title: Prevalence and risk factors for Active Convulsive Epilepsy in Kintampo, Ghana.
abstract: BACKGROUND
  Epilepsy is common in sub-Saharan Africa, but there is little data in West Africa, to develop public health measures for epilepsy in this region.
  
  
  METHODS
  We conducted a three-stage cross-sectional survey to determine the prevalence and risk factors for active convulsive epilepsy (ACE), and estimated the treatment gap in Kintampo situated in the middle of Ghana.
  
  
  RESULTS
  249 people with ACE were identified in a study population of 113,796 individuals. After adjusting for attrition and the sensitivity of the screening method, the prevalence of ACE was 10.1/1000 (95% Confidence Interval (95% CI) 9.5-10.7). In children aged <18 years, risk factors for ACE were: family history of seizures (OR=3.31; 95% CI: 1.83-5.96), abnormal delivery (OR=2.99; 95% CI: 1.07-8.34), problems after birth (OR=3.51; 95% CI: 1.02-12.06), and exposure to Onchocerca volvulus (OR=2.32; 95% CI: 1.12-4.78). In adults, a family history of seizures (OR=1.83; 95% CI: 1.05-3.20), never attended school (OR=11.68; 95% CI: 4.80-28.40), cassava consumption (OR=3.92; 95% CI: 1.14-13.54), pork consumption (OR=1.68; 95% CI: 1.09-2.58), history of snoring at least 3 nights per week (OR=3.40: 95% CI: 1.56-7.41), exposure to Toxoplasma gondii (OR=1.99; 95% CI: 1.15-3.45) and Onchocerca volvulus (OR=2.09: 95% CI: 1.29-3.40) were significant risk factors for the development of ACE. The self-reported treatment gap was 86.9% (95% CI: 83.5%-90.3%).
  
  
  CONCLUSIONS
  ACE is common within the middle belt of Ghana and could be reduced with improved obstetric care and prevention of parasite infestations such as Onchocerca volvulus and Toxoplasma gondii.
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana ; Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana.
authors.forename: Kenneth Ayuurebobi
authors.initials: KA
authors.lastname: Ae-Ngibise
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana ; Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana.
authors.forename: Bright
authors.initials: B
authors.lastname: Akpalu
authors.affiliation: Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana ; KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research- Coast, Kilifi, Kenya ; Population Health Sciences/Research Support Unit, Faculty of Health Sciences, Aga Khan University- East Africa, Nairobi, Kenya.
authors.forename: Anthony
authors.initials: A
authors.lastname: Ngugi
authors.affiliation: Department of Medicine, Korle Bu Teaching Hospital, Ghana.
authors.forename: Albert
authors.initials: A
authors.lastname: Akpalu
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana ; Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana.
authors.forename: Francis
authors.initials: F
authors.lastname: Agbokey
authors.affiliation: Department of Medicine, Korle Bu Teaching Hospital, Ghana.
authors.forename: Patrick
authors.initials: P
authors.lastname: Adjei
authors.affiliation: Kintampo Municipal Hospital, Ghana Health Service, Ghana.
authors.forename: Damien
authors.initials: D
authors.lastname: Punguyire
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Bottomley
authors.affiliation: Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana ; KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research- Coast, Kilifi, Kenya ; Department of Psychiatry, University of Oxford, United Kingdom.
authors.forename: Charles
authors.initials: C
authors.lastname: Newton
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana ; Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network Accra, Ghana.
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005869:Ghana; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010272:Parasitic Diseases / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D055815:Young Adult
keywords: Active Epilepsy; Ghana; risk factors; sub-Saharan Africa