Epilepsy following simple febrile seizure in a rural community in Tanzani
AbstractObjective: To study the outcome of subsequent epilepsy following a single uncomplicated febrile seizure in a cohort of children aged six months to six years followed up for a ten year period.
Design: Observational prospective cohort study
Setting: Mahenge epilepsy clinic, Ulanga district, Morogoro region, Tanzania.
Subjects: Children aged six months to six years living in Ulango District, Morogoro Region, Tanzania.
Results: A total of 6522 children aged six months to six years lived in the study area. Of these 213 (3%) had experienced one uncomplicated febrile seizures within six months of the commencement of the study. At the end of ten years follow-up period 145(65%) were still living in the study area. Of these 44 (30%) had developed epilepsy giving an equivalent of cumulative incidence rate of 3.8 per 100 person years. The age of onset of first uncomplicated FS between the ages of two to five years was significantly associated with the development of later epilepsy in comparison to other ages X2 26.43; P<0.001. This difference was significantly accumulative with time of follow-up. The number of recurrent febrile seizures significantly influenced the development of later epilepsy.
X2 = 32.3; p =<0.001 with relative risk (odds ratio 5.4, 95% CI 2.6-11.41 P<0.001). A positive family history of FS significantly influenced the development of later epilepsy. X2 P<0.001 with relative risk (odds ratio 3.2, 95% CI 2.0-5.1; p<0.001. A positive family history of epilepsy did not significantly influence the development of later epilepsy X2 = 38.1; P <0.212. Conclusion: Cumulative incidence of epilepsy in rural Tanzanian children following a single uncomplicated FS was small but higher than that reported in developed countries. This risk was influenced independently by the number of recurrent FS, family history of FS, and the age of onset of the first ever FS.