Prevalence, characteristics, and treatment outcomes of epilepsy in Nigeria: a systematic review and meta-analysis

Abstract

BACKGROUND: Epilepsy poses a significant health burden globally. In Nigeria, limited access to healthcare and potential regional variations in risk factors necessitate an understanding of epilepsy's characteristics and treatment. This study addresses this gap by conducting a systematic review and meta-analysis to investigate the prevalence, demographic variations, seizure types, and treatment modalities of epilepsy in Nigeria. METHODS: A systematic review was conducted following PRISMA guidelines (CRD42024549637). We searched PubMed, Google Scholar, and other databases (6 total) from inception to February 2024 using a combination of MeSH terms and keywords related to epilepsy and Nigeria. Studies included observational studies, clinical trials, and those reporting on the prevalence, characteristics, and management of epilepsy in Nigeria. We excluded studies outside Nigeria, lacking relevant data, or non-research materials. Two reviewers screened titles/abstracts and full texts for eligibility. Data extraction included demographics, sample size, location, seizure type, and treatment outcomes. The JBI tool assessed study quality. We did systematic synthesis and meta-analysis for prevalence. RESULTS: The prevalence of epilepsy ranged from 0.45 to 36.09%. The overall pooled prevalence of epilepsy is 14.21% (95% CI 1.56-36.16) among all age group patients. Children presented with the highest prevalence (36.09%), followed by adults (11.85%) and in combine adult and children studies (3.16%). The South-South zone had the highest prevalence (21.73%), while the North-Central zone had the lowest (0.47%). Generalized tonic-clonic seizures were the most common type reported (76.9-83.13%). Carbamazepine was a frequent first-line treatment, with some studies indicating good results, particularly in children. Monotherapy was generally preferred. CONCLUSION: Epilepsy prevalence in Nigeria varies considerably. Children and the South-South zone appear to be more affected. Carbamazepine is a common first-line treatment. Further research is required to explore underlying causes, optimal treatment strategies, and adherence challenges.