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

摘要

研究背景
癫痫是最常见的重大神经系统疾病，可累及所有年龄段人群。由于医疗资源有限导致就医可及性不足，不同国家乃至同一国家内部不同地区的癫痫患病率均存在显著差异。

研究目的
癫痫作为全球性公共卫生问题，对墨西哥等发展中国家的民众影响尤为深重，这类国家亟需基于流行病学数据制定更积极的卫生政策，但目前相关数据匮乏，且该类数据随时间的变化趋势仍不明确。本研究旨在概述1970年至2020年间墨西哥癫痫的流行病学特征。

研究方法
我们检索了1970年至2020年间针对墨西哥城乡地区癫痫的描述性流行病学研究，提取其中有关社会人口学特征、患病率及发病率的可用数据。最终，本研究由两名研究者独立完成摘要筛选、全文审阅及数据提取，并遵循系统综述与荟萃分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）规范进行报告，同时采用描述性统计方法开展分析。

研究结果
最终共纳入11项样本代表性不足且异质性较强的流行病学研究。整体而言，墨西哥人群的癫痫患病率为3.9~41/1000；其中农村地区患病率为3.9~41/1000，城市地区为3.49~44.3/1000。所有纳入研究均未涉及癫痫的发病率。近50年来，墨西哥的癫痫患病率未发生明显变化。

研究结论
本研究结果证实，墨西哥城乡地区均存在较高的癫痫患病率，且近50年来该患病率未出现明显波动。本次综述纳入的所有研究均存在多项方法学缺陷。亟需开展高质量、严谨的流行病学研究，以明确墨西哥癫痫的流行病学特征。