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Neurology 1999;53:2064
© 1999 American Academy of Neurology


Articles

Prevalence of epilepsy in rural Bolivia

A door-to-door survey A. Nicoletti, MD, A. Reggio, MD, A. Bartoloni, MD, G. Failla, MD, V. Sofia, MD, F. Bartalesi, MD, M. Roselli, MD, H. Gamboa, MD, E. Salazar, MD, R. Osinaga, MD, F. Paradisi, MD, G. Tempera, MD, M. Dumas, MD and A. J. Hall, PhD

From the Institutes of Neurological Science (Drs. Nicoletti, Reggio, Failla, and Sofia) and Microbiology (Dr. Tempera), University of Catania, Italy; the Institute of Infectious Diseases (Drs. Bartoloni, Bartalesi, Roselli, and Paradisi), University of Florence, Italy; the Health District of the Cordillera Province (Drs. Gamboa and Salazar), Camiri, Bolivia; the Hospital San Juan De Dios (Dr. Osinaga), Santa Cruz, Bolivia; the Institute of Neuroepidemiology and Tropical Neurology (Dr. Dumas), Limoges, France; and the London School of Hygiene and Tropical Medicine (Dr. Hall), UK.

Address correspondence and reprint requests to Dr. Alessandra Nicoletti, Istituto di Scienze Neurologiche, Università di Catania, Viale A. Doria 6, 95125 Catania, Italy.

OBJECTIVE: To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants.

METHODS: A team of nondoctor health workers administered a standard screening instrument for neurologic diseases—a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination.

RESULTS: On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life.

CONCLUSION: This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.

Key words: Epilepsy—Neuroepidemiology—Developing countries—Bolivia.




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