Epilepsy, poverty and early under-nutrition in rural Ethiopia

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• 作者：Nidhi Vaid ; Sintayehu Fekadu ; Shitaye Alemu ; Abere Dessie ; Genale Wabe ; David I.W. Phillips ; Eldryd H.O. Parry ; Martin Prevett
• 关键词：Epilepsy ; Malnutrition ; Africa ; Anthropometry ; Education
• 刊名：Seizure
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：21
• 期：9
• 页码：734-739
• 全文大小：203 K

文摘

Purpose

The incidence of epilepsy in Ethiopia is high compared with industrialised countries, but in most cases the cause of epilepsy is unknown. Childhood malnutrition remains widespread. We performed a case-control study to determine whether epilepsy is associated with poverty and markers of early under-nutrition.

Methods

Patients with epilepsy (n = 112), aged 18-45 years, were recruited from epilepsy clinics in and around two towns in Ethiopia. Controls with a similar age and gender distribution (n = 149) were recruited from patients and relatives attending general outpatient clinics. We administered a questionnaire to define the medical and social history of cases and controls, and then performed a series of anthropometric measurements. Unconditional logistic regression was used to estimate multivariate adjusted odds ratios. Multiple linear regression was used to estimate adjusted case-control differences for continuously distributed outcomes.

Results

Epilepsy was associated with illiteracy/low levels of education, odds ratio = 3.0 (95 % confidence interval: 1.7-5.6), subsistence farming, odds ratio = 2.6 (1.2-5.6) and markers of poverty including poorer access to sanitation (p = 0.009), greater overcrowding (p = 0.008) and fewer possessions (p < 0.001). Epilepsy was also associated with the father's death during childhood, odds ratio = 2.2 (1.0-4.6). Body mass index was similar in cases and controls, but patients with epilepsy were shorter and lighter with reduced sitting height (p < 0.001), bitrochanteric diameter (p = 0.029) and hip size (p = 0.003). Patients with epilepsy also had lower mid-upper arm circumference (p = 0.011) and lean body mass (p = 0.037).

Conclusion

Epilepsy in Ethiopia is strongly associated with poor education and markers of poverty. Patients with epilepsy also had evidence of stunting and disproportionate skeletal growth, raising the possibility of a link between early under-nutrition and epilepsy.