The pattern of epileptic seizures in rural Tanzania

The study was conducted with the aim of assessing the hospital prevalence and aetiology of epileptic seizures with special emphasis on epilepsy and febrile convulsions in a rural African hospital. Symptomatic as well as unprovoked epileptic seizures have also been accounted for.

All patients admitted over a period of nine months to the Haydom Lutheran Hospital in Northern Tanzania were screened for neurological disorders. The present study focuses on epileptic seizures only. All patients with convulsions were seen prospectively in consecutive order by one of the authors (ASW).

Of 8676 admissions 740 patients (8.5%) were given a neurological diagnosis. The most important neurological disorder was epileptic seizures. 272 patients (3.1%) had at least one seizure. Febrile convulsions were responsible for 30% (82 patients) of all epileptic seizures, followed by epilepsy with 24% (65 patients). Symptomatic (provoked) epileptic seizures made up for 27% (72 patients) and were caused by cerebral infections, eclampsia, strokes and head injuries. Seizures due to space-occupying lesions and alcohol withdrawal were also seen. In some cases, the reason remained obscure. The inpatient mortality of all seizures was 19%, being mainly due to the outcome of symptomatic seizures. The socioeconomic burden of hospital treatment of seizures was high corresponding to an average of US $ 20.2, paying for an average of 16.9+/-29.0 days in hospital.

Contrary to developed countries, the most frequent neurological disorder amongst hospital inpatients was seizures. Febrile convulsions and epilepsy were major causes.