High prevalence of epilepsy in Northern Rwanda: Exploring gender differences

Abstract Introduction In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence o...

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Autores principales:	Peter Dedeken, Fidele Sebera, Sylvestre Mutungirehe, Ieme Garrez, Josiane Umwiringirwa, Frank Van Steenkiste, Paul A. J. M. Boon, Dirk E. Teuwen
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	door‐to‐door epilepsy gender gap prevalence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/76b26972415f4425ac6d62b7c4e5953d
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spelling	oai:doaj.org-article:76b26972415f4425ac6d62b7c4e5953d2021-11-25T06:06:36ZHigh prevalence of epilepsy in Northern Rwanda: Exploring gender differences2162-327910.1002/brb3.2377https://doaj.org/article/76b26972415f4425ac6d62b7c4e5953d2021-11-01T00:00:00Zhttps://doi.org/10.1002/brb3.2377https://doaj.org/toc/2162-3279Abstract Introduction In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ reported in 2005 in Rwanda. We report a confirmatory prevalence study focused on gender‐specific observations. Methods A cross‐sectional door‐to‐door approach was used in three rural villages. First, epilepsy screening using the Kinyarwanda version of the Limoges questionnaire was performed. Second, confirmation of epilepsy diagnosis was completed by trained physicians. Results In total, 2681 persons (56.14% female) were screened. Of 168 positively screened, 128 persons were diagnosed with epilepsy confirming the prevalence of lifetime epilepsy of 47.7‰ (CI 39.8–56.8). The diagnosis gap was 62.5% with 80 newly diagnosed. The overall female:male ratio was 1.61:1.00. A male preponderance below 9 years of age inverted to a female preponderance above 20 years of age. Female PwE had an older age at first seizure, reported different reasons for not seeking care, and differed from male PwE in possible etiology. For previously diagnosed PwE, the treatment gap was more than 77%. Conclusion A high prevalence in rural areas was confirmed, with an observed female/male ratio among the highest of published door‐to‐door surveys in SSA. Gender differences in associated co‐morbidities and age at first seizure warrant future research of underlying etiologies and possible survival bias. A better understanding and focus on gender‐associated care‐seeking patterns, education, and specific needs are recommended.Peter DedekenFidele SeberaSylvestre MutungireheIeme GarrezJosiane UmwiringirwaFrank Van SteenkistePaul A. J. M. BoonDirk E. TeuwenWileyarticledoor‐to‐doorepilepsygender gapprevalenceNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain and Behavior, Vol 11, Iss 11, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	door‐to‐door epilepsy gender gap prevalence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	door‐to‐door epilepsy gender gap prevalence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Peter Dedeken Fidele Sebera Sylvestre Mutungirehe Ieme Garrez Josiane Umwiringirwa Frank Van Steenkiste Paul A. J. M. Boon Dirk E. Teuwen High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
description	Abstract Introduction In sub‐Saharan Africa (SSA), the prevalence of lifetime epilepsy varies widely between subregions and is higher in rural compared to urban regions. Observed versus expected numbers of patients with epilepsy (PwE) in the northern province of Rwanda did not match the prevalence of 49‰ reported in 2005 in Rwanda. We report a confirmatory prevalence study focused on gender‐specific observations. Methods A cross‐sectional door‐to‐door approach was used in three rural villages. First, epilepsy screening using the Kinyarwanda version of the Limoges questionnaire was performed. Second, confirmation of epilepsy diagnosis was completed by trained physicians. Results In total, 2681 persons (56.14% female) were screened. Of 168 positively screened, 128 persons were diagnosed with epilepsy confirming the prevalence of lifetime epilepsy of 47.7‰ (CI 39.8–56.8). The diagnosis gap was 62.5% with 80 newly diagnosed. The overall female:male ratio was 1.61:1.00. A male preponderance below 9 years of age inverted to a female preponderance above 20 years of age. Female PwE had an older age at first seizure, reported different reasons for not seeking care, and differed from male PwE in possible etiology. For previously diagnosed PwE, the treatment gap was more than 77%. Conclusion A high prevalence in rural areas was confirmed, with an observed female/male ratio among the highest of published door‐to‐door surveys in SSA. Gender differences in associated co‐morbidities and age at first seizure warrant future research of underlying etiologies and possible survival bias. A better understanding and focus on gender‐associated care‐seeking patterns, education, and specific needs are recommended.
format	article
author	Peter Dedeken Fidele Sebera Sylvestre Mutungirehe Ieme Garrez Josiane Umwiringirwa Frank Van Steenkiste Paul A. J. M. Boon Dirk E. Teuwen
author_facet	Peter Dedeken Fidele Sebera Sylvestre Mutungirehe Ieme Garrez Josiane Umwiringirwa Frank Van Steenkiste Paul A. J. M. Boon Dirk E. Teuwen
author_sort	Peter Dedeken
title	High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_short	High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_full	High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_fullStr	High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_full_unstemmed	High prevalence of epilepsy in Northern Rwanda: Exploring gender differences
title_sort	high prevalence of epilepsy in northern rwanda: exploring gender differences
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/76b26972415f4425ac6d62b7c4e5953d
work_keys_str_mv	AT peterdedeken highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT fidelesebera highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT sylvestremutungirehe highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT iemegarrez highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT josianeumwiringirwa highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT frankvansteenkiste highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT paulajmboon highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences AT dirketeuwen highprevalenceofepilepsyinnorthernrwandaexploringgenderdifferences
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High prevalence of epilepsy in Northern Rwanda: Exploring gender differences

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