Prevalence of epilepsy in 74,949 school children in Khartoum State, Sudan.
BACKGROUND
Data on childhood epilepsy in Sudan are scarce and the only published study on its prevalence was published in 1983. This study aimed to determine the current prevalence of epilepsy in school children in Khartoum State.


METHODS
This is an analytical population-based, cross-sectional study conducted in Khartoum State, Sudan. The study included students in the basic (primary) schools aged 6-14 years. Simple random sampling was used to draw a cluster of four of the seven localities comprising Khartoum State. The sample frame consisted of 1609 public schools (808,624 pupils) and 787 private schools (194,613 pupils), a total of 2396 schools (1,003,237 pupils). A sample size of 75 940 pupils was estimated and 250 schools were drawn from a sample frame of 2396 schools using a stratified random sampling technique. Consent was obtained from the headmaster/head teacher of the selected schools who arranged a meeting with the tutor/teacher responsible for each class. The study team asked whether any of the pupils was ever noticed or known to have had any kind of seizures, and a confidential letter was sent to the parents of each identified pupil. The letter included an explanation of the aims of the study, information on the research group and the kind of help the research group could offer; contact numbers and email addresses were made available if they wished to participate in this study. Those who consented to participate were then given an appointment at the Epilepsy Outpatient Department, Gaafar Ibnauf Children's Hospital, Khartoum where they were evaluated by the paediatric neurologist.


RESULTS
Altogether, 74,949 pupils were enrolled for the study, 398 of whom were identified initially as having seizures and 332 of whom (83.4%) were identified by a paediatric neurologist. Of the 332, 303 (91.3%) proved to have epileptic seizures, 250 (82.5%) were known to have epilepsy, and 53 (17.5%) were newly diagnosed during the survey. The male to female ratio was 1.5:1. The total prevalence of epilepsy in Khartoum State was estimated to be 4/1000. The highest prevalence was in Jabal Awliya Locality (4.87/1000) and the lowest was in Khartoum Locality (3.35/1000). Twenty-nine (8.7%) patients proved to have non-epileptic seizures. The majority (15, 51.6%) had psychogenic non-epileptic seizures, and four (13.6%) had syncope. The majority (171, 56.43%) of patients had generalised epilepsy, 109 (35.97%) had focal epilepsy, and 23 (7.6%) had unclassified epilepsy.


CONCLUSIONS
The prevalence of epilepsy in school children in Khartoum State (4/1000) is higher than that reported previously from Khartoum Province in 1983 (0.9/1000).
a Faculty of Medicine, Department of Paediatrics and Child Health , University of Khartoum , Khartoum , Sudan.
Inaam N
IN
Mohamed
a Faculty of Medicine, Department of Paediatrics and Child Health , University of Khartoum , Khartoum , Sudan.
Maha A
MA
Elseed
a Faculty of Medicine, Department of Paediatrics and Child Health , University of Khartoum , Khartoum , Sudan.
Ahlam A
AA
Hamed
b Faculty of Mathematical Sciences, Department of Statistics , University of Khartoum , Khartoum , Sudan.
Manar E
ME
Abdel-Rahman
c Faculty of Medicine, Department of Medicine , University of Khartoum , Khartoum , Sudan.
Sarah M
SM
El-Sadig
a Faculty of Medicine, Department of Paediatrics and Child Health , University of Khartoum , Khartoum , Sudan.
Ilham M
IM
Omer
d Faculty of Medicine, Department of Psychiatry , University of Khartoum , Khartoum , Sudan.
Abdelgadir H
http://orcid.org/0000-0001-6329-2811
AH
Osman
e Faculty of Medicine, Department of Physiology , University of Khartoum , Khartoum , Sudan.
Ammar E
AE
Ahmed
a Faculty of Medicine, Department of Paediatrics and Child Health , University of Khartoum , Khartoum , Sudan.
Zein A
ZA
Karrar
f Division of Pediatric Neurology, Department of Pediatrics , College of Medicine, King Saud University , Riyadh , Saudi Arabia.
Mustafa A
http://orcid.org/0000-0002-4379-2111
MA
Salih
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012574:Schools; D013334:Students; D013397:Sudan / Q000453:epidemiology
Prevalence; Sudan; children; epilepsy; school