Evidence map›Paper›PMID 38976998›Full record

ArticleThe Lancet. Global health2024

Prevalence of all epilepsies in urban informal settlements in Nairobi, Kenya: a two-stage population-based study.

Daniel M Mwanga, Damazo T Kadengye, Peter O Otieno, Frederick M Wekesah, Isaac C Kipchirchir, George O Muhua, Joan W Kinuthia, Thomas Kwasa, Abigael Machuka, Quincy Mongare and 8 more

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In one paragraph

Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Daniel M MwangaAfrican Population and Health Research Center, Nairobi, Kenya; Department of Mathematics, University of Nairobi, Nairobi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK. Electronic address: dmwanga@aphrc.org.
Damazo T KadengyeAfrican Population and Health Research Center, Nairobi, Kenya; Department of Statistics and Economics, Kabale University, Kabale, Uganda; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Peter O OtienoAfrican Population and Health Research Center, Nairobi, Kenya; Department of Public & Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Frederick M WekesahAfrican Population and Health Research Center, Nairobi, Kenya; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Isaac C KipchirchirDepartment of Mathematics, University of Nairobi, Nairobi, Kenya.
George O MuhuaDepartment of Mathematics, University of Nairobi, Nairobi, Kenya.
Joan W KinuthiaAfrican Population and Health Research Center, Nairobi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Thomas KwasaDepartment of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Abigael MachukaDepartment of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Quincy MongareDepartment of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Samuel IddiAfrican Population and Health Research Center, Nairobi, Kenya; Department of Statistics and Actuarial Science, University of Ghana, Accra, Ghana; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Gabriel Davis JonesOxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Josemir W SanderDepartment of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK; Chalfont Centre for Epilepsy, Buckinghamshire, UK; Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands; Neurology Department, West China Hospital, Sichuan University, Chengdu, China; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Symon M KariukiDepartment of Psychiatry, University of Oxford, Oxford, UK; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Public Health, Pwani University, Kilifi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Arjune SenOxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Charles R NewtonOxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
Gershim AsikiAfrican Population and Health Research Center, Nairobi, Kenya; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; The Centre for Global Epilepsy, University of Oxford, Oxford, UK.
EPInA Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWHO estimates that more than 50 million people worldwide have epilepsy and 80% of cases are in low-income and middle-income countries. Most studies in Africa have focused on active convulsive epilepsy in rural areas, but there are few data in urban settings. We aimed to estimate the prevalence and spatial distribution of all epilepsies in two urban informal settlements in Nairobi, Kenya.

methodsWe did a two-stage population-based cross-sectional study of residents in a demographic surveillance system covering two informal settlements in Nairobi, Kenya (Korogocho and Viwandani). Stage 1 screened all household members using a validated epilepsy screening questionnaire to detect possible cases. In stage 2, those identified with possible seizures and a proportion of those screening negative were invited to local clinics for clinical and neurological assessments by a neurologist. Seizures were classified following the International League Against Epilepsy recommendations. We adjusted for attrition between the two stages using multiple imputations and for sensitivity by dividing estimates by the sensitivity value of the screening tool. Complementary log-log regression was used to assess prevalence differences by participant socio-demographics.

findingsA total of 56 425 individuals were screened during stage 1 (between Sept 17 and Dec 23, 2021) during which 1126 were classified as potential epilepsy cases. A total of 873 were assessed by a neurologist in stage 2 (between April 12 and Aug 6, 2022) during which 528 were confirmed as epilepsy cases. 253 potential cases were not assessed by a neurologist due to attrition. 30 179 (53·5%) of the 56 425 individuals were male and 26 246 (46·5%) were female. The median age was 24 years (IQR 11-35). Attrition-adjusted and sensitivity-adjusted prevalence for all types of epilepsy was 11·9 cases per 1000 people (95% CI 11·0-12·8), convulsive epilepsy was 8·7 cases per 1000 people (8·0-9·6), and non-convulsive epilepsy was 3·2 cases per 1000 people (2·7-3·7). Overall prevalence was highest among separated or divorced individuals at 20·3 cases per 1000 people (95% CI 15·9-24·7), unemployed people at 18·8 cases per 1000 people (16·2-21·4), those with no formal education at 18·5 cases per 1000 people (16·3-20·7), and adolescents aged 13-18 years at 15·2 cases per 1000 people (12·0-18·5). The epilepsy diagnostic gap was 80%.

interpretationEpilepsy is common in urban informal settlements of Nairobi, with large diagnostic gaps. Targeted interventions are needed to increase early epilepsy detection, particularly among vulnerable groups, to enable prompt treatment and prevention of adverse social consequences.

fundingNational Institute for Health Research using Official Development Assistance.

Indexed as

EpilepsyUrban PopulationAdolescentAdultChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantKenyaMaleMiddle AgedPrevalenceYoung Adult

Identifiers

PMID38976998
PMCPMC11254782

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.