Patterns of treatment outcome of epilepsy and associated factors among patients on followup at adult neurology clinic at Tikur Anbessa Specialized Teaching Hospital: Hospital based cross sectional study October 1-30, 2020G.C
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Date
2020-12
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Addis Abeba University
Abstract
Background: Pattern of treatment outcome can be categorized based on the effect of an
intervention on seizure control in relation to occurrence of adverse effects. A minimum of 12
months of seizure freedom from all types of seizure is required to label a treatment outcome as
seizure freedom. Predictors of seizure treatment outcome can be utilized to direct resources
towards strategies that lead to good seizure outcome. Despite the availability of interventions
which can control the seizure frequency to an extent of 70% a large number of epileptic patients
continue to have a seizure.
Objective: Patterns of treatment outcome of epilepsy and associated factors among patients on
follow-up at adult neurology clinic at Tikur Anbessa Specialized Teaching Hospital: Hospitalbased
cross-sectional
study
October
1-30,
2020G.C
Methods: A hospital-based cross-sectional descriptive study is conducted among epileptic
patients who have a follow-up at the Neurology department referral clinic, Tikur Anbessa
Specialized Hospital, Addis Ababa from Oct 1-30. A convenient sampling method was used. A
questionnaire including, sociodemographic status, is used to assess patterns of treatment outcome
with associated factors. The data were entered, processed, and analyzed using SPSS 26 window
version.
Result: A total of 245 participants were included in the study. More than half 145(59.2%) of
patients with epilepsy were in the age range of 15-30. Among participants male gender account
for 113(54.3%) and female gender for 112(45.7%). The age of onset of a seizure was below 15
for 115(46.9%) of patients. Generalized onset seizures 154(62.9%) was the commonest type of seizure diagnosed. Comorbidity is seen in 110(44.9%). Monotherapy 68(27.8%) was commonly
used for treatment of seizure. The 166(67.8%) of patients had developed antiepilepatic related
adverse event. Antiepileptic dugs non adherence seen in 68(27.8%)of patients. In 41(16.7%) of
patients there is no seizure attack after initiation of antiepileptic medications. Seizure freedom was seen in 99(40.4%) of patients. Sex (adjusted odds ratio (AOR)= 3.316,
CI=1.044-10.534;p-value=0.042) was predictor of poor seizure control.
Conclusion: In this study, it was found that more than two-thirds of the participants continue to
have seizure activity despite being placed on antiepileptic medications. Still, a large proportion
of patients are not adherent to the medication prescribed. The older generation of antiepileptic
medications utilized and more than half of patients reporting adverse events. Male sex is found to
have a three times higher risk of developing poor seizure control. A further multicenter study of
different subgroups of treatment is recommended and effect of sex on seizure can be studied
further.
Description
Keywords
Pattern of treatment response, Anti-epileptic drugs, Adverse Events