Paediatric epilepsy: The status and challenges of care in Zimbabwe

  • G.Q. Kandawasvika
  • P. Dingiswayo
  • D. Kaisi
  • B. Ngara


Objectives: To characterize seizure disorders and co-morbidities in children aged one month to 16 years

Study Design: Hospital based, cross-sectional study. Participants: Children aged one month to 16 years referred to the paediatric neurology clinic at Parirenyatwa hospital in Harare, Zimbabwe were consecutively enrolled.

Study Factors: Clinical profile, seizure type, co-morbidities and treatment patterns.

Results: Of the357 children referred with neurological disorders, 252 (76.6%) had seizure disorders with generalized epilepsy the commonest presentation. The median (range) age was 48 (24-96) months and 163 (65%) were males. The majority resided in urban areas 201 (79%) and were more likely to be managed by primary care nurse beforereferral197 (78%). Atotal 152 (60%) children presenting with seizures had co-morbidities: 18 autistic disorder syndrome, 32 attention deficit hyperkinetic disorder, 47 intellectual impairment, 25 sensory impairment, 2 burns, and 64 behavioural and 9 psychiatric conditions. Fifty two children (20%) had drug refractory epilepsy and of these 19 (8%) were on second line anti-epileptic drugs.

Conclusion: The burden of epilepsy among children presenting with neurological conditions was high and the majority were initially managed by nurse practitioners. Sixty percent of the children had co-morbidities associated with epilepsy. There was limited access to second line anti-epileptic drugs with less than one in ten children with drug resistant epilepsy on appropriate therapy. A population based epilepsy survey to estimate the prevalence, management and outcomes of paediatric epilepsy in the Zimbabwe is needed to advocate for further narrowing of the treatment gap in children.


Journal Identifiers

eISSN: 0008-9176