Dataset Information

Antiepileptic drug adherence in children in southern Ethiopia: A cross sectional study.

ABSTRACT:

Background

Epilepsy is one of the commonest chronic neurological disorders with serious health consequences. Treatment adherence is one of the determinants of seizure control. This study was designed to determine factors affecting antiepileptic drug adherence among children with epilepsy.

Methods

A cross sectional study was conducted on 192 children with epilepsy (≤14 years of age) on follow-up at a pediatric neurology clinic in Southern Ethiopia from January 1st to August 30th, 2019. Medication Adherence was measured using the eight-item Morisky's medication adherence scale. Logistic regression analysis was done to determine factors associated with antiepileptic drug adherence.

Result

One hundred twenty-five (65%) of the study subjects were adherent to their medication. On multivariable analysis, factors predictive of good adherence included family size of ≤5 [AOR = 2.34, (95% CI: 1.07, 5.10); P = 0.03] and duration of epilepsy (<1year [AOR = 5.83, (95% CI: 1.48, 22.92); P = 0.012] and 1-2year [AOR = 4.58, (95% CI: 1.12, 18.77); P = 0.035]). Monthly family income of <1000 Ethiopian Birr [AOR = 0.18, (95% CI: 0.06, 0.61); P = 0.005] and presence of seizure attack in the past 3months [AOR = 0.23, 95% (CI: 0.10, 0.55); P = 0.001] predicted poor antiepileptic drug adherence.

Conclusion

Adherence to antiepileptic drugs in children is low in our setting; low family income and occurrence of seizures while on treatment predicted poor adherence. Supplying free antiepileptic drugs to poor children and regular provision of information about expected treatment response to children with epilepsy and their caretakers may help improve adherence.

SUBMITTER: Dima SA

PROVIDER: S-EPMC8853530 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Antiepileptic drug adherence in children in southern Ethiopia: A cross sectional study.

Dima Shamil Ahmed SA Shibeshi Mulugeta Sitot MS

PloS one 20220217 2

<h4>Background</h4>Epilepsy is one of the commonest chronic neurological disorders with serious health consequences. Treatment adherence is one of the determinants of seizure control. This study was designed to determine factors affecting antiepileptic drug adherence among children with epilepsy.<h4>Methods</h4>A cross sectional study was conducted on 192 children with epilepsy (≤14 years of age) on follow-up at a pediatric neurology clinic in Southern Ethiopia from January 1st to August 30th, 2 ...[more]

PMID: 35176045

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Project description:BackgroundInfections caused by antibiotic-resistant bacteria results in high rates of morbidity and mortality. Although the prolonged cotrimoxazole (CTX) prophylaxis is arguably associated with the risk of increasing drug resistance in the common pathogens, information regarding its impact on Streptococci pneumoniae / pneumococcus is very limited.ObjectiveThis study was conducted to investigate the effect of cotrimoxazole prophylaxis on nasopharyngeal colonization rate and antimicrobial resistance using Streptococci pneumoniae (pneumococcus) as an indicator organism among HIV patients in Arba Minch, Ethiopia.Materials and methodsA comparative cross-sectional study was designed and conducted among HIV patients attending the Anti-Retroviral Treatment (ART) clinic of Arba Minch General Hospital (AMGH) from April 01 to August 31, 2018. A total of 252 participants were systematically selected and clustered into two study groups based on their CTX prophylaxis status, one taking CTX prophylaxis, and the second one, the control group (without prophylaxis). A structured questionnaire was used to collect socio-demographic and clinical data from patients. A nasopharyngeal swab was collected and cultured for pneumococcal isolation and identification in accordance with standard microbiological techniques. An antibiotics sensitivity test was performed according to the CLSI guidelines. Data were analyzed using the Statistical package for social science (SPSS) version 20. The primary outcome was determined using logistic regression analysis.ResultsOf the 252 enrolled HIV patients (mean age (37.38± 9.03 years), 144 (57.14%) were males. The overall, nasopharyngeal colonization rate of S. pneumoniae was 13.5% (95% CI: 8.4-15.6). Asymptomatic pneumococcal carriage rates among patients on CTX prophylaxis and the control group were 16.3%, and 10.3% respectively (p-value = 0.03). Regarding the risk factors analyzed, CTX prophylaxis (AOR: 2.2; 95% CI: 1.05-4.9) and gender (AOR: 2.5; 95% CI: 1.09-5.93) were significantly associated with pneumococcal colonization, showing a male preponderance. Cotrimoxazole-resistant pneumococci were 85.7% vs. 47.4% in the prophylaxis group and the control group respectively and it was statistically significant (AOR: 6.7; 95% CI: 1.3-36). Percentages of multi-drug resistant isolates in these two groups were 38.09 and 15.38 respectively (p-value = 0.04). Among the CTX resistant pneumococci isolates, 85% were also found to be co-resistant towards penicillin and was statistically significant.ConclusionThe percentage prevalence of nasopharyngeal pneumococci colonization was higher in patients taking CTX prophylaxis. It was noted that CTX prophylaxis eventually results in the selection of cotrimoxazole resistance and multi-drug resistance in pneumococci. There is evidence of existing cross-resistance between cotrimoxazole and penicillin antibiotics. Therefore, CTX prophylaxis must be administered judiciously. Surveillance for antimicrobial susceptibility is warranted where the prophylaxis is common.

Dataset Information

Antiepileptic drug adherence in children in southern Ethiopia: A cross sectional study.

Background

Methods

Result

Conclusion

Publications

Antiepileptic drug adherence in children in southern Ethiopia: A cross sectional study.

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