Purpose: To study the incidence of epilepsy in a rural area of Ethiopi
a. Methods: A community-based study was performed in a random sample o
f villages with 61,686 inhabitants in a rural area of central Ethiopia
. In a door-to-door survey, all inhabitants in the study area were int
erviewed about seizures. A standardized protocol was used. All new cas
es with epilepsy that had occurred since a previous study was made 3.5
years earlier were included. Fifty-three of the subjects were investi
gated with EEG. Results: One-hundred thirty-nine incident cases were i
dentified, corresponding to an annual incidence of 64 in 100,000 inhab
itants [95% confidence interval (CI) 44-84]. The corresponding rate fo
r males was 72 (CI42-102); for females, it was 57 (CI31-84). The highe
st age-specific incidence occurred in the youngest age groups (0-9 yea
rs); the next highest was in the group aged 10-19 years. Generalized c
onvulsive seizures occurred in 69%, partial seizures occurred in 20%,
and unclassifiable seizures occurred in 11%. Seizures occurred daily i
n 10% and weekly in another 14%; 33% had monthly seizures. Twenty-two
percent had a family history of epilepsy. A history of head trauma was
ascertained in 5.7% and was the most common possible etiologic factor
identified. Thirteen percent were treated with antiepileptic drugs (A
EDs). Conclusions: The incidence of epilepsy in Ethiopia is high. A hi
gh incidence in combination with a prevalence of epilepsy in the study
area comparable to that in the rest of the world may be explained by
a high degree of spontaneous remission of epilepsy and/or a high morta
lity due to epilepsy. Despite health education on epilepsy given to th
e community, a minority of subjects were treated with AEDs, which may
reflect the inadequacies of the health services and transportation dif
ficulties faced by the patients.