Research Articles

Short-term treatment outcome of childhood epilepsy in Jos, Nigeria

2024-06-26T03:43:48Z

Short-term treatment outcome of childhood epilepsy in Jos, Nigeria Aderonke, Courage Background: Childhood epilepsy causes tremendous burden for the child, the family, the society and the healthcare system. While the majority of patients with epilepsy respond well to one antiepileptic drug (AED), many respond poorly to antiepileptic therapy with two or more AEDs, or develop drug-resistant epilepsy (DRE). We evaluated the short-term treatment outcomes of childhood epilepsy at a tertiary hospital in Nigeria. Methods: We reviewed the clinical records of newly diagnosed children with epilepsy that were commenced on AEDs from January 2011 to December 2015 and completed follow-up for at least 2 years. We evaluated their treatment outcomes and studied the association between the treatment outcomes and patients’ characteristics. Results: Three hundred and twenty-six patients met the eligibility criteria. The remission rate was 64.1%, the relapse rate at 2 years was 5.3% while the prevalence of drug-resistant epilepsy was 19.9%. Children with focal seizures were 1.5 times more likely to achieve remission compared to those with generalized seizures (adjusted odds ratio=1.52; P=0.008). Similarly children with normal neurologic examination were about 6 times more likely to achieve remission compared to those with abnormal neurologic examination (adjusted odds ratio= 5.79; P <0.001). Conclusion: Most children with epilepsy will achieve good seizure control if they receive appropriate treatment. We need to create more public awareness on the etiology and treatment of epilepsy in order to reduce the myths and stigma associated with the disorder and improve the long term outcome of childhood epilepsy in our community.

Pattern of Adverse Drug Reaction to Antiepileptic Drugs at a Tertiary Hospital in North-Central Nigeria: A Prospective Observational Study

2024-06-26T03:42:49Z

Pattern of Adverse Drug Reaction to Antiepileptic Drugs at a Tertiary Hospital in North-Central Nigeria: A Prospective Observational Study Aderonke, Courage Background: Epilepsy is a common neurologic condition affecting 0.5-1% of the population. Adverse drug reactions (ADRs) are a major health problem to the individual as well as for the society. There is insufficient awareness and inadequate training on drug safety monitoring among healthcare workers in Nigeria. Aim: To determine the prevalence and pattern of adverse drug reactions in children on antiepileptic drugs. Study Design: This was a prospective observational study. Place and Duration of Study: Pediatric neurology clinic, Jos University Teaching Hospital, Nigeria between January 2011 and December 2015. Methodology: We recruited consecutive newly diagnosed children with epilepsy that were initiated on antiepileptic drugs. We performed thorough symptom checklist and physical examination before initiating antiepileptic drugs. Electroencephalogram, complete blood count, liver function test, and serum electrolytes, urea and creatinine were also done. Patients and their caregivers were counseled on the adverse drug reactions of the drugs being initiated and asked to return to the clinic immediately they observe any of the reactions. Patients were assessed for adverse reactions on each visit. Further laboratory evaluations were done for those with adverse reactions if necessary. Causal relationship between adverse drug reaction and treatment was assessed with the Naranjo Algorithm. Results: Four hundred and nine patients were initiated on antiepileptic drugs within the study period. Two hundred and twenty-one (54.0%) were on monotherapy while 188 (46.0%) were on polytherapy. The most frequently prescribed drugs were carbamazepine (34.7%), carbamazepine+valproic acid (33.7%) and valproic acid (15.2%). A total of 113 (27.6%) patients had 193 different adverse drug reactions. The commonest adverse drug reactions were sleep disorders (33.7%), skin rash (10.9%), dizziness (7.8%), fatigue (10.7%) and nausea (6.75%). Those on polytherapy were significantly more likely to have adverse drug reactions compared to those on monotherapy (Relative Risk = 1.65, 95% confidence interval 1.20-2.27; P = 0.002). Conclusion: Adverse drug reactions are common in children on antiepileptic drugs. Pharmacovigilance is very important in children on antiepileptic drugs so that adverse drug reactions can be identified early and managed appropriately.

Pattern of utilization of antiepileptic drugs in the first 12 months of epilepsy treatment in children

2024-06-26T03:41:47Z

Pattern of utilization of antiepileptic drugs in the first 12 months of epilepsy treatment in children Aderonke, Courage Drug utilization studies are important methods of assessing how drugs are used in the society. Without the knowledge of how drugs are being prescribed and used, it is difficult to initiate discussion on rationale drug use and to suggest measures to change prescribing habits for better management of patients. This study therefore aimed to evaluate the pattern of utilization of antiepileptic drugs (AEDs) in the first 12 months of epilepsy treatment in children in Jos, Nigeria. Methods: A case record form was used to document all relevant information of children with epilepsy that were commenced on AED from January 2011 to December 2015. Information collected in the first 12 months of commencement of AED was used to evaluate the pattern of utilization of AEDs among the study subjects. Information obtained was analyzed with statistical package for social sciences software version 20. Results: Three hundred and eighty one subjects with a median age of 5.4 years were studied. The most frequently prescribed drug at commencement of epilepsy treatment was Carbamazepine (CBZ) (75.9%) followed by Sodium Valproate (VPA) (17.1%) while the most frequent AED combination was CBZ+VPA. Despite the fact that all the patients were commenced on monotherapy, the rate of polytherapy at 12 months was 35.2%. Deviation from standard treatment guidelines was observed in 127 (33.3%) of the subjects with the most common deviation being the use of CBZ for generalized tonic-clonic seizures. Conclusion: Significant deviations were observed in the utilization of AEDs in children with epilepsy. Using standard guidelines in the treatment of childhood epilepsy will reduce the rate of uncontrolled

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

2024-06-26T03:40:56Z

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria Aderonke, Courage Background: Childhood epilepsy causes a tremendous burden for the child, the family, society as well as the healthcare system. Adherence to antiepileptic drugs (AEDs) is key to treatment success, one of the main causes of unsuccessful treatment for epilepsy is poor adherence to medications. Nonadherence in children with epilepsy presents a potential ongoing challenge for achieving a key therapeutic goal of seizure control. Aim: To determine the prevalence and factors associated with nonadherence to AEDs among children with epilepsy at Jos University Teaching Hospital, Jos, Nigeria. Methodology: This cross sectional study was done to assess the prevalence and factors associated with non-adherence to AEDs among children with epilepsy from November 2019 to February 2020. A structured questionnaire was used to collect relevant information on the adherence of study subjects to AEDs based on self/ caregiver report. Part of the questionnaire was derived from Morisky Medication Adherence Scale (MMAS-8). Results: One hundred and ninetyfour subjects were recruited for the study. The prevalence of nonadherence to AEDs was 44.8%. Factors significantly associated with non-adherence were low socioeconomic status, multiple drug therapy and long duration of treatment. The main reasons for nonadherence were financial constraint, forgetfulness, lack of improvement and medication side effects. Conclusion: Non-adherence to medication is common among children with epilepsy and it hampers the key therapeutic goal of seizure control. Improving per capita income of families, providing universal health insurance, medication reminders and appropriate education/counseling will reduce non-adherence and improve the long term outcome of