Poor academic performance among adolescents with epilepsy in Kaduna, Northern Nigeria: A case-control study

Abstract

ARTICLEEpilepsy is the most common severe non-infectious neurological disorder affecting both children and adults, 1 and the majority of sufferers live in developing countries. 2 In children and adolescents epilepsy is associated with impairment in academic performance, 3-7 which may limit future employment opportunities. 8 In Nigeria, studies have linked epilepsy with missing school, dropping out of school and poor academic performance. 4-,11 Factors that predispose a child or adolescent with epilepsy to poor school performance include the age of the child, age of onset of seizures, seizure frequency, 12 type of seizure, IQ of the child, 4 poor memory, inattention, 13 low self-esteem, and psychosocial and sociodemographic factors. 9 The aims and objectives of this study were therefore to assess the academic performance of adolescents with epilepsy in Kaduna and identify factors that may be associated with poor performance in this population in a Northern Nigerian setting. MethodsThe study was carried out in the outpatient clinic of Federal Neuropsychiatric Hospital, Kaduna, North-West, Nigeria. The hospital is a tertiary health institution that receives referrals (mostly psychiatric, but also neurological) from virtually all the states in Northern Nigeria and the Federal Capital Territory Abuja. In this cross-sectional study, the socio-demographic/clinical characteristics of 77 consecutive adolescents (aged 12 -17 years) with epilepsy attending the Child and Adolescent Clinic of the hospital between March 2008 and September 2010 and the socio-demographic characteristics of 76 controls (matched for age and sex) were recorded. Information concerning school attendance (regularity of attendance at school) and academic performance (academic records for the three most recent consecutive terms) of the patients and the controls were obtained from the adolescents and their parents or caregivers. For the purposes of the study, poor academic performance was defined as persistent below-average performance as reported by the informants, or a decline from previous performance since the onset of the illness Results. The mean ages of the subjects and the controls were 15.1 (standard deviation (SD) 2.1) and 14.7 (SD 1.7) years, respectively (p>0.05), the mean duration of illness was 6.1 (SD 4.6) years, the mean seizure-free period was 16.8 (SD 15.6) weeks, and 64.9% of the subjects and 57.9% of the controls were males. Forty-six subjects (59.7%) and 12 controls (15.8%) had poor academic performance (p<0.001). Long duration of illness, short seizure-free periods and irregular school attendance were significantly associated with poor academic performance (p<0.05). Conclusions. Poor academic performance is common among adolescents with epilepsy and is associated with early onset, poor seizure control and missing school. Efforts should be made to control seizures and educate society about the illness.

Childhood epilepsy in a tropical child psychiatric unit: Challenges of providing care in a resource-constrained environment

“…[20] All caregivers who had a positive family history indicated higher number of challenges most likely occasioned by the additional burden. However, the observation was not significant.…”

“…[22] For example, stress has been identified as a cofounding issue among caregivers in epilepsy and other conditions with special health care needs. [20,22,23] It calls for the formal incorporation and strengthening of caregiver psychosocial management in the management plan for children with epilepsy.…”

“…[19] Poor school performance has been reported among children with epilepsy. [20] This has been attributed to several factors including uncontrolled seizures resulting in absenteeism, mockery at school, and impact of some of the AEDs on learning. [20] Additionally, some children are discriminated against and denied educational opportunities because they have epilepsy.…”

“…[20] This has been attributed to several factors including uncontrolled seizures resulting in absenteeism, mockery at school, and impact of some of the AEDs on learning. [20] Additionally, some children are discriminated against and denied educational opportunities because they have epilepsy. Nuhu et al, [20] reported an 18% school rejection rate among a group of adolescents with epilepsy.…”

“…[20] Additionally, some children are discriminated against and denied educational opportunities because they have epilepsy. Nuhu et al, [20] reported an 18% school rejection rate among a group of adolescents with epilepsy. Over half of the caregivers indicated their child's poor school performance as a challenge in this study.…”