title: [Prolonged seizures in children in sub-Saharan Africa Clinical aspects and management].
abstract: BACKGROUND
  There is a paucity of epidemiologic studies of prolonged seizures (persisting for more than 5 minutes) in the Democratic Republic of Congo (DRC) and in Rwanda.
  
  
  OBJECTIVE
  We sought to analyze the clinical presentation, causes, pharmacologic management, and shortterm course of these seizures.
  
  
  METHODS
  We enrolled 436 children, aged five months to ten years, who presented with prolonged seizures at the pediatric emergency departments of nine hospitals. Findings: Overall, 57.8% of the children were younger than three years; 7% had pre-existing psychomotor delay. Although 21% had had previous seizures, only 13% were receiving antiepileptic therapy. On presentation, 63.5% of the patients had fever and 26% were in status epilepticus. The seizures were focal in 21% of the cases. Malaria was the most common cause, involving 63% of the cases. The recurrence rate was 38%, and the mortality rate 4%.
  
  
  CONCLUSIONS
  Prolonged seizures in DRC and Rwanda are frequently associated with fever, most commonly caused by malaria. The immediate use of long-acting antiepileptic drug could improve their outcomes.
authors.affiliation: Université de Kinshasa service de neurologie pédiatrique, département de neurologie, centre neuropsychopathologique, faculté de médecine, université de Kinshasa, République démocratique du Congo, Service universitaire de pédiatrie-neuropédiatrie, CHR-CHU Sart-Tilman, université de liège, 4000 Liège, Belgique.
authors.forename: C
authors.initials: C
authors.lastname: Kaputu-Kalala-Malu
authors.affiliation: Université de Kinshasa service de neurologie pédiatrique, département de neurologie, centre neuropsychopathologique, faculté de médecine, université de Kinshasa, République démocratique du Congo.
authors.forename: D
authors.initials: D
authors.lastname: Mukeba Kahamba
authors.affiliation: Département de pédiatrie, centre hospitalier universitaire de Butare, université du Rwanda.
authors.forename: O
authors.initials: O
authors.lastname: Ntumba-Tshitenge
authors.affiliation: École de sante publique, université de Kinshasa, République démocratique du Congo.
authors.forename: E
authors.initials: E
authors.lastname: Mafuta Musalu
authors.affiliation: University of Rwanda - College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda.
authors.forename: V
authors.initials: V
authors.lastname: Ndahindwa
authors.affiliation: Université de Kinshasa service de neurologie pédiatrique, département de neurologie, centre neuropsychopathologique, faculté de médecine, université de Kinshasa, République démocratique du Congo.
authors.forename: D
authors.initials: D
authors.lastname: Okitundu Luwa E-Andjafono
authors.affiliation: Université de Kinshasa service de neurologie pédiatrique, département de neurologie, centre neuropsychopathologique, faculté de médecine, université de Kinshasa, République démocratique du Congo.
authors.forename: T
authors.initials: T
authors.lastname: Kayembe Kalula
authors.affiliation: Neurologie-neuropédiatrie, hôpital Saint Joseph, Mons, Belgique.
authors.forename: R
authors.initials: R
authors.lastname: Mukendi Kavulu Mayamba
authors.affiliation: Service universitaire de pédiatrie-neuropédiatrie, CHR-CHU Sart-Tilman, université de liège, 4000 Liège, Belgique.
authors.forename: J P
authors.initials: JP
authors.lastname: Misson
mesh_terms: D017954:Africa South of the Sahara; D000927:Anticonvulsants / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors
chemical_list: D000927:Anticonvulsants
keywords: Democratic Republic of Congo; Rwanda; children; prolonged seizures; sub-Saharan Africa