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Published on: September 20, 2024
Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda - A Retrospective Study
Jane Namusisi1,2, Stella Kyoyagala1, Josephine Nantongo2
1Department of Pediatrics and Child Health, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
Insights
Seizure control in children with epilepsy (CWE) on anti-seizure medications (ASMs) is poor in low-resource settings. Comorbidities, birth asphyxia history, and adolescence are linked to poor seizure control in these children.
Area of Science:
- Pediatric Neurology
- Epilepsy Management
- Global Health
Background:
- Seizure control in children with epilepsy (CWE) on anti-seizure medications (ASMs) is a significant challenge, particularly in low-resource settings.
- Uncontrolled seizures in CWE are associated with increased morbidity, mortality, reduced quality of life, and heightened stigma.
Purpose of the Study:
- To determine the seizure control status among children with epilepsy (CWE) receiving anti-seizure medications (ASMs) at Mbarara Regional Referral Hospital (MRRH).
- To identify factors associated with poor seizure control in this pediatric population.
Main Methods:
- A retrospective chart review of 112 medical records of CWE receiving ASMs for at least six months was conducted.
- Caregiver interviews (physical or telephone) were used to ascertain current seizure control status.
Main Results:
- Poor seizure control was observed in 60.4% of the 112 enrolled participants.
- Factors significantly associated with poor seizure control included comorbidities (AOR 3.2), a history of birth asphyxia (AOR 17.8), and being an adolescent (AOR 6.8).
Conclusions:
- Seizure control among children with epilepsy on ASMs at MRRH remains suboptimal.
- Interventions to improve seizure control and optimize ASM treatment are crucial, especially for children with comorbidities, a history of birth asphyxia, and adolescents.
Background:
Seizure control among children with epilepsy (CWE) receiving anti-seizure medications (ASMs) remains a challenge in low-resource settings. Uncontrolled seizures are significantly associated with increased morbidity and mortality among CWE. This negatively impacts their quality of life and increases stigma.
Aim:
This study determined seizure control status and described the factors associated among CWE receiving ASMs at Mbarara Regional Referral Hospital (MRRH).
Methods:
In a retrospective chart review study, socio-demographic and clinical data were obtained from 112 medical records. CWE receiving ASMs for at least six months and regularly attending the clinic were included in the study. Physical or telephone interviews were conducted with the immediate caregivers of the CWE to establish the current seizure control status of the participants.
Results:
A total of 112 participants were enrolled. Of these, three-quarters had generalized onset seizures, 23% had focal onset seizures, while 2% had unknown onset motor seizures. About 60.4% of the study participants had poor seizure control. Having a comorbidity (p-value 0.048, AOR 3.2 (95% CI 1.0-9.9)), history suggestive of birth asphyxia (p-value 0.014, AOR 17.8 (95% CI 1.8-176.8)), and being an adolescent (p-value 0.006, AOR 6.8 (95% CI 1.8-26.6)) were significantly associated with poor seizure control.
Conclusion:
Seizure control among CWE receiving ASMs at MRRH remains poor. Efforts geared to addressing seizure control and optimizing drugs are needed, especially among children with comorbidities, those with history of birth asphyxia, and adolescents.
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