埃塞俄比亚慢性随访癫痫儿童的治疗结果及其预测因素：系统评价和荟萃分析。

BACKGROUND: Seventy percent of epileptic patients may not experience seizures if they receive proper treatment with antiepileptic drugs (AEDs). However, many children and adolescents face poor seizure control (PSC). Therefore, the purpose of this review is to systematically and quantitatively summarize the pooled prevalence of PSC and its predictors among children with epilepsy in Ethiopia. METHODS: The following databases were used to conduct a thorough literature search: Africa Journal of the Online Library, Hinari, Google Scholar, PubMed, Science Direct, EMBASE, Cochrane Database, Sci-Hub, and Scopus. To evaluate the quality of the studies, Newcastle‒Ottawa Scale (NOS) checklists were utilized. The data on study characteristics and prevalence estimates were then combined via random effects meta-analysis, followed by subgroup and sensitivity analyses. Both visual and statistical analyses were employed to assess for any potential publication bias. RESULTS: This review analyzed a total of 12 main studies and reported that the overall prevalence of PSC was 42.42% (95% CI: 33.42-51.42). However, there was significant heterogeneity in the results based on the study region, design, and seizure-free period. The subgroup analysis revealed that the highest prevalence of PSC was found in Southern Nations, Nationalities, and Peoples' (SNNPs) studies (61.88%; 95% CI: 35.91-87.85), studies with a cross-sectional design (46.73%; 95% CI: 36.83-56.62), and studies with a seizure-free period < 6 months (44.69%; 95% CI: 34.51-54.86). However, the lowest prevalence was observed in the Amhara region (35.54%; 95% CI: 27.40-43.67), cohort studies (29.53%; 95% CI: 21.26-38.21), and studies with a seizure-free duration of six months or more (41.64%; 95% CI: 29.94-53.35). The results also revealed a significant correlation between PSC and medication nonadherence (4.64, 95% CI: 2.84-7.58), comorbidities (2.08, 95% CI: 1.01-4.26), and seizure type (3.59, 95% CI: 1.18-10.8). CONCLUSION: Based on this review, the findings suggest a notable prevalence of poorly controlled seizures (PSC) among children with epilepsy who are receiving antiepileptic drugs (AEDs) in Ethiopian outpatient epilepsy clinics. Seizures of tonic‒clonic status, comorbidities, and medication nonadherence were associated with poor seizure control.

背景：如果癫痫患者接受适当的抗癫痫药物（AED）治疗，70%的患者可能不会发作。然而，许多儿童和青少年面临着较差的癫痫发作控制（PSC）。因此，本综述的目的是系统地和定量地总结埃塞俄比亚癫痫儿童 PSC 的总体患病率及其预测因素。

方法：使用以下数据库进行全面的文献检索：非洲在线图书馆杂志、Hinari、Google Scholar、PubMed、Science Direct、EMBASE、Cochrane 数据库、Sci-Hub 和 Scopus。为了评估研究的质量，使用了纽卡斯尔-渥太华量表（NOS）检查表。然后通过随机效应荟萃分析合并研究特征和患病率估计值，随后进行亚组和敏感性分析。采用视觉和统计分析来评估是否存在潜在的发表偏倚。

结果：本综述共分析了 12 项主要研究，报告称 PSC 的总体患病率为 42.42%（95%CI：33.42-51.42）。然而，基于研究区域、设计和无癫痫发作期的结果存在显著异质性。亚组分析显示，PSC 患病率最高的是南部各族人民（SNNPs）研究（61.88%；95%CI：35.91-87.85），横断面设计的研究（46.73%；95%CI：36.83-56.62），无癫痫发作期<6 个月的研究（44.69%；95%CI：34.51-54.86）。然而，在阿姆哈拉地区（35.54%；95%CI：27.40-43.67），队列研究（29.53%；95%CI：21.26-38.21）和无癫痫发作持续时间为 6 个月或更长时间的研究（41.64%；95%CI：29.94-53.35）中观察到的PSC 患病率最低。结果还表明，PSC 与药物依从性差（4.64，95%CI：2.84-7.58）、合并症（2.08，95%CI：1.01-4.26）和癫痫发作类型（3.59，95%CI：1.18-10.8）之间存在显著相关性。

结论：根据本综述，研究结果表明，在埃塞俄比亚门诊癫痫诊所接受抗癫痫药物（AED）治疗的癫痫儿童中，癫痫发作控制不良（PSC）的发生率相当高。强直-阵挛性癫痫状态、合并症和药物依从性差与癫痫发作控制不良相关。