Incidence, causes and phenotypes of acute seizures in Kenyan children post the malaria-decline period
نویسندگان
چکیده
BACKGROUND Acute seizures are a common cause of paediatric admissions to hospitals in Africa, and malaria is an important cause of seizures in endemic areas. Malaria has declined in the past decade whilst neonatal admissions have increased, both which may affect the incidence and phenotypes of acute seizures in African children. METHODS We examined the effect of recent decline in malaria and the increasing burden of neonatal admissions on the incidence, causes and phenotypes of acute seizures admitted to hospital from 2009-2013. We used logistic regression to measure associations and Poisson regression to calculate the incidence and rate ratios. RESULTS The overall incidence of acute seizures over the 5-year period was 312 per 100,000/year (95% CI, 295-329): 116 per 100,000/year (95% CI, 106-127) for complex seizures and 443 per 100,000 live births (95% CI, 383-512) for neonatal seizures. Over the period, there was an increase in incidence of seizures-attributable to malaria (SAM) (incidence rate ratio (IRR) = 1.25; p < 0.001), but neither non-SAM (IRR = 1.03; p = 0.569) nor neonatal seizures (IRR = 0.99; p = 0.905). Important causes of acute seizures were malaria (33%) and respiratory tract infections (19%); and for neonatal seizures were neonatal sepsis (51%), hypoglycemia (41%) and hypoxic-ischemic encephalopathy (21%). Mortality occurred in 6% of all acute seizures, being more common in complex seizures (8%) and neonatal seizures (10 %) than other seizures (p < 0.001 for both comparisons). CONCLUSIONS Acute seizures remain common in children despite a decline in the incidence of malaria; suggesting that causes for these seizures need to be prevented in the community.
منابع مشابه
Acute seizures attributable to falciparum malaria in an endemic area on the Kenyan coast
Falciparum malaria is an important cause of acute symptomatic seizures in children admitted to hospitals in sub-Saharan Africa, and these seizures are associated with neurological disabilities and epilepsy. However, it is difficult to determine the proportion of seizures attributable to malaria in endemic areas since a significant proportion of asymptomatic children have malaria parasitaemia. W...
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