Risk factors for epilepsy in a rural area in Tanzania - A community-based case-control study

Background and Methods: The high prevalence of epilepsy detected in rural T anzania by Dr. Jilek-Aall since 1960, was verified by the World Health Orga nization (WHO) survey on neurological and seizure disorders. Neurologists a nd psychiatrists further interviewed both patients and controls using stand ard methods. The presence of possible risk factors was complemented by corr oborative evidence through interviewing close relatives and scrutinizing me dical records. Seizures were classified based on clinical symptoms and the use of EEG. Results: A family history of epilepsy in first-degree relatives was found in 46.6% of patients, but in only 19.6% of controls. The odds ra tio for family history with epilepsy was 3.52 (95% confidence interval, CI 2.4-5.74, p < 0.001). A past history of febrile convulsion was found in 44% of patients in comparison to 23% of the control group which was significan t (odds ratio 2.4, 95% CI 1.5-3.8; p < 0.001). A history of intrapartum com plications was found in 12.1% of patients and 1.8% of controls (odds ratio 7.3, 95% CI 2.5-25.2; p < 0.002). Head injury was not a significant risk fa ctor for epilepsy in this rural community. Conclusion: The results indicate d a strongly independent association between four factors and the risk of d eveloping epilepsy. It would seem more likely that previous brain insults/d iseases play a significant major role in the cause of epilepsy in the Mahen ge area. However, a genetic predisposition to low threshold for convulsions cannot be excluded. Copyright (C) 2001 S. Karger AG, Basel.