Prevalence and Associated Factors of Phenytoin Induced Gingival Over growth (Pigo) among Children Receiving Phenytoin Treatment in Selected Addis Ababa Governmental Hospitals,Ethiopia, Cross-Sectional Study
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Date
2025-02-05
Authors
GebreEgziabher Kassa
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Publisher
Addis Ababa University
Abstract
Gingival overgrowth (GO) is a frequent complication associated with various medications, including anticonvulsants such as phenytoin, which is a medication commonly prescribed to treat epilepsy. Other drugs, such as immunosuppressant and calcium channel blockers can also cause GO. Phenytoin is a particularly concerning medication, as it is estimated that 30–50% of patients taking it experience significant gum enlargement. This side effect, known as phenytoin-induced gingival overgrowth (PIGO), can cause considerable cosmetic and functional problems, especially for children, because phenytoin remains widely used, particularly in developing countries. This is reflected in research conducted at Tikur Anbessa Hospital in Addis Ababa, Ethiopia. Among children with epilepsy who were on monotherapy, phenytoin was the most commonly used medication, accounting for 33.6% of the cases. This study investigated the prevalence of PIGO and associated factors among children in Addis Ababa-selected governmental hospitals, which is highly relevant.
Objectives This study aims to address the prevalence and associated factors of phenytoin-induced gingival overgrowth (PIGO) among children receiving phenytoin treatment in selected Addis Ababa governmental hospitals, in Ethiopia.
Methodology This study was conducted using a hospital-based cross-sectional study design from August 2024 to January 2025 GC at Tikur Anbessa Specialized Hospital and Yekatit 12 Hospital pediatric neurology follow-up clinics. Using a single population proportion formula with 95% confidence and 5% precision, the required sample size was 328. The data were entered into the Statistical Package for Social Sciences version 27 (SPSS) for subsequent descriptive and analytical statistical analysis where applicable. Descriptive statistics were employed to summarize the data, and the results were presented using tables and figures. All variables were included in the bivariate logistic regression analysis. Variables with a p-value of less than 0.2 were further considered for multivariate logistic regression to identify potential predictors of PIGO. A statistically significant association was defined as a p-value of < 0.000, AOR = 5.704, 95% CI = 3.060–10.633). Additionally, children using other AEDs had a 3.26-fold higher risk than those on phenytoin alone (p < 0.000, AOR = 3.259).
Conclusion In this study, the prevalence of PIGO was 52%, slightly above half .Age, duration of phenytoin use, dosage, and the use of additional antiepileptic drugs (AEDs) were identified as significant predictors of PIGO.
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Keywords
PREVALENCE AND ASSOCIATED FACTORS OF PHENYTOIN INDUCED GINGIVAL OVERGROWTH