Treatment of epilepsy in rural Ethiopia: 2 year follow-up
Shibru Berhanu; Prevett, M.
Ethiopian Journal of Health Development 18(1): 31-34
2004
ISSN/ISBN: 1021-6790 Document Number: 251664
Objective: To review treatment outcome in epileptic patients. Methods: The study was conducted in December 2001 at epilepsy clinics in 5 health centres (HCs) in Gondar, Ethiopia. The case records of 813 patients with active epilepsy who had been followed up for 2 or more years were reviewed. Result: 49 and 38% of patients were still under follow-up after one and 2 years, respectively. There was marked variation between HCs with 73% still under follow-up at 2 years in 2 HCs. Of those still under follow-up at 2 years, 48% had been seizure free for one year or more and another 34% experienced a >90% reduction in seizure frequency. 87% were treated with phenobarbitone monotherapy (median dose: 150 mg/day). The majority of the remainder were treated with combination of phenobarbitone and phenytoin and less than 1% were treated with phenytoin monotherapy. Age of epilepsy onset before 15 years and seizure frequency of one or more seizures per week prior to treatment were associated with failure to achieve one year remission. Duration of epilepsy and seizure type did not affect seizure control. Review of the records of 318 patients who had defaulted from follow-up at one HC showed that seizure control at the time of default was similar to that achieved by the patients still attending, with only 5% poorly controlled patients compared with 3.9%. The mean travelling time to the HC was 4.1 h for the defaulters and 5.4 h for those still attending. Conclusion: Good follow-up rates can be achieved even after 2 years and the treatment response of those who remain under follow-up is very good.