Prevalence of epilepsy in rural Bolivia - A door-to-door survey

Objective: To carry out a door-to-door survey in rural areas of the Cordill era Province, Santa Cruz Department, Bolivia, to determine the prevalence o f neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuro pathy) in a sample of approximately 10,000 inhabitants. Methods: A team of nondoctor health workers administered a standard screening instrument for n eurologic diseases-a slightly modified version of the World Health Organiza tion protocol. All subjects found positive during the screening underwent a neurologic examination. Results: On screening, the authors found 1,130 pos itive subjects, of whom 1,027 were then investigated by neurologists. On th e basis of the definition proposed by the International League Against Epil epsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of w hom had active epilepsy (prevalence, 11.1/1000) on the prevalence day (Nove mber 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year a ge group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1, 000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standa rd EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the Intern ational League Against Epilepsy. The mean age at onset was 20.7 years for p artial seizures and 13.6 years for generalized seizures. Only 10.5% of pati ents had received specific treatment for more than 2 months of their life. Conclusion: This report on epilepsy prevalence in Bolivia confirms that epi lepsy is a major health problem in rural areas of developing countries.