scholarly journals Clinical profile of childhood epilepsy in Nigerian children seen in a tertiary hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1138 ◽  
Author(s):  
Komomo Ibor Eyong ◽  
Emmanuel E. Ekanem ◽  
Asindi A. Asindi ◽  
Torty Chimaeze
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Age At Onset ◽  
Central Nervous System Infection ◽  
Birth Asphyxia ◽  
Sub Saharan Africa ◽  
Cns Infection ◽  
Seizure Type ◽  
P Value ◽  
Neurology Clinic

Background: Epilepsies are the most common conditions encountered in most paediatric neurology clinics in many parts of the developing world. In sub-Saharan Africa epilepsies are secondary, reflecting persistently high risks at birth, and the adverse neurological sequelae of CNS infections during and beyond childhood. The study was designed to determine the clinical pattern of childhood epilepsies, probable aetiologies and associated comorbidities of the disease children.Methods: The study was conducted within an 18 months period among children having established epilepsy attending the Neurology Clinic of University of Calabar Teaching Hospital (UCTH). The children and or care givers were interviewed by the authors and the following data were obtained and recorded in a questionnaire; bio data, age at onset of seizure. History was obtained to determine the possible cause of the seizure, type of epilepsy and associated comorbidities. The data obtained was analysed with SPSS version 20. P-value <0.05 was considered significant.Results: Of the one hundred eighty children seen with various neurological morbidities during the study period, one hundred and seven had epilepsy which constitutes 59.4%. Generalized tonic clonic epilepsy was the commonest type of epilepsy found in 66 (61.1%) of the children with epilepsy, followed by simple partial and myoclonic epilepsy in 18.5% and 6.5% respectively. Severe birth asphyxia was responsible was the commonest identifiable cause of epilepsy in 19 (17.8%) of cases while central nervous system infection accounted for 14 (13.1%). Cerebral palsy was the commonest comorbidity in 20 (18.6%) followed by mental retardation in 17 (15.9%) of the children.Conclusions: The study showed epilepsy to be the commonest neurological presentation among children presenting at the paediatric neurology clinic of our facility. Primary generalised tonic clonic epilepsy was the commonest type of epilepsy seen, followed by simple partial seizures. Cerebral palsy and mental retardation were the main associated comorbidities. Birth injuries mainly severe birth asphyxia and CNS infection were the major causes of epilepsy in our study. In conclusion, epilepsy is the commonest neurological morbidity in our environment, limited facilities and resources still militate against identifying the actual aetiology in most children with the disease. Effort should be intensifying to eradicate the preventable causes of the disease.

scholarly journals Co-morbidities among epilepsy patients: experience in Bangladesh

2014 ◽  
Vol 24 (2) ◽  
pp. 65-69
Author(s):  
Rajib Nayan Chowdhury ◽  
ATM Hasibul Hasan ◽  
Kazi Mohibur Rahman ◽  
Sudip Ranjan Deb
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Psychiatric Disorder ◽  
Tertiary Care ◽  
Pain Disorder ◽  
P Value ◽  
Care Hospital ◽  
Comorbid Conditions ◽  
Generalized Epilepsy ◽  
Patients Experience

Objective: To determine comprehensively all the major comorbid diseases observed among epilepsy patients. Methods: In this observational study, 1168 patients were recruited from outpatient based epilepsy clinic in a tertiary care hospital. Four categories of comorbid conditions namely neuropsychiatric, developmental (mental retardation, cerebral palsy), pain disorder (migraine) and others (hypertension, diabetes, stroke) were evaluated in these patients through a prefilled questionnaire and data were then analyzed. Epilepsy were broadly classified into generalized epilepsy (GE), localization related epilepsy (LRE), symptomatic and unclassified. Result: Among the 1168 subjects we included in this study, 71.5% were male. The most common age group at the time of interview was 11-20 years (36.8%). Only 29 (2.5%) respondents were older than 60 years. Among the listed comorbid conditions, mental retardation was the most common entity (15.5%), followed by psychiatric disorder (12.8%), hypertension (5.6%), migraine (5.4%) and cerebral palsy (5.0%). Only 1.5% had diabetes and 0.6% had stroke. Mental retardation and cerebral palsy were more common and significantly associated (p=0.0001 and 0.005) with GE patients (95 and 44), psychiatric disorder was also common among GE patients (108)) with a p value of 0.0001. But migraine was more common and significantly associated (p=0.0001) with LRE patients (46). Stroke was only present in symptomatic epilepsy group (7) and diabetes was present only in GE patients (19). Both were significant (p= 0.0001 and 0.01). But hypertension among different epilepsy groups was not significant (p=0.08). Conclusion: Neuropsychiatric, developmental and pain disorder are common comorbid associations within different epilepsy syndromes which may need special care during management of epilepsy patients. DOI: http://dx.doi.org/10.3329/bjmed.v24i2.20219 Bangladesh J Medicine 2013; 24 : 65-69

scholarly journals HUBUNGAN PENGETAHUAN, SIKAP DAN MOTIVASI IBU DENGAN PERILAKU PENCEGAHAN KEJANG DEMAM BERULANG PADA BALITA USIA 1- 5 TAHUN DI RSUD RADEN MATTAHER JAMBI

2018 ◽  
Vol 7 (2) ◽  
pp. 165
Author(s):  
Untung Tarunaji ◽  
Fithriyani Fithriyani
Keyword(s):  
Febrile Seizure ◽  
Quantitative Research ◽  
Central Nervous System Infection ◽  
Febrile Seizures ◽  
Seizure Type ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Prevention Behavior ◽  
Chi Square Test

ABSTRACTA febrile seizure is a seizure that occurs when an infant or child has a fever without central nervous system infection that occurs at temperatures over 380 C. a febrile seizure is seizure type most often encountered in childhood. This study aimed to determine the correlation of knowledge, attitude and mother’s motivation with behavior of febrile seizures prevention in toddlers’ age 1-5 years in the child’s room RSUD Raden Mattaher Jambi year 2017. This is a quantitative research by using cross sectional design, it used Accidental Sampling by using questionnaire instrument. This study analyzed as univariate and bivariate by using chi-square test with significant levels 95% (<0.05).The findings indicated that, 35 respondents as many as 19 (54.3%) have low knowledge, less good attitude as many as 20 (57.1%), less good motivation as many as 18 (51.4%) and less good prevention behavior 18 (51.4%). The result of chi-square test indicated that there is the correlation of knowledge, attitude and mother’s motivation with behavior of febrile seizures prevention in toddlers age 1-5 years in the child’s room RSUD Raden Mattaher Jambi year 2017 with p-value < 0.05 while the motivation, there is no correlation with behavior of febrile seizures prevention in toddlers age 1-5 years in the child’s room RSUD Raden Mattaher Jambi year 2017 p-value > 0.05. It is expected to RSUD Raden Mattaher Jambi is not only providing treatment but also providing health education periodically to increase of knowledge, attitude and mother’s motivation so the febrile seizures do not reoccur.

scholarly journals Aetiology and comorbidities of cerebral palsy in a developing country

2018 ◽  
Vol 6 (10) ◽  
pp. 3246 ◽  
Author(s):  
Komomo I. Eyong ◽  
Asindi A. Asindi ◽  
Chimaeze Torty
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Social Class ◽  
Perinatal Care ◽  
Birth Asphyxia ◽  
Cortical Atrophy ◽  
Dominant Type ◽  
Care Givers ◽  
Neurology Clinic ◽  
Pregnancy And Delivery

Background: Cerebral palsy (CP) is a common disabling condition of movement and posture causing activity limitation arising from a static injury to the developing brain. Common risk factors for cerebral palsy in Africa include severe birth asphyxia, kernicterus and neonatal infections. This study is aimed at determining the aetiology and comorbidities associated with cerebral palsy in our environment.Methods: All children with CP presenting to the Paediatric Neurology clinic of the University of Calabar Teaching Hospital whose parent gave consent were recruited into the study. The biodata of the children and that of the parent’s/ care givers were obtained. A detailed pregnancy and delivery history, neonatal history, seizures during first three years of life and developmental mile stones was documented.Results: Seventy children with CP were recruited into the study of which 46 (65.7%) were males and 24 (34.3%) females. Majority of the children were from low social class and products of home, church or TBA’S delivery where supervision is poor. Severe birth asphyxia and CNS infections are the commonest identified risk factors. Spastic quadriplegic CP is the dominant type of CP followed by spastic hemiplegia. There is a significant statistical relationship between the aetiology and the type of CP. Epilepsy (60%) speech defect (42.9%) and microcephaly (40%) are the predominant comorbidities seen in the study. Cortical atrophy and ventricular dilatation are predominant CT findings in contrast to periventricular leukomalecia seen in developed countries.Conclusions: Majority of the patients with CP in this study are from low social class and were delivered in places with poor obstetrics care. Improved perinatal care through an adequate social support system may reduce the burden of the disease.

scholarly journals Changing Trends in Clinical Profile of Cerebral Palsy

2016 ◽  
Vol 27 (1) ◽  
pp. 10-13
Author(s):  
Vinay Goyal ◽  
Nonica Laisram ◽  
Tufail Muzaffar ◽  
Shikha Bhatnagar
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Aetiological Factor ◽  
Speech Impairment ◽  
Group A ◽  
Care Health ◽  
Group B ◽  
Previous Group

Abstract Background There may be change in clinical spectrum of cerebral palsy (CP) due to improvement in maternal and child care health service. The clinical profi le, aetiological factors and comorbidities of children with CP attending Department of PMR, VMMC & Safdarjang Hospital during the years 1981- 1989 and 2008 - 2012 were therefore compared and analysis done. Methods Four hundred and ten (group B) children with CP registered in last 4 years (2008 - 2012) at PMR Department of VMMC & Safdarjang Hospital were compared with previous study of 544 (group A) children during year 1981 - 1989 from same centre. Results Spastic CP remained most common in both the groups. Diplegia is commonest type of CP (38.78%) as compared to previous group where quadriplegia (34.9%) was most common. The mixed type showed a statistical signifi cant increase in percentage (group A: 0.18 % versus group B: 3.7 %). In aetiology, there is decrease in prenatal and postnatal causes and increase in natal causes which were statistically signifi cant. Birth asphyxia (50.3 %) remains the main aetiological factor as earlier (24.5%). Speech problems (59.7%), mental retardation (31.7%) and seizures (26.8%) are common comorbidities as compared to previous studies where mental retardation (47.2 %) was found to be most common followed by speech impairment (37%), visual impairment (9%) and seizures (8.8%). Conclusions Clinical profile of CP has evolved with an increase in diplegic and a decrease in quadriplegic CP.

scholarly journals Profile of People with Epilepsy seen at a Tertiary Hospital in North-West Nigeria

2020 ◽  
Vol 3 (3) ◽  
pp. 406-414
Author(s):  
EU Iwuozo ◽  
OR Obiako ◽  
MO Ogiator ◽  
A Ogunniyi
Keyword(s):  
Median Duration ◽  
University Teaching ◽  
Aetiological Factor ◽  
Seizure Type ◽  
P Value ◽  
Monthly Income ◽  
North West ◽  
Never Married ◽  
Neurology Clinic

Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons with epilepsy (PWE) have unique characteristics that have social impacts on the affected individuals and their family. This study sought to describe the profile of patients with epilepsy attending the out-patient neurology clinic in a tertiary health care centre in North West Nigeria. The study was carried out at Neurology clinic of Ahmadu Bello University Teaching Hospital Kaduna State, Nigeria from August 2013 to October 2014. Consecutively presenting PWE on follow-up were recruited after obtaining ethical approval and informed consent. Those recruited were at least 18 years and have been on routine follow-up for at least 1 year. Patients with clinical and electroencephalography (EEG) features suggestive of non-epileptic seizures, acute metabolic or febrile illness precipitating seizures were excluded. A structured questionnaire was used to obtain all relevant information. The data was analyzed using SPSS version 17 with p-value set at less than 0.05. A total of 103 PWE were recruited with median age of 29 years. More than 50% were in the 21-30 years age group. About 55.3% were single (never married), 58.2% were unemployed and earned < ₦50,000.00 monthly income. The median age of onset of epilepsy was 20 years, while median duration of illness was 7 years. About 50.5% were focal seizures, with traumatic head injury (14.6%) and febrile convulsion (12.6%) as aetiological factors, while 52.5% of them had no identifiable aetiological factor. About 96% were on antiepileptic drug monotherapy, 82% of them on carbamazepine only for a median duration of 7.5 years. Our study shows that epilepsy is predominant among the young population, who are mostly single (never married), unemployed, with poor monthly income occurring more as focal seizure type, with majority of them on carbamazepine monotherapy. There is the need for public enlightenment campaign and effort targeted at mitigating the prevalence of the disease among the young and productive population.

scholarly journals Evaluation of risk factors for cerebral palsy

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Dina Salama Abd Elmagid ◽  
Hend Magdy
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Intracranial Hemorrhage ◽  
Cns Infection ◽  
Motor Impairments ◽  
Cerebrovascular Accidents ◽  
Common Causes ◽  
Children With Cerebral Palsy ◽  
Infant Brain ◽  
Cns Malformation

Abstract Background Cerebral palsy (CP) has been identified as one of the most important and common causes of childhood disabilities worldwide and is often accompanied by multiple comorbidities. CP is defined as a group of disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The objective of our study was to describe main clinical pattern and motor impairments of our patients, and to evaluate the presence of risk factors and if there is a relation to the type of cerebral palsy. Methods Children with cerebral palsy were retrospectively enrolled over 2 years from the neurology outpatient clinics. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination. Results One thousand children with cerebral palsy were enrolled. Subjects were 64.4% male, with a median age of 2.5 years. The risk factors for cerebral palsy in our study were antenatal (21%), natal and post-natal (30.5%), post-neonatal (17.1%), and unidentified (31.4%). Antenatal as CNS malformation (26.6%), maternal DM (17.6%), prolonged rupture of membrane (11.9%), maternal hemorrhage (10.4%), and pre-eclampsia (4.7%). Natal and post-natal as hypoxic ischemic encephalopathy (28.5%), infection (16.3%), hyperbilirubinemia (12.7%), cerebrovascular accidents (8.8%), meconium aspiration (6.2%), and intracranial hemorrhage. Post-neonatal as CNS infection (34.5%), cerebrovascular accidents (28.6%), sepsis (23.9%), and intracranial hemorrhage (8.7%). Conclusions Cerebral palsy has different etiologies and risk factors. Further studies are necessary to determine optimal preventative strategies in these patients.

scholarly journals Adolescent, Pregnant, and HIV-Infected: Risk of Adverse Pregnancy and Perinatal Outcomes in Young Women from Southern Mozambique

2021 ◽  
Vol 10 (8) ◽  
pp. 1564
Author(s):  
Clara Pons-Duran ◽  
Aina Casellas ◽  
Azucena Bardají ◽  
Anifa Valá ◽  
Esperança Sevene ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Maternal Morbidity ◽  
Low Birthweight ◽  
Negative Binomial ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
P Value ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Impact

Sub-Saharan Africa concentrates the burden of HIV and the highest adolescent fertility rates. However, there is limited information about the impact of the interaction between adolescence and HIV infection on maternal health in the region. Data collected prospectively from three clinical trials conducted between 2003 and 2014 were analysed to evaluate the association between age, HIV infection, and their interaction, with the risk of maternal morbidity and adverse pregnancy and perinatal outcomes in women from southern Mozambique. Logistic regression and negative binomial models were used. A total of 2352 women were included in the analyses; 31% were adolescents (≤19 years) and 29% HIV-infected women. The effect of age on maternal morbidity and pregnancy and perinatal adverse outcomes was not modified by HIV status. Adolescence was associated with an increased incidence of hospital admissions (IRR 0.55, 95%CI 0.37–0.80 for women 20–24 years; IRR 0.60, 95%CI 0.42–0.85 for women >25 years compared to adolescents; p-value < 0.01) and outpatient visits (IRR 0.86, 95%CI 0.71–1.04; IRR 0.76, 95%CI 0.63–0.92; p-value = 0.02), and an increased likelihood of having a small-for-gestational age newborn (OR 0.50, 95%CI 0.38–0.65; OR 0.43, 95%CI 0.34–0.56; p-value < 0.001), a low birthweight (OR 0.40, 95%CI 0.27–0.59; OR 0.37, 95%CI 0.26–0.53; p-value <0.001) and a premature birth (OR 0.42, 95%CI 0.24–0.72; OR 0.51, 95%CI 0.32–0.82; p-value < 0.01). Adolescence was associated with an increased risk of poor morbidity, pregnancy and perinatal outcomes, irrespective of HIV infection. In addition to provision of a specific maternity care package for this vulnerable group interventions are imperative to prevent adolescent pregnancy.

scholarly journals The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Antenatal Care ◽  
Child Survival ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
P Value ◽  
Difference In Differences ◽  
Under Five ◽  
Care Services ◽  
Sub Saharan ◽  
The Impact

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.

scholarly journals Akwenda intervention programme for children and youth with cerebral palsy in a low-resource setting in sub-Saharan Africa: protocol for a quasi-randomised controlled study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047634
Author(s):  
Gillian Saloojee ◽  
Francis Ekwan ◽  
Carin Andrews ◽  
Diane L Damiano ◽  
Angelina Kakooza-Mwesige ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Sub Saharan Africa ◽  
Children And Youth ◽  
Controlled Study ◽  
Motor Disorder ◽  
National Council ◽  
Low Resource ◽  
Resource Setting ◽  
Low Middle Income Countries ◽  
Randomised Controlled

IntroductionCerebral palsy (CP) is the most common childhood-onset motor disorder accompanied by associated impairments, placing a heavy burden on families and health systems. Most children with CP live in low/middle-income countries with little access to rehabilitation services. This study will evaluate the Akwenda CP programme, a multidimensional intervention designed for low-resource settings and aiming at improving: (1) participation, motor function and daily activities for children with CP; (2) quality of life, stress and knowledge for caregivers; and (3) knowledge and attitudes towards children with CP in the communities.MethodsThis quasi-randomised controlled clinical study will recruit children and youth with CP aged 2–23 years in a rural area of Uganda. Children will be allocated to one of two groups with at least 44 children in each group. Groups will be matched for age, sex and motor impairment. The intervention arm will receive a comprehensive, multidimensional programme over a period of 11 months comprising (1) caregiver-led training workshops, (2) therapist-led practical group sessions, (3) provision of technical assistive devices, (4) goal-directed training and (5) community communication and advocacy. The other group will receive usual care. The outcome of the intervention will be assessed before and after the intervention and will be measured at three levels: (1) child, (2) caregiver and (3) community. Standard analysis methods for randomised controlled trial will be used to compare groups. Retention of effects will be examined at 12-month follow-up.Ethics and disseminationThe study has been approved by the Uganda National Council for Science and Technology (SS 5173) and registered in accordance with WHO and ICMJE standards. Written informed consent will be obtained from caregivers. Results will be disseminated among participants and stakeholders through public engagement events, scientific reports and conference presentations.Trial registration numberPan African Clinical Trials Registry (PACTR202011738099314) Pre-results.

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