%0 Journal Article
%T Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization
%A Michael Mwaniki
%A Ali Mathenge
%A Samson Gwer
%A Neema Mturi
%A Evasius Bauni
%A Charles RJC Newton
%A James Berkley
%A Richard Idro
%J BMC Medicine
%D 2010
%I BioMed Central
%R 10.1186/1741-7015-8-16
%X From 1st January 2003 to 31st December 2007, we assessed for seizures all neonates (age 0-28 days) admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint) was modelled from the census data.Seizures were reported in 142/1572 (9.0%) of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI) 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%), neonatal encephalopathy in 30 (21%) and meningitis in 21 (15%), but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR) 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, P = 0.02). Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ¡Ý 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46), P = 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge.There is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and postnatal care available to the neonates.The first month of life is one of the highest risk periods for seizures [1] and seizures are the most common manifestation of neurological conditions in the neonate [2]. Neonatal seizures have been shown to be a major risk factor for inpatient death and subsequent neurological disability [3-5]. They show marked differences from seizures in older age groups: tonic-cloni
%U http://www.biomedcentral.com/1741-7015/8/16