OBJECTIVE: Determine the prevalence of active epilepsy among children in northern Nigeria. METHODS: Epilepsy-trained community health workers (CHWs) screened children, ages 6 months - < 17 years, door-to-door for epilepsy using a Hausa language validated epilepsy screening tool designed to detect convulsive and non-convulsive epilepsies. Sampling of houses screened in Zaria, Kaduna and Kano metropolitan areas was performed using a random walk method developed by the World Health Organization. Children who screened positive were evaluated by physicians and CHWs; final diagnosis of epilepsy was made by physicians with epilepsy expertise. The screening data and all other data in the BRIDGE studies were entered directly into a REDCap database and transmitted to the BRIDGE office in Kano, and the data coordinating center at Vanderbilt Institute for Global Health. RESULTS: 1197 of 30,579 children who were screened door-to-door using the Hausa language epilepsy screening tool screened positive; final epilepsy diagnoses were verified by physicians with expertise in epilepsy in 1128 of these children (predictive value of a positive epilepsy screen = 94%). The prevalence of active epilepsy was 36.9 per 1000 children (95% CI = 34.8, 39.0). CONCLUSION: The prevalence of active epilepsy in a door-to-door survey in the local language, using a screening tool designed to ascertain convulsive and non-convulsive epilepsy (e.g., focal onset with alteration of awareness, absence), administered by epilepsy-trained CHWs was higher than prior estimates. The burden of epilepsy in these communities may have been significantly under-estimated by previous studies.

Edwin Trevathan
Vanderbilt University Medical Center
United States

Aminu Abdullahi
Aminu Kano Teaching Hospital
Nigeria

Hafsat Ahmad
Ahmadu Bello University
Nigeria

Folorunsho Nuhu
Federal Neuropsychiatric Hospital
Nigeria

Umar Sabo
Aminu Kano Teaching Hospital
Nigeria

Liping Du
Vanderbilt University Medical Center
United States

Ibrahim Sodangi
Aminu Kano Teaching Hospital
Nigeria

Angela Paolucci
Vanderbilt University Medical Center
United States

Lizet Tirres
Vanderbilt University Medical Center
United States

Gregory Ayers
Vanderbilt University Medical Center
United States

Zubairu Iliyasu
Aminu Kano Teaching Hospital
Nigeria