Kaputu-Kalala-Malu C.1,2, Mukeba Kahamba D.1, Ntumba-Tshitenge O.3, Mafuta Musalu E.4, Ndahindwa V.5, Okitundu Luwa E-Andjafono D.1, Kayembe Kalula T.1, Mukendi Kavulu Mayamba R.6, Misson J.P.2
1 Universite´ de Kinshasa service de neurologie pe´diatrique, de´partement de neurologie, centre neuropsychopathologique, faculte´ de me´decine, universite´ de Kinshasa, Re´publique de´mocratique du Congo 2 Service universitaire de pe´diatrie-neurope´diatrie, CHR-CHU Sart-Tilman, universite´ de lie`ge, 4000 Lie`ge, Belgique 3 De´partement de pe´ diatrie, centre hospitalier universitaire de Butare, universite´ du Rwanda 4 E ´ cole de sante publique, universite´ de Kinshasa, Re´publique de´mocratique du Congo 5 University of Rwanda - College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda 6 Neurologie-neurope´diatrie, hoˆ pital Saint Joseph, Mons, Belgique
doi: 10.1684/mst.2015.0469
Médecine et Santé Tropicales, Vol. 25, N8 3 - juillet-août-septembre 2015
Abstract.
Background: There is a paucity of epidemiologic studies of prolonged seizures (persisting for more than 5 minutes) in the Democratic Republic of Congo (DRC) and in Rwanda.
Objective: We sought to analyze the clinical presentation, causes, pharmacologic management, and shortterm course of these seizures. Methods: We enrolled 436 children, aged five months to ten years, who presented with prolonged seizures at the pediatric emergency departments of nine hospitals. Findings: Overall, 57.8% of the children were younger than three years; 7% had pre-existing psychomotor delay. Although 21% had had previous seizures, only 13% were receiving antiepileptic therapy. On presentation, 63.5% of the patients had fever and 26% were in status epilepticus. The seizures were focal in 21% of the cases. Malaria was the most common cause, involving 63% of the cases. The recurrence rate was 38%, and the mortality rate 4%. Conclusion: Prolonged seizures in DRC and Rwanda are frequently associated with fever, most commonly caused by malaria. The immediate use of long-acting antiepileptic drug could improve their outcomes. Key words: children, prolonged seizures, sub-Saharan Africa, Democratic Republic of Congo, Rwanda.