Treatment outcome and associated factors among patients with epilepsy

Yirga Legesse Niriayo,Gebre Teklemariam Demoz,Kidu Gidey,Tesfaye Dessale Kassa,Abraham Mamo,Seid Ibrahim,Solomon Weldegebreal Asgedom,Tesfay Mahari Atey

doi:10.1038/s41598-018-35906-2

Yirga Legesse Niriayo, Gebre Teklemariam Demoz + Show 6 more

Open Access

https://doi.org/10.1038/s41598-018-35906-2

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Journal: Scientific Reports	Publication Date: Nov 26, 2018
Citations: 46	License type: open-access

Affiliation: Mekelle University, Aksum University

Abstract

Epilepsy is a major public health problem worldwide. Despite multiple drug therapies, people with epilepsy continue to have frequent seizures. There is a dearth of data on epilepsy treatment outcome and associated factors in our setting. Therefore, the aim of this was to assess treatment outcome and associated factors among epileptic patients on follow up at the neurologic clinic of Ayder comprehensive specialized hospital, Ethiopia. A cross-sectional study was conducted on randomly selected epileptic patients. Data were collected through patient interview and review of medical records. Epilepsy treatment outcome was evaluated in terms of seizure control status in the last one year follow up period. Binary logistic regression analysis was performed to identify predictors of treatment outcome. A total of 270 patients were included. Of whom, 46.6% had controlled seizures. Whereas, 38.5%, 8.8%, and 5.9% had experienced seizure attacks 1–5 times, 6–10 times, and greater than 10 times, respectively. Alcohol consumption [adjusted odds ratio [(AOR): 14.87, 95% confidence interval (CI): 3.25–68.11], negative medication belief [AOR: 3.0, 95%CI: 1.31–6.71], low medication adherence [AOR:11.52, 95%CI: 3.25–40.82], and presence of comorbidities [AOR: 10.35, 95%CI: 4.40–24.40] were predictors of uncontrolled seizure. Our finding revealed that more than half of the epileptic patients had uncontrolled seizure. Epileptic patients with a negative medication belief, comorbidities, low medication adherence, and those who consume alcohol were more likely to have uncontrolled seizure. Therefore, more emphasis should be given to these patients.

Highlights

Epilepsy is a chronic neurologic disorder characterized by repeated epileptic seizures attacks which result from paroxysmal uncontrolled discharges of neurons within the central nervous system[1,2,3,4]
Most of the people with epilepsy can become seizure-free with the optimal use of drug therapy, the treatment outcome in the majority of epileptic patients remains unsatisfactory in resources limited countries[8]
A number of problems affect the provision of adequate treatment of epilepsy and these problems are more pronounced in developing countries

Summary

Introduction

Epilepsy is a chronic neurologic disorder characterized by repeated epileptic seizures attacks which result from paroxysmal uncontrolled discharges of neurons within the central nervous system[1,2,3,4]. Epilepsy is a major public health problem that affects more than 50 million people worldwide, of whom, 80% were living in developing countries[5,6,7,8]. Majority of epileptic seizures are controlled with the optimal use of the currently available AEDs. about one-third remained uncontrolled despite optimal therapy[12,13]. Most of the people with epilepsy can become seizure-free with the optimal use of drug therapy, the treatment outcome in the majority of epileptic patients remains unsatisfactory in resources limited countries[8]. Studies have shown that majority [80–90%] of the patients with epilepsy are not receiving appropriate treatment in developing countries[8,14]. Controlled seizure leads to impairment of quality of life, excessive bodily injury, neuropsychological impairment, social stigma, reduced marriage rates, poor education, reduced employment levels, and shortened lifespan[23,24,25]

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