Estimating the active and lifetime prevalence and incidence of epilepsy in Asian Countries: A systematic review and meta-analysis

Mohammed Safeer V S; Jitendra Kumar Sahu; Priyanka Madaan; Sebastian F Winter; Gus A Baker; Dipika Bansal

doi:10.1016/j.yebeh.2024.109739

Estimating the active and lifetime prevalence and incidence of epilepsy in Asian Countries: A systematic review and meta-analysis

Epilepsy Behav. 2024 May:154:109739. doi: 10.1016/j.yebeh.2024.109739. Epub 2024 Mar 21.

Authors

Mohammed Safeer V S¹, Jitendra Kumar Sahu², Priyanka Madaan³, Sebastian F Winter⁴, Gus A Baker⁵, Dipika Bansal⁶

Affiliations

¹ Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar, India.
² Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: jsh2003@gmail.com.
³ Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India; Department of Pediatric Neurology, Amrita Institute of Medical Sciences, Faridabad, India.
⁴ Head of Policy and Research, International Bureau for Epilepsy, Washington D.C., USA.
⁵ Secretary General, International Bureau for Epilepsy, Washington D.C., USA.
⁶ Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar, India. Electronic address: dipikabansal079@gmail.com.

PMID: 38518674
DOI: 10.1016/j.yebeh.2024.109739

Abstract

Objective: In the current era of the World Health Organization's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 (IGAP), precise and updated estimates of epilepsy burden are vital in formulating policies to improve the care of persons with epilepsy, especially in Asian countries with significant treatment gap. Hence, we aimed to consolidate the available data and quantify epilepsy prevalence and incidence estimates in Asian countries.

Methods: We systematically searched PubMed, Embase, Ovid, and Scopus databases from inception until March 2023 for studies reporting epilepsy prevalence and incidence in Asian countries. We applied random effects meta-analysis to generate the pooled prevalence and incidence using the Meta package in R. Additionally, we performed a subgroup meta-analysis to explore the potential sources of heterogeneity. A meta-regression analysis was conducted to examine the trend of epilepsy over time.

Results: A total of 99 studies with 100,654,124 participants were included in the meta-analysis. The pooled prevalence was 5.6 per 1000 (95 % confidence interval (CI) 4.4-6.8) for active epilepsy and 6.7 per 1000 (95 % CI 5.7-7.9) for lifetime epilepsy. The pooled incidence rate of epilepsy was 52.5 per 100,000 person-years (95 % CI 42.7-79.4). The subgroup analysis revealed a higher prevalence of active epilepsy (6.7/1000) and lifetime epilepsy (8.6/1000) in West Asia than in other regions. The funnel plot and Egger's test (p-value =<0.0001) revealed publication bias for active epilepsy.

Conclusion: Our findings highlight a high prevalence of active and lifetime epilepsy in West Asia and emphasize the necessity of implementing and formulating specific strategies to tackle the epilepsy burden in this region. Furthermore, high-quality epidemiological studies incorporating economic burdens and comorbidities associated with epilepsy in Asia are still needed.

Keywords: Active epilepsy; Incidence rate; Lifetime epilepsy; Prevalence.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Asia / epidemiology
Epilepsy* / epidemiology
Humans
Incidence
Prevalence