Prevalence of active convulsive epilepsy in Dunukofia County in South East Nigeria: a door-to-door survey

BackgroundRegional variations in the prevalence of epilepsy in Nigeria have been validated. We determined the prevalence of active convulsive epilepsy in six towns of Dunukofia County and compared the findings with existing regional prevalence data.MethodsPatients with active convulsive epilepsy were identified in a two-phase cross-sectional descriptive community-based door-to-door study using a validated questionnaire in the first phase and a modified epilepsy questionnaire developed for tropical countries in the second phase after clinical assessment and electroencephalogram.ResultsA total of 9000 persons were surveyed in the first stage, of which 56 had active convulsive epilepsy. The highest point prevalence was found in Nawgu, 7.3 per 1000 (95% confidence interval [CI]: 2.7-15.8) while the lowest point prevalence of 5.0 per 1000 (95% CI: 2.0-10.3) was obtained in Ukpo. The observed rates after age adjustment to the Nigeria standard population of 4.9-5.7 per 1000 in this study, which was comparable to 4.6-5.7 per 1000 reported in previous studies, besides two isolated reports of rates as low as 2.7 per 1000 and as high as 20.0 per 1000 reported in the past from two sites in the northern section of the region.ConclusionsThe burden of epilepsy is high in this region, and intra-regional differences in prevalence rates exist. The implications of this finding do not only border on the care of people living with epilepsy but also highlight the need to identify local risk factors as well as appropriate and locally acceptable approaches to reduce the epilepsy burden.