Outliers identified in “Prevalence and Incidence of Epilepsy: A Systematic Review and Meta-Analysis of International Studies” by Fiest et al.

In this review article, Fiest and colleagues have provided a rigorous, quantitative summary of epilepsy prevalence and incidence studies globally. Interestingly, they identified outliers in LMICs (low- and middle-income countries) in Latin America, Africa, and the Middle East with higher than expected numbers of cases. As noted by the authors, this might be due to unique influences in these regions related to infection, consanguinity or other causes not routinely captured in epidemiologic studies. They also found active annual period and lifetime prevalence and incidence rates were higher in LMICs, but point prevalence was not. Unfortunately, this may be due to higher mortality rates among people with epilepsy. Something already well-documented in China.1

  1. Birbeck G, Hesdorffer D. The geography of epilepsy: a fatal disease in resource-poor settings. Neurology 2011;77:96-97.
Gretchen L. Birbeck, MD, MPH

Gretchen L. Birbeck, MD, MPH

Gretchen Birbeck is a neurologist who divides her time between the US and Africa. Her US academic home is the University of Rochester where she is the Rykenboer Professor of Neurology and Research Director for the Strong Epilepsy Center with adjunct appointments in the Center for Human Experimental Therapeutics and the Department of Public Health. Her additional skills in epidemiology, health services research, and tropical medicine are brought to bear during the 6-months annually she spends in Africa where she serves as Director for the Chikankata Epilepsy Care Team in rural Mazabuka, Zambia, an Honorary Lecturer at the University of Zambia and a consultant for the Paediatric Research Ward at Queen Elizabeth Central Hospital in Blantyre, Malawi. Gretchen’s research programs are aimed at identifying opportunities to prevent or ameliorate the medical and social morbidities of common neurologic conditions in low-income, tropical settings with the ultimate goal of developing successful interventions feasible for scale up and broad implementation. She has been recognized as an Ambassador for Epilepsy by the International League against Epilepsy, a Global Health Research Ambassador by the US Paul Rogers Society, a National Outreach Scholar by the WK Kellogg Foundation and a Leader in Medicine by the American Medical Students Association.

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