Epilepsy affects nearly one in forty people aged 12 and older in central Côte d’Ivoire districts

A large household survey in central Côte d’Ivoire has found that epilepsy affects roughly one in forty residents aged 12 years and older in the districts of Béoumi, Botro and Sakassou in the Gbeke region. The community-based cross-sectional study, run as part of an epilepsy and mental health programme launched by Médecins Sans Frontières in the region in 2021, estimated a survey-adjusted prevalence of 22.8 per 1,000 people (95% confidence interval: 17.4–29.3). When the results were further adjusted for the published sensitivity of the screening instrument, the estimate rose slightly to 24.0 per 1,000.

The survey took place between 29 April and 31 May 2025 and recruited 2,586 participants using a two-stage cluster sampling design. Villages were selected as first-stage clusters with probability proportional to their size, and households were then chosen within villages. The age cut-off of 12 years reflected the fact that the screening questionnaire had been validated only for adolescents and adults; including younger children would have required specialised paediatric neurological evaluation beyond the operational scope of the survey. Participants who screened positive were subsequently examined by neurologists, who confirmed diagnoses using clinical assessment and supportive diagnostic investigations where indicated.

Of the 2,586 participants, 61.7% were female and 70.3% lived in rural areas. In total, 424 people screened positive for epilepsy, 288 of whom were assessed by a neurologist, and 59 were confirmed to have the condition. Because the analysis accounted for the two-stage cluster design, the resulting prevalence estimates and confidence intervals reflect the survey’s sampling structure rather than a simple count of confirmed cases.

Prevalence varied noticeably across the three districts: 33.2 per 1,000 in Botro, 23.8 per 1,000 in Sakassou and 11.9 per 1,000 in Béoumi. However, the authors report that this district association was not statistically significant after design-adjusted testing (p = 0.147), so the apparent geographic gradient should be interpreted with caution rather than as firm evidence of differing local burden.

In the study’s prespecified primary model, age was the only sociodemographic factor associated with epilepsy, with an adjusted odds ratio of 0.98 per additional year of age (95% CI: 0.95–1.00; p = 0.038), indicating a modestly lower odds of epilepsy with each additional year. An exploratory model that additionally included marital status, education and occupation found that being single (adjusted odds ratio 2.72; 95% CI: 1.20–6.17) and working from home (adjusted odds ratio 3.88; 95% CI: 1.20–12.53) were associated with epilepsy. With only about 3.5 confirmed events per variable, however, these estimates are statistically unstable and the authors explicitly label them exploratory.

The treatment findings are among the most consequential. Of the 59 confirmed cases, 57 met the definition of active epilepsy, and 33 of those — 57.9% (95% CI: 38.4–75.2) — were not receiving antiseizure medication. Among all 59 confirmed cases, the proportion untreated was 35, or 59.3%. In other words, close to six in ten people with active epilepsy in these districts were going without medication at the time of the survey.

The authors stress that apart from age, the sociodemographic associations should not be interpreted causally, given the small number of confirmed cases and the cross-sectional design, which captures a single point in time and cannot establish temporal relationships between factors and disease. The study also excludes children under 12, meaning the total burden of epilepsy in the wider population, including young children, is not captured by these figures.

The background to the study notes that epilepsy affects more than 50 million people worldwide, with nearly 80% of the disease burden occurring in low- and middle-income countries, while population-based prevalence data for Côte d’Ivoire have remained scarce. That gap has limited evidence-based planning and implementation of control strategies, which is precisely what the survey in the Gbeke region was designed to address.

The authors conclude that the findings support strengthening access to epilepsy diagnosis, antiseizure medication and continuity of care in the three study districts. Given the high proportion of untreated active cases, the survey provides a concrete baseline for the ongoing Médecins Sans Frontières programme and for health authorities weighing where to direct diagnostic and treatment resources in central Côte d’Ivoire.

Subject of Research: Community-based cross-sectional study of epilepsy prevalence and associated factors in central Côte d'Ivoire

Article Title: Prevalence and factors associated with epilepsy among people aged 12 years and older in Beoumi, Botro and Sakassou districts of Gbeke region, Cote d’Ivoire: a community-based cross-sectional study

Article References: Doumbia, C. O., Biaou Boni, O. R., Kambou Fomo, M. B., Ophelia Dovoedo, N. S., Cissokho, Y., Katsomya, A. M., Sassi, R., Katuala, Y., Sidibe, D., Issoufou, S. H., Adjaho, I. I., Salumu, L., Abdou, A., Achi, H. V., Karidioula, H. A., Ale, F., & Houinato, D. (2026). Prevalence and factors associated with epilepsy among people aged 12 years and older in Beoumi, Botro and Sakassou districts of Gbeke region, Cote d’Ivoire: a community-based cross-sectional study. BMC Neurology. https://doi.org/10.1186/s12883-026-05515-y

Image Credits: AI Generated

DOI: 10.1186/s12883-026-05515-y

Keywords: epilepsy, Côte d'Ivoire, prevalence, cross-sectional study, Gbeke region, Médecins Sans Frontières, antiseizure medication, treatment gap, community survey, neurology, factors, associated