INCIDENCE OF EPILEPSY IN RURAL CENTRAL ETHIOPIA

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.