Nasir Mohammed, Abebaw Ermias, Ahmed Muluken, Ketema Daniel Bekele
Pediatrics Department, Hawassa University, Hawassa, Ethiopia.
Pediatrics Department, ALERT Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
Pediatric Health Med Ther. 2023 Oct 31;14:385-404. doi: 10.2147/PHMT.S436022. eCollection 2023.
Epilepsy is an important cause of neurological morbidity in children and adolescents. Clinical parameters are the main diagnostic tools, especially in developing countries. Although cost-effective treatments for epilepsy are available, studies have shown that uncontrolled seizures can occur in many patients.
To assess clinical characteristics, treatment outcomes, and associated factors for controlled epilepsy among children with epilepsy who underwent follow-up at the Debre Markos Comprehensive Specialized Hospital, North-west Ethiopia from October 28, 2020, to April 28, 2021.
An institutional-based retrospective cohort study was conducted from October 28, 2020, to April 28, 2021. A total of 385 participants who fulfilled the inclusion criteria were included in the study. A pretested, structured, interviewer-administered questionnaire with a chart review was used to collect data. The data were entered into the Epi-data software version 4.4.2.1 and then exported to the Stata version 14 statistical package for analysis. Descriptive statistics were used to describe the sociodemographic and clinical characteristics, treatment profiles, and treatment outcomes of patients with epilepsy. Bivariate and multivariate analyses were used to identify factors associated with treatment outcomes.
The most frequent type of seizure among the 385 respondents was Generalized-tonic-clonic seizures (88.1%). The proximate cause of seizures was identified in 15% of patients, of whom 45 had a perinatal history (8.8%), head injury (3.6%), and CNS infection (2.3%). One-third of patients had poor seizure control. Caregiver relationship (father AOR=0.58; 95th CI:0.35,0.97) and poor adherence (AOR=2.97; 95th CI:1.82, 4.86) were significantly associated with treatment outcome.
One-third of children with epilepsy have poor seizure control. Poor adherence to treatment is implicated in poor control. Counseling caregivers on proper treatment and adherence to anti-epileptic medication is recommended to improve treatment outcome in children.
癫痫是儿童和青少年神经疾病发病的一个重要原因。临床参数是主要的诊断工具，在发展中国家尤其如此。尽管有成本效益高的癫痫治疗方法，但研究表明，许多患者仍可能出现癫痫发作不受控制的情况。
评估2020年10月28日至2021年4月28日在埃塞俄比亚西北部德布雷马尔科斯综合专科医院接受随访的癫痫患儿的临床特征、治疗结果以及癫痫得到控制的相关因素。
2020年10月28日至2021年4月28日进行了一项基于机构的回顾性队列研究。共有385名符合纳入标准的参与者被纳入研究。通过一份经过预测试的、结构化的、由访谈员实施的问卷并结合病历审查来收集数据。数据录入Epi - data软件4.4.2.1版本，然后导出到Stata 14统计软件包进行分析。描述性统计用于描述癫痫患者的社会人口学和临床特征、治疗情况及治疗结果。采用双变量和多变量分析来确定与治疗结果相关的因素。
385名受访者中最常见的癫痫发作类型是全身强直 - 阵挛性发作（88.1%）。15%的患者明确了癫痫发作的近因，其中45人有围产期病史（8.8%）、头部受伤（3.6%）和中枢神经系统感染（2.3%）。三分之一的患者癫痫发作控制不佳。照顾者关系（父亲，调整后比值比=0.58；95%置信区间：0.35，0.97）和依从性差（调整后比值比=2.97；95%置信区间：1.82，4.86）与治疗结果显著相关。
三分之一的癫痫患儿癫痫发作控制不佳。治疗依从性差与控制不佳有关。建议对照顾者进行适当治疗和坚持服用抗癫痫药物的咨询，以改善儿童的治疗结果。
