Department of Psychiatry, Gilgil Sub-county Hospital, Nakuru County, P.O. BOX 129-20116, Gilgil, Kenya.
Department of Psychiatry, Mbagathi Hospital, Nairobi County, P.O. BOX 20725-00202, Nairobi, Kenya.
Epilepsy Behav. 2021 Jan;114(Pt A):107477. doi: 10.1016/j.yebeh.2020.107477. Epub 2020 Dec 4.
Epilepsy is a common neurological condition, with a lifetime prevalence of 1% in children. Research has shown a high prevalence of emotional and behavioral problems in children with epilepsy. The aim of this study was to determine the prevalence of emotional and behavioral problems in children with epilepsy attending the pediatric neurology clinic in a referral hospital in Kenya and examine associated sociodemographic and clinical variables.
This was a cross-sectional descriptive study. Children with epilepsy aged between 6 and 12 years attending the Kenyatta National Hospital pediatric neurology clinic were recruited. Inclusion criteria for the study were children diagnosed with epilepsy, age between 6 and 12 years, accompanied by a primary caregiver, and the primary caregiver being willing to participate in the study. A sociodemographic questionnaire as well as the Child Behavior Checklist school-age version (CBCL/6-18) was administered to the caregiver accompanying the child.
One hundred and seventy-seven children with epilepsy were recruited (66% males) with a mean age of 8.9 (standard deviation (SD): 2) years. The mean age at onset of seizures was 4.5 years; 48% of the children had first seizure while aged less than 2 years, 76% reported generalized tonic-clonic seizures, and 58% were on antiepileptic drugs (AEDs). The overall prevalence of emotional and behavioral problems was 46%, and the four leading symptom clusters were attention problems, aggressive behavior, social problems, and withdrawal/depression. The risk of emotional and behavioral problems was increased in children using more than one AED (odds ratio (OR) = 2.21, 95% confidence interval (CI), 1.18-4.14) and those aged ten years and above (OR = 2.7, 95% CI, 1.3-5.64). The risk of emotional and behavioral problems was reduced in children with infrequent seizures (OR = 0.08, 95% CI, 0.01-0.06) and in children reporting no seizure in the past year (OR = 0.08, 95% CI, 0.01-0.65).
Emotional and behavioral problems are common among children with epilepsy in Kenya. This highlights the need to screen for these problems in children on treatment for epilepsy for early identification and subsequent management to improve outcome.
癫痫是一种常见的神经系统疾病，儿童终生患病率为 1%。研究表明，癫痫儿童存在较高的情绪和行为问题发生率。本研究旨在确定在肯尼亚一家转诊医院的儿科神经科诊所就诊的癫痫儿童的情绪和行为问题发生率，并探讨相关的社会人口学和临床变量。
这是一项横断面描述性研究。纳入年龄在 6 至 12 岁之间、在肯雅塔国家医院儿科神经科诊所就诊的癫痫儿童。研究的纳入标准为：被诊断为癫痫、年龄在 6 至 12 岁之间、有主要照顾者陪同、且主要照顾者愿意参与研究的儿童。为陪同孩子的照顾者发放社会人口学问卷和儿童行为检查表（学龄版）（CBCL/6-18）。
共纳入 177 名癫痫儿童（66%为男性），平均年龄为 8.9（标准差：2）岁。癫痫发作的平均起始年龄为 4.5 岁；48%的儿童在 2 岁以下时首次发作，76%报告为全面强直阵挛发作，58%正在服用抗癫痫药物（AED）。情绪和行为问题的总体发生率为 46%，四个主要症状群为注意力问题、攻击性行为、社会问题和退缩/抑郁。使用一种以上 AED（优势比（OR）=2.21，95%置信区间（CI），1.18-4.14）和年龄在 10 岁及以上的儿童（OR=2.7，95% CI，1.3-5.64）发生情绪和行为问题的风险增加。发作频率较低的儿童（OR=0.08，95% CI，0.01-0.06）和过去一年无发作的儿童（OR=0.08，95% CI，0.01-0.65）发生情绪和行为问题的风险降低。
在肯尼亚，癫痫儿童中情绪和行为问题很常见。这凸显了需要对接受抗癫痫治疗的儿童进行这些问题的筛查，以便早期发现和后续管理，从而改善预后。
