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A systematic review of the epidemiology of epilepsy in Mexico during 1970 to 2020

Revision sistematica de la epidemiologia en Mexico de la epilepsia de 1970 a 2020

Abstract

Background

Epilepsy is the most common major neurological disorder that affects people of all ages. The prevalence varies from one country to another and even between different areas, due to a lack of access to medical care for reasons related to limited resources.

Objective

Epilepsy is a worldwide public health problem that affects more deeply populations living in developing countries such as Mexico, where more aggressive health policies based on epidemiological data are needed; however, this information is scarce and the evolution of this data over time remains unclear. The aim of the present study is to provide an overview of the epidemiology of epilepsy in Mexico from 1970 to 2020.

Methods

We searched descriptive epidemiological studies on epilepsy in rural and urban regions of Mexico from 1970 to 2020. Available data on the sociodemographic characteristics, prevalence, and incidence data were extracted. Finally, the abstract, full-text review, and data abstraction were conducted in duplicate and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Descriptive statistics was also used.

Results

Overall, 11 underrepresented and heterogeneous epidemiological studies were included. In total, the prevalence of epilepsy in Mexico is 3.9 to 41:1,000 inhabitants; 3.9 to 41 per 1,000 persons in rural regions, and 3.49 to 44.3 per 1,000 persons in urban regions. None of these studies addressed the incidence of epilepsy. The prevalence of epilepsy in Mexico has remained unchanged during the last 5 decades.

Conclusions

Our results confirm a high prevalence of epilepsy in both urban and rural settings in Mexico that remain unchanged during the last 5 decades. All studies included in the present review showed multiple methodological limitations. New and robust epidemiological studies are needed to delineate the epidemiological profile of epilepsy in Mexico.

Keywords
Epilepsy; Epidemiology; Prevalence; Mexico; Rural Areas; Urban Area; Developing Countries

Resumen

Antecedentes

La epilepsia es el trastorno neurológico más común que afecta a individuos de todas las edades. La prevalencia varía entre paises e incluso entre diferentes áreas del mismo pais debido a la falta de acceso a la atención médica.

Objectivo

La epilpesía es un problema de salud pública mundial que afecta de manera más importante a los países en desarrollo como México, donde hacen falta políticas en salud y datos epidemiológicos, para conocer el impacto real de esta enfermedad. El objetivo de este estudio es brindar una visión general de la epidemiología de la epilepsia en México (1970-2020).

Métodos

Se realizo unas búsquedas bibliografica de estudios epidemiológicos descriptivos sobre epilepsia en regiones rurales y urbanas de México desde 1970 a 2020. Se extrajeron los datos disponibles sobre las características sociodemográficas, prevalencia e incidencia. Finalmente, el resumen, la revisión completa del texto y la extracción de datos se realizaron por duplicado y se informaron utilizando PRISMA. Se utilizo estadística descriptiva.

Resultados

Se incluyeron 11 estudios epidemiológicos heterogeéneos. En total la prevalencia de epilepsia en México es 3.9-41: 1000 habitantes; 3,9 a 41 por 1000 personas en las regiones rurales y 3,49 a 44,3 por 1000 personas en las regiones urbanas. Ninguno de estos estudios abordó la incidencia de epilepsia. La prevalencia de la epilepsia en México se ha mantenido sin cambios durante las últimas cinco décadas.

Conclusiones

Nuestros resultados confirman una alta prevalencia de epilepsia en las areas urbanas y rurales de México que se mantiene sin cambios durante las últimas cinco décadas. Todos los estudios incluidos en esta revisión mostraron múltiples limitaciones metodológicas. Se necesitan estudios epidemiológicos nuevos y sólidos para delinear el perfil epidemiológico de la epilepsia en México.

Palabras claves
Epilepsia; Epidemiología; Prevalencia; México; Medio Rural; Area Urbana; Países en Desarrollo

INTRODUCTION

Epilepsy is the most common major neurological disorder that affects people of all ages. Worldwide, the frequency of epilepsy is estimated to be 69 million people, with a prevalence of active epilepsy at 6.38 per 1,000 inhabitants.11 World Health Organization. Epilepsy. Fact sheet. No. 999. 2012. Updated February 2016. Available in: http://www.who.int/mediacentre/factsheets/fs999/en/
http://www.who.int/mediacentre/factsheet...
Forty-five (65%) out of 69 million people with epilepsy live within rural regions in developing countries, 17 (25%) million are living in the urban areas of these countries, and the rest, 7 (10%) million people, are living in developed countries.22 Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a metaanalytic approach. Epilepsia 2010;51(05):883-890 About 5 million live in Latin America and the Caribbean, with a median prevalence interval ranging from 15.8 to 17.8 patients per 1,000 inhabitants.33 Meyer AC, Dua T, Ma J, Saxena S, Birbeck G. Global disparities in the epilepsy treatment gap: a systematic review. Bull World Health Organ 2010;88(04):260-266. Doi: 10.2471/BLT.09.064147
https://doi.org/10.2471/BLT.09.064147...
Incidence rates are higher in developing countries, especially in Africa and Latin America, where figures can exceed 150 per 100,000 inhabitants.33 Meyer AC, Dua T, Ma J, Saxena S, Birbeck G. Global disparities in the epilepsy treatment gap: a systematic review. Bull World Health Organ 2010;88(04):260-266. Doi: 10.2471/BLT.09.064147
https://doi.org/10.2471/BLT.09.064147...
Globally, almost 2.4 million people are diagnosed with epilepsy each year.44 Keste D, Acevedo C, Medina MT Tomás Mesa, Jorge Rodríguez; Epilepsy in Latin America; Technical document based on presentations at the international work shop in Santiago, Chile, in August 2013. https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
https://www.ilae.org/files/dmfile/PAHO-r...

The prevalence of epilepsy varies from one country to another and even between different areas within the same country due to a lack of access to medical care for reasons related to limited resources, geography, and due to problems with communicating epidemiological data and addressing it appropriately. To this point, < 40% of Latin American countries had at least 1 epidemiological study on epilepsy. In fact, there is sparce epidemiological information available from local health authorities in these countries, and few epidemiological studies have been conducted, which are essential for creating plans and strategies to address the disparities of epilepsy cases at the local level as recommended by The PanAmerican Health Organization (PAHO) as noted in the last report released in 2013.55 Panamericana de la Salud O Organización Mundial de la Salud. Liga Internacional Contra la Epilepsia-Buró Internacional para la Epilepsia. Estrategia y Plan de Acción sobre la Epilepsia. Washington (DC), Estados Unidos: OPS;2011[http://www.paho.org/hq/dmdocuments/epilepsia%20doc.pdf, last accessed on March 2015]. August 2013. https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
http://www.paho.org/hq/dmdocuments/epile...

Mexico is a developing country located in Latin America with > 126 million inhabitants (78.8% urban and 21.2% rural);66 All-Mexican Population Census 2020Instituto Nacional de Estadìstica y Geograf ìa; https://www.inegi.org.mx/temas/estructura/
https://www.inegi.org.mx/temas/estructur...
however, like other developing countries, there has been a lack of overview of the epidemiological studies conducted in the last decades which are necessary for the support of public health policies and strategies in reducing the gaps in the number of epilepsy cases, especially in areas with a higher burden of disease.

Demographic data of Mexico

Mexico is located in North America and covers 1,972,550 km2, with a density of ∼ 57 people per km.22 Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a metaanalytic approach. Epilepsia 2010;51(05):883-890,66 All-Mexican Population Census 2020Instituto Nacional de Estadìstica y Geograf ìa; https://www.inegi.org.mx/temas/estructura/
https://www.inegi.org.mx/temas/estructur...
According to The National Institute of Statistics and Geography (INEGI) survey 2020 in Mexico, the population of Mexico is 126,014,024 inhabitants, with a total of 78.84% living in urban areas and 21.16% living in rural areas; 48.8% men and 51.2% women. The distribution in percentages of the inhabitants for the age groups is 18.6% (0 to 14 years old), 67.3% (15 to 64 years old) and 14.1% (≥ 65 years old).66 All-Mexican Population Census 2020Instituto Nacional de Estadìstica y Geograf ìa; https://www.inegi.org.mx/temas/estructura/
https://www.inegi.org.mx/temas/estructur...

The aim of our review is to provide an outline of the epidemiological studies of epilepsy in both urban and rural regions of Mexico from 1970 to 2020.

METHODS

The present review adhered to the methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.77 Hamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2016;354:i4086. Doi: 10.1136/bmj.i4086
https://doi.org/10.1136/bmj.i4086...

Search strategy

We searched between November and December 2020 for epidemiological studies (from 1970 to 2015) in Spanish or English conducted in Mexico in five databases: PubMed, Scielo, Health Information from Latin America and the Caribbean (LILACS), Medigraphic, and OVID. The mesh terms used were: epilepsy, Mexico, Latin America, epidemiology, prevalence, incidence, and distribution. The exactitude of the search strategy was validated by cross-verification with the results of previous reviews. Likewise, we reviewed the bibliographic reference lists of the included studies and previous systematic and descriptive reviews on that subject.

Study selection

Abstracts and titles of all references were screened in duplicate by 2 independent reviewers to identify original population-based studies on the prevalence or incidence of epilepsy in Mexico.

Articles were included if they met the following inclusion criteria: (1) population-based studies that provide a standardized definition of epilepsy having more than one stage of diagnosis and (2) that the main objective of the study is to determine the prevalence and/or incidence of epilepsy in adults and/or children in Mexico without any language restrictions. 3) reported a prevalence or incidence of epilepsy. We excluded descriptive case-series from single centers, review studies, or other type of studies of epilepsy in Mexico. Disagreements pertaining to the inclusion of articles were resolved by consensus or involvement of a third author, as necessary.

Data extraction

Data abstraction was completed in duplicate by 2 independent reviewers using a standardized data collection form and stored in a Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) sheet. The extracted variables were author, year of publication, sociodemographic characteristics, location, type of population area (urban or rural), type of study, number of patients, prevalence of epilepsy, and age group (only children, only adults, or both). Regarding age, we stratified the cases into 3 large groups for age-specific distribution: 1. Children (preschool and school age); 2. Adults ≥ 18 years old; 3. Any age (children and adults). For the definition of epilepsy, we relied on a common definition that defines epilepsy as ≥ 2 unprovoked seizures > 24 hours apart.

We defined prevalence as the number of existing cases of epilepsy in a population over the total population at a specific point in time. In the present study, we focused on two types of prevalence: the lifetime prevalence of epilepsy (including active and inactive epilepsy/historical cases over time between birth and assessment) and (2) the prevalence of active epilepsy (individuals reporting recent seizures or those currently taking anticonvulsants). The populational study was defined as a study of a group of individuals taken from the general population who shares a common characteristic, such as age, sex, or health condition.88 Banerjee A, Chaudhury S. Statistics without tears: Populations and samples. Ind Psychiatry J 2010;19(01):60-65. Doi: 10.4103/ 0972-6748.77642
https://doi.org/10.4103/0972-6748.77642...
Regarding incidence, none of these studies addressed incidence of epilepsy. After reviewing the abstracts of the articles found; 11 studies focused on the prevalence of epilepsy in Mexico were chosen.

Data synthesis and analysis

We used descriptive statistics to calculate frequencies, percentages, and the rates of both prevalence and incidence of epilepsy in Mexico based on 1,000 inhabitants. This was done using Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) version 2020.

RESULTS

Initially, there were 220 scientific articles recognized, 170 were deemed out-of-scope of the epidemiological study design and were excluded solely based on their abstract. Then, out of the remaining papers, 15 were selected for full text review, and, subsequently, 11 scientific articles met the study criteria and were selected for the present review99 Olivares L. Neurological epidemiology in Mexico. Study of an urban population sample. Salud Publica Mex 1976;18(04): 665-672

10 Gutíerrez-Avila H, Rubio-Donnadieu F, Escobedo-Ríos F, González-Cortés A, Herón-Minero J. [Prevalence of epilepsy in schoolage children of an urban community in Mexico City]. Gac Med Mex 1980;116(11):497-501

11 Garcia-Pedroza F, Rubio-Donnadieu F, et al. Prevalence of epilepsy in children: Tlalpan Mexico City, Mexico. Neuroepidemiology 1983;2:16-23

12 García-Pedroza F, Rubio-Donnadieu F. Prevalencia de las crisis epilépticas en 23.000 niños de 3 año de primaria en escuelas públicas de 30 estados de la República Mexicana. [Prevalence of epileptic crises in 23,000 third-year primary school children in public schools in 30 Mexican states]. Epilepsia 1991;32 (Suppl 1):111

13 García Pedroza F, Rubio-Donnadieu F. Prevalencia de la Epilepsia en Comalcalco, Tabasco Prevalence: [Prevalence of Epilepsy in Camacalco, Tabasco]. Personal communication 1993-1994

14 Cruz-Alcala LE, Velazquez-Castellanos JL. Prevalencia de algunas enfermedades neurologicas en la ciudad de Tepatitlan Jalisco Mexico. Rev. Mex. Neuroci. 2002;3:71-76

15 Márquez L, Olivares L. Epilepsia en México. Estudio epidemiológico de una comunidad rural. Salud Publica Mex 1979;21(05): 487-495

16 Gutiérrez Avila JH. [Prevalence of epileptic seizures among children in a rural town of Mexico]. Salud Publica Mex 1980;22(03): 269-273

17 Gutierrez. Prevalence of Epilepsy in Naolinco, Veracruz. Archivos INNN 1993;8(03):168

18 Quet F, Preux PM, Huerta M, et al. Determining the burden of neurological disorders in populations living in tropical areas: who would be questioned? Lessons from a Mexican rural community. Neuroepidemiology 2011;36(03):194-203. Doi: 10.1159/000327496
https://doi.org/10.1159/000327496...
-1919 San-Juan D, Alvarado-León S, Barraza-Díaz J, Davila-Avila NM, Ruíz AH, Anschel DJ. Prevalence of epilepsy, beliefs and attitudes in a rural community in Mexico: A door-to-door survey. Epilepsy Behav 2015;46:140-143 (Figure 1). Tables 1 and 2 show the epidemiological studies according to the rural or urban areas covered. Six (54.4%) studies were conducted in urban areas and 5 (45.6%) studies in rural communities. There was no disagreement among reviewers. The epidemiological studies analyzed were methodologically heterogenous and included few urban and rural regions of Mexico, as shown in Figure 2.

Figure 1
Flowchart of epidemiological studies related to epilepsy in Mexico.

Table 1
Epidemiological studies on the prevalence of epilepsy in urban areas of Mexico (1970-2015)
Table 2
Studies on the prevalence of epilepsy in rural areas of Mexico (1970-2015)

Figure 2
Geographical distribution of Mexico where epilepsy prevalence studies were carried out.

In total, the prevalence of epilepsy (urban and rural) was 3.9 to 41:1,000 inhabitants. We found a prevalence of epilepsy ranging from 3.9 to 41 per 1,000 persons in rural regions and 3.49 to 44.3 per 1,000 persons in urban regions of Mexico. None of these studies addressed the incidence of epilepsy. The prevalence of epilepsy in the epidemiological studies analyzed remain unchanged in rural and urban settings during the last 5 decades in Mexico.

DISCUSSION

The present systematic review found a high prevalence of epilepsy in urban and rural regions in Mexico during the last 5 decades compared with developed countries and globally. The prevalence of epilepsy in the epidemiological studies analyzed remain unchanged in rural and urban settings during the last 5 decades in Mexico. However, there was a significant heterogeneity between the epidemiological studies and caution is needed in interpreting these results. The current etiology of epilepsy in Latin America and Caribbean (LAC continues to be associated with neurocysticercosis (NCC) in 17.3% of the epidemiological studies in this region. Unfortunately, the etiology in Mexican epidemiological studies has not been addressed appropriately; however, local studies show that NCC is considered one of the leading causes of epilepsy.2020 Fleury A, Sciutto E, Larralde C. Neurocysticercosis is still prevalent in Mexico. Salud Publica Mex 2012;54(06):632-636. Doi: 10.1590/s0036-36342012000600012
https://doi.org/10.1590/s0036-3634201200...

Mexico is a middle-income country, with 62.25 million people living in poverty, which may explain the higher risk of developing epilepsy given that it is reported to a greater degree in the sector of the population considered to occupy a lower socioeconomic status. Furthermore, no epidemiological studies concerning the incidence of epilepsy in Mexico were found. Finally, low levels of education have been shown to translate into low-income levels which are related to poor health conditions, a likely factor for the higher incidence of epilepsy in Mexico.2121 Programa Especial de los Pueblos Indígenas 2014-2018, Primera edición, 2014http://www.cdi.gob.mx
http://www.cdi.gob.mx...

The WHO's 2016 Global Burden of Disease study of epilepsy reported an estimation of 45.9 million patients with all-active epilepsy globally, accounting for 0.56% of total disability-adjusted life-years (DALYs) internationally. The study also found a greater severity and higher sum of years of life lost for premature mortality and years lived with disability due to epilepsy in low-income settings.2222 GBD 2016 Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18 (04):357-375. Doi: 10.1016/S1474-4422(18)30454-X
https://doi.org/10.1016/S1474-4422(18)30...
The prevalence of epilepsy worldwide differs significantly among countries depending on the sociodemographic characteristics, as well as both the local distribution of risk and etiologic factors. The overall global prevalence of epilepsy was 7.60 per 1,000 inhabitants (95% confidence interval [CI]: 6.17-9.38).2323 Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology 2017;88(03):296-303. Doi: 10.1212/WNL.0000000000003509
https://doi.org/10.1212/WNL.000000000000...
According to a recent systematic review and meta-analysis of population-based studies of the epidemiology of epilepsy in LAC, there is a lifetime prevalence that ranges from 11.7 to 16.6 patients per 1,000 inhabitants with an incidence range of 111.24 per 100,000 person-years (95%CI: 64.88-169.51).2424 Alva-Díaz C, Navarro-Flores A, Rivera-Torrejon O, et al. Prevalence and incidence of epilepsy in Latin America and the Caribbean: A systematic review and meta-analysis of population-based studies. Epilepsia 2021;62(04):984-996. Doi: 10.1111/epi.16850
https://doi.org/10.1111/epi.16850...
Our results are included in this data. Currently, Mexico is considered one of the countries with the highest prevalence of epilepsy (25:1,000) in Latin America, followed by Chile (17.75:1,000) and Guatemala (12.95:1,000); however, this estimation was established based on only 4 epidemiological studies from Mexico.2424 Alva-Díaz C, Navarro-Flores A, Rivera-Torrejon O, et al. Prevalence and incidence of epilepsy in Latin America and the Caribbean: A systematic review and meta-analysis of population-based studies. Epilepsia 2021;62(04):984-996. Doi: 10.1111/epi.16850
https://doi.org/10.1111/epi.16850...
Interestingly, in the present study, there were no differences were observed in relation to setting, whether it be urban/rural, or differences attributable to sex or age clusters, or even the income in LAC.

A recent report of the Prevention Task Force of the International League of Epilepsy conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories: perinatal insults, traumatic brain injury (TBI), CNS infection, and stroke. In fact, CNS infections were a more common attributed cause in low- and middle-income countries (LMIC), accounting for ∼ 5% of all epilepsy cases. Among some rural LMIC communities, the median proportion of epilepsy cases attributable to endemic NCC was as high as 34%. Therefore, a large proportion of the overall public health burden of epilepsy is due to preventable causes as well as to the attributable fraction for perinatal causes, infections, TBI and stroke, in sum reaching nearly 25%.2525 Thurman DJ, Begley CE, Carpio A, et al. The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy. Epilepsia 2018;59(05):905-914. Doi: 10.1111/epi.14068
https://doi.org/10.1111/epi.14068...

Significant limitations of the epidemiological studies used for the present review include the low sample size of each study, the heterogeneity of the studies, insufficient detail in describing the epilepsy types, the absence of stating epilepsy status (active or resolved), and the lack of mention of etiological sources.

Worthy of attention are the results of our study that show that the prevalence of epilepsy in Mexico in both rural and urban settings remain unchanged during the last 5 decades, even with scientific and technological advances in the sector of corresponding health issues; all the while, there continues to be a lack of access to health services in developing countries, and even more, in rural communities which greatly limit the diagnosis and treatment of epilepsy. This causes the prevalence to be higher in these regions compared with developed countries or communities with greater access to health services.2626 Thurman DJ, Logroscino G, Beghi E, et al; Epidemiology Commission of the International League Against Epilepsy. The burden of premature mortality of epilepsy in high-income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy. Epilepsia 2017;58(01):17-26. Doi: 10.1111/epi.13604
https://doi.org/10.1111/epi.13604...
In such a way that epilepsy is a public health problem that must be taken seriously, public policies must reflect this and be generated in order to guarantee access to adequate health services.

Furthermore, new, robust, and broad prospective epidemiological studies are needed to determine the national epidemiological profile of patients with epilepsy in Mexico to contribute delineated health policies, research investment and dedicated health infrastructure to reduce the existing gap disparities in epilepsy.

In conclusion, our results confirm a high prevalence of epilepsy in both urban and rural settings in Mexico that remain unchanged during the last 5 decades. All studies included in the present review showed multiple methodological limitations. The heterogeneity of the results could be due to differences in the population samples, the use of differing screening methods, the definitions and classifications used in the questionnaires, and selection bias. Caution is needed to interpret our findings. New and robust epidemiological studies are needed to delineate the epidemiological profile of epilepsy in Mexico.

References

  • 1
    World Health Organization. Epilepsy. Fact sheet. No. 999. 2012. Updated February 2016. Available in: http://www.who.int/mediacentre/factsheets/fs999/en/
    » http://www.who.int/mediacentre/factsheets/fs999/en/
  • 2
    Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a metaanalytic approach. Epilepsia 2010;51(05):883-890
  • 3
    Meyer AC, Dua T, Ma J, Saxena S, Birbeck G. Global disparities in the epilepsy treatment gap: a systematic review. Bull World Health Organ 2010;88(04):260-266. Doi: 10.2471/BLT.09.064147
    » https://doi.org/10.2471/BLT.09.064147
  • 4
    Keste D, Acevedo C, Medina MT Tomás Mesa, Jorge Rodríguez; Epilepsy in Latin America; Technical document based on presentations at the international work shop in Santiago, Chile, in August 2013. https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
    » https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
  • 5
    Panamericana de la Salud O Organización Mundial de la Salud. Liga Internacional Contra la Epilepsia-Buró Internacional para la Epilepsia. Estrategia y Plan de Acción sobre la Epilepsia. Washington (DC), Estados Unidos: OPS;2011[http://www.paho.org/hq/dmdocuments/epilepsia%20doc.pdf, last accessed on March 2015]. August 2013. https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
    » http://www.paho.org/hq/dmdocuments/epilepsia%20doc.pdf» https://www.ilae.org/files/dmfile/PAHO-report2016-English1.pdf
  • 6
    All-Mexican Population Census 2020Instituto Nacional de Estadìstica y Geograf ìa; https://www.inegi.org.mx/temas/estructura/
    » https://www.inegi.org.mx/temas/estructura/
  • 7
    Hamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2016;354:i4086. Doi: 10.1136/bmj.i4086
    » https://doi.org/10.1136/bmj.i4086
  • 8
    Banerjee A, Chaudhury S. Statistics without tears: Populations and samples. Ind Psychiatry J 2010;19(01):60-65. Doi: 10.4103/ 0972-6748.77642
    » https://doi.org/10.4103/0972-6748.77642
  • 9
    Olivares L. Neurological epidemiology in Mexico. Study of an urban population sample. Salud Publica Mex 1976;18(04): 665-672
  • 10
    Gutíerrez-Avila H, Rubio-Donnadieu F, Escobedo-Ríos F, González-Cortés A, Herón-Minero J. [Prevalence of epilepsy in schoolage children of an urban community in Mexico City]. Gac Med Mex 1980;116(11):497-501
  • 11
    Garcia-Pedroza F, Rubio-Donnadieu F, et al. Prevalence of epilepsy in children: Tlalpan Mexico City, Mexico. Neuroepidemiology 1983;2:16-23
  • 12
    García-Pedroza F, Rubio-Donnadieu F. Prevalencia de las crisis epilépticas en 23.000 niños de 3 año de primaria en escuelas públicas de 30 estados de la República Mexicana. [Prevalence of epileptic crises in 23,000 third-year primary school children in public schools in 30 Mexican states]. Epilepsia 1991;32 (Suppl 1):111
  • 13
    García Pedroza F, Rubio-Donnadieu F. Prevalencia de la Epilepsia en Comalcalco, Tabasco Prevalence: [Prevalence of Epilepsy in Camacalco, Tabasco]. Personal communication 1993-1994
  • 14
    Cruz-Alcala LE, Velazquez-Castellanos JL. Prevalencia de algunas enfermedades neurologicas en la ciudad de Tepatitlan Jalisco Mexico. Rev. Mex. Neuroci. 2002;3:71-76
  • 15
    Márquez L, Olivares L. Epilepsia en México. Estudio epidemiológico de una comunidad rural. Salud Publica Mex 1979;21(05): 487-495
  • 16
    Gutiérrez Avila JH. [Prevalence of epileptic seizures among children in a rural town of Mexico]. Salud Publica Mex 1980;22(03): 269-273
  • 17
    Gutierrez. Prevalence of Epilepsy in Naolinco, Veracruz. Archivos INNN 1993;8(03):168
  • 18
    Quet F, Preux PM, Huerta M, et al. Determining the burden of neurological disorders in populations living in tropical areas: who would be questioned? Lessons from a Mexican rural community. Neuroepidemiology 2011;36(03):194-203. Doi: 10.1159/000327496
    » https://doi.org/10.1159/000327496
  • 19
    San-Juan D, Alvarado-León S, Barraza-Díaz J, Davila-Avila NM, Ruíz AH, Anschel DJ. Prevalence of epilepsy, beliefs and attitudes in a rural community in Mexico: A door-to-door survey. Epilepsy Behav 2015;46:140-143
  • 20
    Fleury A, Sciutto E, Larralde C. Neurocysticercosis is still prevalent in Mexico. Salud Publica Mex 2012;54(06):632-636. Doi: 10.1590/s0036-36342012000600012
    » https://doi.org/10.1590/s0036-36342012000600012
  • 21
    Programa Especial de los Pueblos Indígenas 2014-2018, Primera edición, 2014http://www.cdi.gob.mx
    » http://www.cdi.gob.mx
  • 22
    GBD 2016 Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18 (04):357-375. Doi: 10.1016/S1474-4422(18)30454-X
    » https://doi.org/10.1016/S1474-4422(18)30454-X
  • 23
    Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology 2017;88(03):296-303. Doi: 10.1212/WNL.0000000000003509
    » https://doi.org/10.1212/WNL.0000000000003509
  • 24
    Alva-Díaz C, Navarro-Flores A, Rivera-Torrejon O, et al. Prevalence and incidence of epilepsy in Latin America and the Caribbean: A systematic review and meta-analysis of population-based studies. Epilepsia 2021;62(04):984-996. Doi: 10.1111/epi.16850
    » https://doi.org/10.1111/epi.16850
  • 25
    Thurman DJ, Begley CE, Carpio A, et al. The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy. Epilepsia 2018;59(05):905-914. Doi: 10.1111/epi.14068
    » https://doi.org/10.1111/epi.14068
  • 26
    Thurman DJ, Logroscino G, Beghi E, et al; Epidemiology Commission of the International League Against Epilepsy. The burden of premature mortality of epilepsy in high-income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy. Epilepsia 2017;58(01):17-26. Doi: 10.1111/epi.13604
    » https://doi.org/10.1111/epi.13604

Publication Dates

  • Publication in this collection
    28 Apr 2023
  • Date of issue
    2023

History

  • Received
    20 Aug 2021
  • Accepted
    09 Jan 2022
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