Correlates of Seizure Control Among Patients with Epilepsy at Two Referral Hospitals in Zambia

Abstract

Background and Objective: Epilepsy is a neurological condition that has proven to be a major public health challenge worldwide, including Zambia. Despite the availability of many treatment alternatives, people with epilepsy still experience seizures. There is paucity of information on the control of seizures and associated factors in Zambia. The purpose of this study was to examine the factors associated with seizure control in people with epilepsy in two tertiary hospitals in Zambia. Methods: A cross-sectional study was conducted among epileptic patients at Kitwe and Ndola Teaching Hospitals, two referral hospitals in Northern Zambia, from September 2 to September 23, 2019. A multivariate logistic regression analysis was performed using SPSS to identify independent predictors of seizure control. Adjusted odds ratios (AOR) and their 95% confidence intervals are reported. Results: A total of 220 epileptic patients were enrolled in the study. Of these, 23.6% had controlled seizures, while 76.4% had uncontrolled seizures. Occupation (p value=0.018), level of education (p value <0.001), clinic attendance (p value<0.001), drug adherence (p value<0.001), beliefs about drugs (p value=0.006), and having friends (p value=0.025), were significantly associated with seizure control. A higher level of education (AOR:0.243, CI:0.080-0.738), regular clinic attendance (AOR:8.578, CI:3.327-22.112) and age at first seizure of 3-6 years (AOR: 1.035, CI:0.240-4.454) were predictors of controlled seizures. Conclusion and Implications for Translation: It was shown that there was a low prevalence of controlled seizures among the study population. However, in this study, controlled seizure can be associated with a positive response to medication, regular clinic attendance, employment, having friends, having a higher level of education, and being 3-6 years old when a first seizure occurs. Risk factors should be taken into consideration such as alcohol consumption and drug compliance to better manage seizures.