Prevalence and associated factors of physical injuries among patients with epilepsy in Sub-Sharan Africa: A systematic review and meta-analysis

• Published in: Epilepsy & behavior Vol. 161; p. 110099
• Main Authors: Kibret Abebe, Gebremeskel, Abate, Biruk Beltew, Birara Zemariam, Alemu, Azmeraw, Molla, Setegne Ngusie, Habtamu, Abiye Munie, Melesse, Baylie Taye, Amsalu, Molla, Bogale, Derese Tilahun, Befkad, Wondmagegn Almaw, Addis
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2024
• Subjects: Epileptic related injuries; Physical injuries; Seizure-related physical injuries; Sub-Sharan Africa; Epileptic related injuries; Sub-Sharan Africa; Physical injuries; Seizure-related physical injuries
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2024.110099

•In Sub-Saharan Africa, seizure-related injuries in epilepsy patients far exceed those seen in developed countries.•More than 60 % of patients with epilepsy in Sub-Sharan Africa sustained physical injuries.•Anti-seizure medication adherence, and frequent seizures increase the occurrence of seizure-related physical injuries.•Sub-Sharan African countries should set strategies to control the occurrences of physical injuries.
Globally, 50 million people suffer from epilepsy, with more than 80% of patients with epilepsy living in low‐ and middle‐income countries. The World Health Organization (WHO) estimates that approximately 25 million people in Africa have epilepsy. In Sub-Saharan Africa, 50 % of patients with epilepsy experience seizure-related physical injuries, including burns, fractures, motor vehicle accidents, dental injury, soft-tissue injuries, and submersion accidents.
This systematic review and meta-analysis was conducted to assess the prevalence and associated factors of physical injuries among patients with epilepsy in Sub-Sharan Africa.
A systematic review and meta-analysis were conducted between January 2012 and December 2023. An experienced librarian performed a thorough search across several databases, including PubMed, Medline, the Cochrane Database of Systematic Reviews, Up To Date, EMBASE, and NICE (National Institute for Health and Care Excellence). The search also included grey literature and unpublished studies. Data were extracted on the prevalence of physical injuries and associated factors among patients with epilepsy in Sub-Saharan Africa. A pooled analysis of prevalence was conducted using a random-effects model, and a systematic review of risk factors for physical injuries was performed.
A total of seven studies (n = 1724) were included. The pooled prevalence physical of injuries among patients with epilepsy in Sub-Sharan Africa is found to be 63.68 % (95 % CI: 62.15, 65.22; I2 = 99.7 %; p < 0.0001). Subgroup analyses were conducted by grouping the studies by country. We also employed a leave-one-out sensitivity analysis to identify potential sources of heterogeneity. Publication bias was assessed by visual inspection of meta-funnel plot and egger, begs test, and revealed there was no publication bias.
This systematic review and meta-analysis can be used for policy maker, stakeholders and concerned body to set strategies to prevent seizure-related physical injuries among patients with epilepsy. The finding also allows clinicians to provide appropriate patient care.