Seizure Control Among Children on Anti-epileptic Drugs at a Tertiary Hospital in South Western Uganda- A Retrospective Cohort Study

Background: Epilepsy is the commonest neurological disease globally. Up to 70% of the people with epilepsy can attain good seizure control with appropriate timely diagnosis and treatment, hence better quality of life. However, this is not often achievable in low resource settings.Aims: This study aimed at determining the seizure control status, describing the factors associated with poor seizure control among children on anti-epileptic drugs (AEDs) for at least six months at MRRH.Methods: A two stage retrospective cohort study was done. In the first stage, eligible participants were identified and secondary data obtained from their medical records about the baseline social demographics and clinical characteristics at enrollment into the Epilepsy clinic. In the second stage, physical or telephone interview with the care takers were conducted about the current status of the participants. Children below 18 years of age on anti-epileptic drugs for at least six months were consecutive enrolment into this study. Results: A total of 112 participants were enrolled. Of these, three quarters (75%) had generalized onset seizures, 23% had focal onset seizures and 2% had unknown onset motor seizures. Poor seizure control occurred among 60.4% (95% CI 50.9- 69.9) of the participants. 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 (95% CI 1.8-26.6)) were significantly associated with poor seizure control.Conclusion: The commonest seizure type in our setting were the generalized onset seizures. The proportion with poor seizure control among children on AEDs for at least six months was high. Children with a comorbidity, history suggestive of birth asphyxia at baseline and adolescents were more likely to have poor seizure control and therefore need to be keenly followed up.