The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital

<p>Abstract</p> <p>Background</p> <p>Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the im...

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Main Authors: Maitland Kathryn, Ndiritu Moses, Kazungu Tony, Gatakaa Hellen, Kahindi Michael, Gwer Samson, Idro Richard, Neville Brian GR, Kager Piet A, Newton Charles RJC
Format: Article
Language:English
Published: BMC 2008-02-01
Series:BMC Pediatrics
Online Access:http://www.biomedcentral.com/1471-2431/8/5
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spelling doaj-3f05a70234b24e50a18a192171363b6f2020-11-25T00:18:54ZengBMCBMC Pediatrics1471-24312008-02-0181510.1186/1471-2431-8-5The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospitalMaitland KathrynNdiritu MosesKazungu TonyGatakaa HellenKahindi MichaelGwer SamsonIdro RichardNeville Brian GRKager Piet ANewton Charles RJC<p>Abstract</p> <p>Background</p> <p>Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya.</p> <p>Methods</p> <p>We recruited all children with and without seizures, aged 0–13 years and admitted to Kilifi District hospital over 2 years from 1<sup>st </sup>December 2004 to 30<sup>th </sup>November 2006. Only incident admissions from a defined area were included. Patients with epilepsy were excluded. The population denominator, the number of children in the community on 30<sup>th </sup>November 2005 (study midpoint), was modelled from a census data.</p> <p>Results</p> <p>Seizures were reported in 900/4,921(18.3%) incident admissions and at least 98 had status epilepticus. The incidence of acute seizures in children 0–13 years was 425 (95%CI 386, 466) per 100,000/year and was 879 (95%CI 795, 968) per 100,000/year in children <5 years. This incidence data may however be an underestimate of the true incidence in the community. Over 80% of the seizures were associated with infections. Neonatal infections (28/43 [65.1%]) and falciparum malaria (476/821 [58.0%]) were the main diseases associated with seizures in neonates and in children six months or older respectively. Falciparum malaria was also the main illness (56/98 [57.1%]) associated with status epilepticus. Other illnesses associated with seizures included pyogenic meningitis, respiratory tract infections and gastroenteritis. Twenty-eight children (3.1%) with seizures died and 11 surviving children (1.3%) had gross neurological deficits on discharge. Status epilepticus, focal seizures, coma, metabolic acidosis, bacteraemia, and pyogenic meningitis were independently associated with mortality; while status epilepticus, hypoxic ischaemic encephalopathy and pyogenic meningitis were independently associated with neurological deficits on discharge.</p> <p>Conclusion</p> <p>There is a high incidence of acute seizures in children living in this malaria endemic area of Kenya. The most important causes are diseases that are preventable with available public health programs.</p> http://www.biomedcentral.com/1471-2431/8/5
collection DOAJ
language English
format Article
sources DOAJ
author Maitland Kathryn
Ndiritu Moses
Kazungu Tony
Gatakaa Hellen
Kahindi Michael
Gwer Samson
Idro Richard
Neville Brian GR
Kager Piet A
Newton Charles RJC
spellingShingle Maitland Kathryn
Ndiritu Moses
Kazungu Tony
Gatakaa Hellen
Kahindi Michael
Gwer Samson
Idro Richard
Neville Brian GR
Kager Piet A
Newton Charles RJC
The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
BMC Pediatrics
author_facet Maitland Kathryn
Ndiritu Moses
Kazungu Tony
Gatakaa Hellen
Kahindi Michael
Gwer Samson
Idro Richard
Neville Brian GR
Kager Piet A
Newton Charles RJC
author_sort Maitland Kathryn
title The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
title_short The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
title_full The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
title_fullStr The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
title_full_unstemmed The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital
title_sort incidence, aetiology and outcome of acute seizures in children admitted to a rural kenyan district hospital
publisher BMC
series BMC Pediatrics
issn 1471-2431
publishDate 2008-02-01
description <p>Abstract</p> <p>Background</p> <p>Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya.</p> <p>Methods</p> <p>We recruited all children with and without seizures, aged 0–13 years and admitted to Kilifi District hospital over 2 years from 1<sup>st </sup>December 2004 to 30<sup>th </sup>November 2006. Only incident admissions from a defined area were included. Patients with epilepsy were excluded. The population denominator, the number of children in the community on 30<sup>th </sup>November 2005 (study midpoint), was modelled from a census data.</p> <p>Results</p> <p>Seizures were reported in 900/4,921(18.3%) incident admissions and at least 98 had status epilepticus. The incidence of acute seizures in children 0–13 years was 425 (95%CI 386, 466) per 100,000/year and was 879 (95%CI 795, 968) per 100,000/year in children <5 years. This incidence data may however be an underestimate of the true incidence in the community. Over 80% of the seizures were associated with infections. Neonatal infections (28/43 [65.1%]) and falciparum malaria (476/821 [58.0%]) were the main diseases associated with seizures in neonates and in children six months or older respectively. Falciparum malaria was also the main illness (56/98 [57.1%]) associated with status epilepticus. Other illnesses associated with seizures included pyogenic meningitis, respiratory tract infections and gastroenteritis. Twenty-eight children (3.1%) with seizures died and 11 surviving children (1.3%) had gross neurological deficits on discharge. Status epilepticus, focal seizures, coma, metabolic acidosis, bacteraemia, and pyogenic meningitis were independently associated with mortality; while status epilepticus, hypoxic ischaemic encephalopathy and pyogenic meningitis were independently associated with neurological deficits on discharge.</p> <p>Conclusion</p> <p>There is a high incidence of acute seizures in children living in this malaria endemic area of Kenya. The most important causes are diseases that are preventable with available public health programs.</p>
url http://www.biomedcentral.com/1471-2431/8/5
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