Incidence and outcomes of childhood status epilepticus in Kano, northern Nigeria.

objectiveConvulsive status epilepticus (CSE) is a major neurological emergency in childhood, but population-based data from low- and middle-income countries remain limited. We estimated the incidence, mortality, neurological outcomes, and predictors of adverse outcomes among children with CSE in Kano, northern Nigeria.

methodsWe conducted a review of one-year surveillance data on childhood CSE across eight hospitals and a random sample of eight primary health centers in the Kano metropolis. Cases were identified using standardized definitions and weighted to account for sampling at primary health centers. Demographic and clinical data were collected at presentation and during hospitalization. Logistic regression analysis was used to identify predictors of mortality and new-onset neurological deficits.

resultsA total of 972 children with CSE were identified at participating hospitals, with additional cases detected at primary health centers. After weighting, an estimated 1921 CSE cases occurred during the study period, corresponding to an annual incidence of 98 per 100 000 children aged 1 month-14 years. Incidence was highest among infants (175 per 100 000). Among hospitalized children, in-hospital mortality was 24.7%, with more than half of the deaths occurring within 24 h of admission. New-onset neurologic deficits were observed in 9.6% of hospitalized survivors. In multivariable analysis, hypoglycemia at presentation, presumed meningoencephalitis, and CSE lasting longer than 30 min were independently associated with increased odds of death. Neurological deficits were associated with multiple CSE episodes, prolonged seizures, and presumed meningoencephalitis. SIGNIFICANCE: Childhood CSE in Kano is associated with a high incidence and substantial mortality, particularly among infants. Hypoglycemia, central nervous system infections, and prolonged seizures are key predictors of adverse outcomes. These findings highlight the need for improved early recognition and strengthened emergency seizure management in resource-limited settings. PLAIN LANGUAGE SUMMARY: Convulsive status epilepticus is a dangerous type of prolonged seizure in children. In this study from Kano, Nigeria, many children developed this condition and about one in four hospitalized patients died. Low blood sugar, suspected brain infections, and long seizures increased the risk of poor outcomes. Improving early treatment and emergency care may help reduce these deaths.