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乌干达西南部一家三级医院儿童癫痫控制不佳的回顾性研究

Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda - A Retrospective Study.

作者信息

Namusisi Jane, Kyoyagala Stella, Nantongo Josephine, Kyewalyanga Mike, Sabiiti Stephen, Murorunkwere Angelique, Najjuma Josephine Nambi, Nakibuuka Jane, Kaddumukasa Mark, Sajatovic Martha, Kalubi Peter

机构信息

Department of Pediatrics and Child Health, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.

Department of Pediatrics and Child Health, Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda.

出版信息

Int J Gen Med. 2023 Mar 7;16:895-904. doi: 10.2147/IJGM.S398318. eCollection 2023.

Abstract

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 (-value 0.048, AOR 3.2 (95% CI 1.0-9.9)), history suggestive of birth asphyxia (-value 0.014, AOR 17.8 (95% CI 1.8-176.8)), and being an adolescent (-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.

摘要

背景

在资源匮乏地区,接受抗癫痫药物(ASMs)治疗的癫痫儿童(CWE)的癫痫控制仍然是一项挑战。癫痫发作不受控制与CWE发病率和死亡率增加显著相关。这对他们的生活质量产生负面影响,并增加耻辱感。

目的

本研究确定了姆巴拉拉地区转诊医院(MRRH)接受ASMs治疗的CWE的癫痫控制状况,并描述了相关因素。

方法

在一项回顾性病历审查研究中,从112份病历中获取了社会人口统计学和临床数据。纳入研究的CWE接受ASMs治疗至少六个月且定期到诊所就诊。对CWE的直接照顾者进行了面对面或电话访谈,以确定参与者目前的癫痫控制状况。

结果

共招募了112名参与者。其中,四分之三为全面性发作,23%为局灶性发作,2%为发作类型不明的运动性发作。约60.4%的研究参与者癫痫控制不佳。患有合并症(P值0.048,调整后比值比3.2(95%置信区间1.0 - 9.9))、有出生窒息史(P值0.014,调整后比值比17.8(95%置信区间1.8 - 176.8))以及为青少年(P值0.006,调整后比值比6.8(95%置信区间1.8 - 26.6))与癫痫控制不佳显著相关。

结论

在MRRH接受ASMs治疗的CWE的癫痫控制仍然很差。需要努力解决癫痫控制问题并优化药物治疗,特别是对于患有合并症、有出生窒息史的儿童以及青少年。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d640/10007866/34e08beb4df2/IJGM-16-895-g0001.jpg

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