OBJECTIVES: Determine childhood status epilepticus (SE) associated short-term mortality in northern Nigeria. METHODS: 1408 children with SE, ages 30days to <15 years, managed using a standardized protocol with point-of-care EEG-video, were enrolled into a cohort upon arrival to emergency units in Kano, with prospective recording of SE and clinical data into a REDCap database. Age-specific mortality rates, and odd ratios for clinical predictors of short-term SE-associated mortality were determined. Hypoglycemia is defined as RBS of < 2.2mmol/l or < 3.0mmol/l in severely malnourished children.[1] Benzodiazepine resistant (BR) SE is defined as persistence of seizure after 2 weight-appropriate doses of a benzodiazepine.[2] RESULTS: Death within one-month of hospital discharge (short-term mortality), was 21% (300 of 1408); 267 of 1408 (19%) died prior to hospital discharge. Short-term mortality was higher among females (24%) than males (19%). Mortality was higher among the infants (1 – 11 months; 43%), and children < 5 years (20%), and was lowest among children ages 6 – 9 years (11%). Age <1 year, hypoglycemia (OR = 7.15; 95% CI = 4.18, 12.22), SE duration > 30 minutes (OR = 1.35;95% CI = 1.05, 1.75) and BR SE (OR = 2.75; 95% CI = 1.48, 5.12) were significantly associated with higher risk of death. CONCLUSION: SE-associated mortality is high in northern Nigeria, even with a standardized diagnostic and treatment protocol, point-of-care EEG-video, and trained SE treatment teams. Infancy, hypoglycemia, BR, and prolonged SE are all associated with higher SE-associated mortality.

Umar Abba Sabo
Bayero University Kano & Aminu Kano Teaching Hospital
Nigeria

Yasir Sani
Aminu Kano Teaching Hospital
Nigeria

Halima Adamu
Aminu Kano Teaching Hospital
Nigeria

Fatime Othman Kyari
Aminu Kano Teaching Hospital
Nigeria

Aminu Taura Abdullahi
Bayero University Kano & Aminu Kano Teaching Hospital
Nigeria

Aliyu Ibrahim
Bayero University Kano & Aminu Kano Teaching Hospital
Nigeria

Kabiru Lbrahim Gurama
Bayero University Kano & Aminu Kano Teaching Hospital
Nigeria

Zuwaira Ma'aruf
Aminu Kano Teaching Hospital
Nigeria

Mansurah Abdulazeez
Bayero University Kano
Nigeria

Shamsu Lekan Pedro
Bayero University Kano
Nigeria

Angela Paolucci
Vanderbilt University
United States

Lizet Tirres
Vanderbilt University
United States

Maggie Mash-Nation
Baptist College of Health Sciences
United States

Abubakar Yakasai
Aminu Kano Teaching Hospital
Nigeria

Muhammad Umar
Aminu Kano Teaching Hospital
Nigeria

Sani Wada
Aminu Kano Teaching Hospital
Nigeria

Halima Kabir
Bayero University Kano & Aminu Kano Teaching Hospital
Nigeria

Binta Wudil Jibir
Khalifa Isyaku Rabiu Paediatric Hospital
Nigeria

Michele Ramsay
University of Witwatersrand
Nigeria

Edwin Trevathan
Vanderbilt University
United States