Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda – A Retrospective Study

Abstract

Background: Seizure control among children with epilepsy (CWE) receiving anti-seizure medications (ASMs) remains a challenge in low-resource settings. Uncontrolled seizures are significantly associated with increased morbidity and mortality among CWE. This negatively impacts their quality of life and increases stigma.Aim: This study determined seizure control status and described the factors associated among CWE receiving ASMs at Mbarara Regional Referral Hospital (MRRH). Methods: In a retrospective chart review study, socio-demographic and clinical data were obtained from 112 medical records. CWE receiving ASMs for at least six months and regularly attending the clinic were included in the study. Physical or telephone interviews were conducted with the immediate caregivers of the CWE to establish the current seizure control status of the participants. Results: A total of 112 participants were enrolled. Of these, three-quarters had generalized onset seizures, 23% had focal onset seizures, while 2% had unknown onset motor seizures. About 60.4% of the study participants had poor seizure control. Having a comorbidity (p-value 0.048, AOR 3.2 (95% CI 1.0-9.9)), history suggestive of birth asphyxia (p-value 0.014, AOR 17.8 (95% CI 1.8-176.8)), and being an adolescent (p-value 0.006, AOR 6.8 (95% CI 1.8-26.6)) were significantly associated with poor seizure control. Conclusion: Seizure control among CWE receiving ASMs at MRRH remains poor. Efforts geared to addressing seizure control and optimizing drugs are needed, especially among children with comorbidities, those with history of birth asphyxia, and adolescents.

Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda – A Retrospective Study [Letter]

“…Physical or telephone interviews were conducted with the patient’s direct caregiver. 1 This method was quite effective although the researcher acknowledged that some telephone contacts were not available online at the time of data collection. We suggest that researchers also complete data on recurrence factors in patients such as the number of antiepileptic drugs (AED), electroencephalogram (EEG) data and seizure-free time, because all of these data will help in assessing factors that cause seizure control in children with epilepsy.…”

“…In conclusion we agree that seizure control in Children with Epilepsy (CWE) receiving Anti-Seizure Medications (ASM) at MRRH is still poor. 1 However, the hospital has been trying to overcome seizure control and optimize the drug needed. We recommend that future studies can provide genetic analysis data representing detailed individual phenotypes to assist in the interdisciplinary treatment and prognosis of patients who have complicated neurodevelopmental disorders.…”

“…2 The study conducted by Jane Namusisi et al aimed to determine seizure control status and factors related to control among Children with Epilepsy (CWE) who received Anti-Seizure Medications (ASM). 1 The results found that threequarters of the correspondents had generalized onset seizures and the remainder had unrecognized focal and motor seizures. However, because the data obtained using medical records, it is difficult for researchers to determine matters related to the seizure onset, nature, and duration of the seizure when the patient comes to the hospital.…”

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We have read the paper by Jane Namusisi et al on Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda. 1 This study helps us to assess the factors that cause seizure control in children with epilepsy, including the medication given. We would like to share our views about this study because mismanagement of epilepsy can have a negative impact on the quality of life of children who suffer from it.

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Poor Seizure Control Among Children Attending a Tertiary 8 Hospital in South Western Uganda – A Retrospective Study [Response to Letter]

“…All the children attending the epilepsy clinic are reviewed by a pediatric neurologist and diagnoses various comorbidities associated with the seizures. 2 …”