Children and residents of Nigeria’s South-South region appear to have a higher burden of epilepsy, while medication adherence and access to treatment remain significant challenges, according to a systematic review and meta-analysis.
The study, published in the European Journal of Medical Research, analysed 21 studies examining the prevalence, clinical characteristics and treatment outcomes of epilepsy in Nigeria.
The researchers, led by Nicholas Aderinto and including Bonaventure Ukoaka, Gbolahan Olatunji and Emmanuel Kokori, reported prevalence estimates ranging from 0.45 per cent to 36.09 per cent across the studies reviewed.
An analysis of 12 studies involving 39,792 participants produced a pooled prevalence estimate of 14.21 per cent. However, the researchers reported a wide confidence interval, indicating considerable uncertainty around the estimate.
The findings also showed differences across age groups and geopolitical zones, although the researchers cautioned that variations in study methods and the identification of epilepsy cases could have influenced the results.
Children recorded the highest reported prevalence, at 36.09 per cent, compared with 11.85 per cent among adults and 3.16 per cent in studies involving both adults and children.
The South-South zone had the highest regional estimate, at 21.73 per cent, followed by the South-East at 14.78 per cent and the South-West at 14.05 per cent. North-Central recorded the lowest estimate, at 0.47 per cent.
The review covered only four of Nigeria’s six geopolitical zones, highlighting the need for more representative studies to establish the national burden of the condition.
The researchers suggested that complications during pregnancy and childbirth, childhood infections and other neurological conditions could contribute to the burden among children. Regional differences may also reflect variations in environmental exposures, healthcare access, diagnosis and reporting.
Generalised tonic-clonic seizures emerged as the most frequently reported seizure type, accounting for between 76.9 and 83.1 per cent of cases in the studies reviewed.
These seizures typically involve loss of consciousness, muscle stiffening and rhythmic jerking. The researchers suggested that their prominence in the findings could partly reflect the difficulty of identifying less obvious seizure types in settings where specialist diagnostic services are limited.
Carbamazepine was the most commonly reported first-line antiseizure medication. Some studies recorded seizure-control rates exceeding 70 per cent, while one study involving children reported a rate of up to 99 per cent.
Other medications used included sodium valproate, levetiracetam, phenytoin, phenobarbital and ethosuximide. Most studies favoured treatment with a single antiseizure medicine rather than combinations, although the appropriate treatment depends on the type of epilepsy and the patient’s response.
Despite the reported treatment successes, medication adherence and missed clinic appointments remained challenges. The researchers identified drug costs, medicine availability, adverse effects and sociocultural beliefs as factors that could undermine effective treatment.
They called for greater public awareness, more affordable access to medicines, and improved diagnosis and follow-up care, particularly through primary healthcare services.
The researchers also recommended further studies to establish the causes of regional differences, compare treatment approaches and examine the social and economic factors affecting medication adherence.
Epilepsy is a chronic neurological condition characterised by recurrent seizures that are not caused by an immediate, temporary trigger. It can affect people of any age and disrupt education, work and daily life, particularly when seizures are not adequately controlled.
The authors said more reliable data would help health authorities estimate the number of people requiring care and develop targeted interventions to improve diagnosis, treatment and quality of life.