paediatrics, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headington, Oxford OX3 9DU, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Seaton
authors.affiliation: International Centre for Behavioral Studies, P.O. Box 34307, Mombasa 80118, Kenya.
authors.forename: Penny
authors.initials: P
authors.lastname: Holding
authors.affiliation: Centre for Geographic Medicine Research-Coast (CGMRC), Kenya Medical Research Institute (KEMRI), P.O. Box 230, Kilifi 80108, Kenya ; Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Old Road, Oxford OX3 7LJ, UK.
authors.forename: Greg
authors.identifier: 0000-0002-2663-2765
authors.initials: G
authors.lastname: Fegan
authors.affiliation: Centre for Geographic Medicine Research-Coast (CGMRC), Kenya Medical Research Institute (KEMRI), P.O. Box 230, Kilifi 80108, Kenya ; Neurosciences Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK ; Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton