The effect of seizure on school attendance among children with epilepsy: a follow-up study at the pediatrics neurology clinic, Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia.

BACKGROUND

Epilepsy is the most common chronic neurological disease seen in Pediatrics Neurology Units in many developing countries. It affects negatively on school attendance and academic performance. This study tries to assess the extent and factors contributing school absenteeism among school-aged children and adolescents among epilepsy cases attending at Tikur Anbessa Hospital, Addis Ababa, Ethiopia.

METHODS

A hospital based follow-up study was conducted among school-aged children and adolescents with epilepsy between the ages of 7-18 years attending an outpatient Pediatric Neurology Clinic. A sample of consecutive 183 children and adolescents were included in the study full filling criteria of "attended school for at least 6 months in an academic year and walk by themselves with no disability." The participants (children and their parents/caregivers) gave information concerning the socio-demographic characteristics of the child and the primary caregiver, and review of the child's presentation and school absenteeism was defined as the average missed days per month over 6 months period and was asked in the questionnaire. Medical charts were thoroughly reviewed on the diagnosis and treatment they received. Study participants characteristics were described using frequency tables and factors associated with school absenteeism were analyzed using logistic regression.

RESULTS

School absenteeism (≥1 days/month) over 6 month period among children aged 7-18 years with epilepsy was 69.4%. Factors which correlated with school absenteeism included female sex (AOR 2.19, 95% CI 1.03-4.84), children with known causes for seizures (AOR 2.51, 95% CI 1.09-5.86), not experiencing seizure at school (AOR 0.39(0.17-0.89) and longer epilepsy duration (AOR 2.36: 1.09, 5.15). The mean age at onset Epilepsy was 4.6 years (±SD = 3.6). One hundred and thirty two (72.1%) had generalized epilepsy, 49(26.8%) had focal epilepsy and the remaining 2(1.1%) had unclassified epilepsy. One hundred and thirty (71.4%) received mono-therapy.

CONCLUSION

Experience of school absenteeism reported by over two thirds of children aged 7-18 years with epilepsy attending an outpatient epilepsy clinic in Ethiopia. Children with known seizure should be followed regularly, and compensation for missed school has to be organized.