Link between epilepsy and malnutrition in a rural area of Benin

Purpose: Epilepsy and malnutrition are both important public health problems in sub-Saharan Africa. A relationship between epilepsy and malnutrition has been suspected for many years. Our objective was to investigate the association between epilepsy and malnutrition in Djidja, Benin. Methods: A matched population-based cross-sectional case-control survey was performed: cases (patients with epilepsy) were matched to controls according to sex, age 5 years, and village of residence. The World Health Organization's criteria for malnutrition was used. Anthropometric measurements (weight, height, mid arm upper circumference, triceps skinfold thickness) were taken. Bioelectrical impedance analysis, a standardized food and social questionnaire and a clinical examination were done. Statistical analysis (conditional logistic regression) was performed using SAS 8.0. Results: A total of 131 cases and 262 controls were included. The prevalence of malnutrition was higher in cases than in controts (22.1% vs. 9.2%, p = 0.0006). Social factors were significantly different between cases and controls. Feeding difficulties were more frequent and health status was worse in cases. Seven variables were associated with epilepsy: (i) nutritional factors: mid arm upper circumference (prevalence odds ratio (pOR) = 0.7, CI: 0.6-0.9), cereal consumption <3 times during the 3 days before the study (pOR = 4.2, CI: 1.8-10.0), <3 meals/day (pOR = 4.2, Cl: 1.6-10.9), tooth decay (pOR = 2.9, CI: 1.1-7.4), food taboos (pOR = 25.0, CI: 8.3-100.0), (ii) social factors: surrogate respondent (pOR = 16.8, CI: 3.1-90.3) and no second job (pOR = 7.1, CI: 2.3-22.3). Conclusion: Epilepsy and nutritional status are linked in sub-Saharan Africa. Programs to improve the nutritional status of people with epilepsy are needed.