Seizure Remission and Its Predictors Among Epileptic Patients on Follow-Up at Public Hospitals in Eastern Ethiopia: A Retrospective Cohort Study

Abstract

Ammas Siraj Mohammed,1 Kirubel Minsamo Mishore,1 Tadesse Bekele Tafesse,2 Abera Jambo,1 Ahmed Mohammed Husen,3 Addisu Alemu4 1Clinical Pharmacy Department, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Pediatrics, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Reproductive Health and Nutrition, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Kirubel Minsamo Mishore, Email [email protected]: Epilepsy is one of the common chronic neurological disorders with varying therapeutic responses. Despite the high prevalence of epilepsy and the significant treatment gaps in developing nations, such as Ethiopia, there is a dearth of data on seizure remission and its predictors in Eastern Ethiopia in particular.Objective: This study aimed to determine seizure remission and its predictors among epileptic patients on follow-up in Hiwot Fana Specialized University Hospital (HFSUH) and Dilchora Referral Hospital (DCRH), from July 2 to 31, 2021.Methods: A retrospective cohort study was conducted among 418 newly diagnosed epilepsy patients receiving anti-seizure drugs (ASDs) between July 1, 2014, and July 31, 2019, in two public hospitals in Eastern Ethiopia. Relevant data were collected for all patients with a minimum follow-up period of two years. Data were analyzed using SPSS Version 21. Cox proportional hazards model was performed to identify predictors of seizure remission.Results: Overall, 252 (60.3%) of the study participants have achieved seizure remission for at least one year. The mean time to achieve seizure remission was 1.9 ± 0.87 years. Regarding the seizure remission pattern, 171 (40.9%) patients achieved early remission, 81 (19.4%) achieved late remission, and 166 (39.7%) achieved no remission. Shorter pre-treatment duration (AHR = 2.36, 95% CI: 1.28– 4.37); good adherence to ASDs (AHR = 2.40, 95% CI: 1.33– 4.34); and monotherapy (AHR = 0.56, 95% CI: 0.32– 0.98) were predictors of seizure remission.Conclusion: We observed that less than two-thirds of epileptic patients had achieved seizure remission. A shorter pre-treatment duration, good adherence to ASDs, and monotherapy were predictors of seizure remission. Therefore, we recommend the requirement of an integrated effort from different health disciplines that increases patients’ adherence to ASDs, promotes early visits to medical facilities, and improves the health-seeking behavior of epileptic patients.Keywords: seizure, epilepsy, remission, predictors, Eastern Ethiopia

Keywords

• seizure
• epilepsy
• remission
• predictors
• eastern ethiopia