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Prevalence of pediatric and adolescent epilepsy in India: A systematic review and meta-analysis
Mamta Patel1, Akhil Dhanesh Goel2, Lokesh Saini1
1Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Insights
Epilepsy affects 0.8% of Indian children and adolescents, with prevalence varying by region. Addressing this significant public health issue requires improved healthcare access and targeted interventions to bridge the treatment gap.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Epilepsy is a prevalent neurological disorder, disproportionately affecting children globally.
- In low and middle-income countries like India, children with epilepsy face significant barriers to care, widening the treatment gap.
Purpose of the Study:
- To determine the pooled prevalence of epilepsy in pediatric and adolescent populations in India.
- To analyze regional variations in epilepsy prevalence and identify potential biases in existing research.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Searched PubMed, Scopus, and Shodhganga for community-based studies on epilepsy in individuals aged 0-19 years in India.
- Employed random-effect models for data synthesis and conducted subgroup analyses by geographic zone and gender.
Main Results:
- Thirteen studies with seventeen datasets met the inclusion criteria.
- The overall pooled prevalence of pediatric and adolescent epilepsy in India was found to be 0.8% (95% CI: 0.6%-1.0%).
- Significant regional variations were observed, with the North-Eastern zone exhibiting the highest prevalence (2.3%) and the Central zone the lowest (0.4%). Publication bias and high heterogeneity (I²=93%) were noted.
Conclusions:
- Epilepsy represents a substantial public health challenge for children and families in India.
- Effective management necessitates tailored, age-specific interventions and comprehensive support services.
- Improving healthcare accessibility and closing the treatment gap for pediatric epilepsy in India are critical public health priorities.
Introduction:
Epilepsy is a widespread neurological disorder that affects millions of people worldwide, with a large proportion of cases emerging in childhood. Many children with epilepsy in low and middle-income countries, such as India, encounter obstacles to care despite effective treatments, which add to the treatment gap.
Methodology:
A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Scopus and Shodhganga databases were searched for studies on epilepsy prevalence in pediatric and adolescent groups aged 0 to 19 years in India. Eligible studies were identified, and data were collected and synthesised using random-effect models. Geographic zones and gender were used to conduct subgroup analysis.
Results:
Thirteen community-based studies with seventeen datasets satisfied the inclusion requirements. The overall pooled prevalence of paediatric and adolescent epilepsy in India is 0.8 % (95 % CI: 0.6 %, 1.0 %). Significant variation was found among Indian zones according to subgroup analysis, with the Central zone showing the lowest prevalence (0.4 %) and the North-Eastern zone showing the highest prevalence (2.3 %). A Doi plot revealed major asymmetry with an LFK index of 4.24, indicating publication bias and small study effects. The studies had a high degree of heterogeneity (I2 = 93 %).
Conclusion:
In India, epilepsy affects a large number of children and families, posing a significant public health burden. Effective management requires age-specific strategies for specialised interventions and full support services. This study underscores the necessity of improving healthcare access and addressing the treatment gap for children with epilepsy in India.
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