A comprehensive community epilepsy programme: the Nakuru project.

A T Feksi; J Kaamugisha; S Gatiti; J W Sander; S D Shorvon

doi:10.1016/0920-1211(91)90072-n

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A comprehensive community epilepsy programme: the Nakuru project.

A T Feksi·J Kaamugisha·S Gatiti·J W Sander·S D Shorvon

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Abstract

The methodology of a programme of investigation of epilepsy carried out at a community health level in Nakuru district, Kenya, East Africa, and the characteristics of patients with tonic-clonic epilepsy in this community, are presented. The study identified a group of 302 patients with untreated generalised tonic-clonic seizures (with or without other seizure types) from the general population. Case finding was carried out using the key informant method over a 12-month period. The clinical characteristics of this cohort of patients, the majority of whom had never had previous contact with a formal medical system, is described. Most were young, living in a rural area, with a mean age of seizure onset of 14 years and a mean duration of seizures of 7 years. Thirty-eight per cent had a clinically evident focal disturbance associated with the tonic-clonic seizures. In 77% of the cases, no aetiology was established. Most cases had had a substantial number of seizures during the course of their condition and only about a third of the patients had less than 1 seizure a month in the previous year. Only 26% had ever had previous anti-epileptic drug treatment. In addition to the medical inquiry, psychological and sociological studies were also conducted and a prospective treatment programme was carried out. Throughout the study, strict definitions and standardised instruments were used, and the study was the result of a collaboration between local investigators, an international neurological team, the Kenyan Government agencies and the pharmaceutical industry. We consider this a model for community-based investigations for the management of epilepsy in developing countries.

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Adolescent Adult Aged Anticonvulsants Child Community Health Centers Community Health Services Epilepsy Female Humans Kenya Male Middle Aged Journal Article Research Support, Non-U.S. Gov't

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A T Feksi, J Kaamugisha, S Gatiti, J W Sander, S D Shorvon. 1991. A comprehensive community epilepsy programme: the Nakuru project.. https://doi.org/10.1016/0920-1211(91)90072-n

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