Change in the Frequency of Seizure Attacks and Associated Factors Among Adult Epilepsy Patients at Amanuel Mental Specialized Hospital (AMSH): A Generalized Linear Mixed Model (GLMM)

Abstract

Temam Beshir Raru,1 Bisrat Misganaw Geremew,2 Koku Sisay Tamirat2 1Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Temam Beshir Raru Email [email protected]: While getting anti-epileptic drugs (AEDs) treatment around two-thirds of the patients with epilepsy enter a seizure-free state, but some of them continue to experience seizures which increase the risk of accident, disability, death, and treatment side effects. Therefore, this study aimed to identifychanges in the frequency of seizure attacks overtime and associated factors among adult patients with epilepsy.Methods: A retrospective two year follow-up study was conducted among adult patients with epilepsy who initiated AEDs between July 2017 and June 2019. A simple random sampling technique was applied to select 394 patient charts. The data were entered into Epi-data and then exported to R software for further analysis. A generalized linear mixed model under a negative binomial family was applied to identify determinants of the frequency of seizure attacks.Results: The median number of seizure attacks at baseline were 3 with the IQR of 2 and on average the frequency of seizure attacks decrease in a linear pattern over time. Age group 25– 34 years (AIRR = 0.81 and 95% CI: 0.69– 0.94), smoking (AIRR = 1.28 and 95% CI: 1.11– 1.48), khat use (AIRR = 1.39 and 95% CI: 1.19– 1.62), sleep deprivation (AIRR = 1.49 and 95% CI: 1.32– 1.69), head injury (AIRR = 1.30 and 95% CI: 1.11– 1.53), depression (AIRR = 1.39 and 95% CI: 1.17– 1.65), treatment mode (AIRR= 1.22 and 95% CI: 1.07– 1.39), and clumsiness (AIRR= 1.85 and 95% CI: 1.24– 2.75) were statistically significant seizure predicting factors.Conclusion: The number of seizure attack changes over time was decreased by a linear function that might reflect treatment effects of AEDs. Smokers, khat chewers, suffering a head injury, depression, experienced sleep deprivation, and clumsiness increases the number of seizure attacks. Conversely, the age group 25– 34 years saw a decrease in the number of seizure attacks. This underscores that special attention should be given to substance users and those with related mental health disorders.Keywords: change in seizures frequency, epilepsy, anti-epileptic drugs, Ethiopia, AEDs

Keywords

• change in seizures frequency
• epilepsy
• antiepileptic drugs
• ethiopia