Factors associated with uncontrolled seizures among adult epileptic patients at the Kenyatta National Hospital in Kenya: a cross-sectional study

Abstract

Introduction: epilepsy is a condition characterised by recurrent seizures which are 24 hours apart. Eighty per cent of global cases are found in Low-and-Middle Income Countries. Methods: an analytical cross-sectional study design was adopted for this study. A total of 185 adult epileptic patients were recruited between June and September 2023 at the neurology clinic of the Kenyatta National Hospital. Participants were interviewed, and medical records were reviewed. Multivariable logistic regression was carried out to identify factors associated with uncontrolled seizures. The level of significance was set at P<.05. Results: oral carbamazepine was the most prescribed antiepileptic drug (AED) followed by sodium valproate and levetiracetam. Only 71(38.4%) participants were adherent to their antiepileptic drugs. Participants with at least one seizure in the past year were considered to have uncontrolled seizures 128(69.2%). Factors associated with uncontrolled seizures were non-adherence to antiepileptic drugs (aOR = 2.56, 95% CI: 1.21 - 5.42; P=.01), treatment with phenobarbitone (aOR = 2.76, 95% CI: 1.18 - 6.45; P=.02), sodium valproate (aOR = 1.50, 95% CI: 1.10 - 2.03; P=.01) or levetiracetam (aOR = 1.28, 95% CI: 1.07 - 1.53; P=.01), and head trauma as an aetiology of the first epileptic seizure (aOR = 0.81, 95% CI: 0.67 - 0.98; P=.03). Conclusion: the prevalence of uncontrolled seizures was notably high at 69.6%. The best predictors for uncontrolled seizures in this study included non-adherence to AEDs, treatment with either phenobarbitone, sodium valproate or head trauma as an aetiology of the first epileptic seizure.