Clinico-etiological profile of children with seizures at a tertiary care centre in rural area in North India with special emphasis on “treatment gap”: a retrospective observational study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20223065Keywords:
Childhood seizures, Etiological profile, Treatment gap, Developing country, Rural areaAbstract
Background: Childhood seizures are common neurological disorder. There is paucity of studies on etiology of seizures with revised standard definitions and of studies highlighting the treatment gap, required to plan health care services in rural areas of developing countries with limited resources. Objectives were to study the clinical and etiological profile of children with seizures and treatment gap in outpatient department of tertiary care centre in rural area in Northern India.
Methods: It was a retrospective observational study in which relevant data on clinical, etiological profile and treatment details collected from OPD records was analyzed,
Results: Study population of 249 children with mean age 9.2 (4.6) years and 52% females was analyzed. Generalized seizure was most frequent seizure type (71.50%). Neurocysticercosis was most common etiology (45.8%). Neuroimaging was abnormal in 79% cases. There was treatment gap of 66% with 43% children not started on any antiepileptic drug. The 58% children were taken to local tantriks believing that seizure is due to evil spirit. Amongst children who were given antiepileptic drugs (AEDs) (n=142), 86.6% were on monotherapy of which carbamazepine was most frequently prescribed drug (41%).
Conclusions: The results of study would help to streamline the limited resources available for treatment and prevention of childhood seizures in the rural community and conduct socio culturally acceptable health campaigns to educate people about seizure and bridge the treatment gap.
References
Friedman M, Sharieff G. Seizures in children. Pediatr Clin North Am. 2006;53(2):257-77.
Chaudhary N, Gupta M, Shrestha S. Clinicodemographic Profile of Children with Seizures in a Tertiary Care Hospital: A Cross-Sectional Observational Study. Neurol Res Int. 2017;2017:1524548.
Adhikari S, Sathian B, Koirala D, Rao K. Profile of children admitted with seizures in a tertiary care hospital of Western Nepal. BMC Pediatr. 2013;13(1).
Myland M, Buysse B, Tsong W, Power G, Nordli D, Chin R. Seizure frequency, healthcare resource utilisation and mortality in childhood epilepsy: a retrospective cohort study using the THIN database. Arch Dis Child. 2019;104(11):1070-76.
Fine A, Wirrell EC. Seizures in Children. Pediatr Rev. 2020;41(7):321-47.
Brodtkorb E, Samsonsen C, Sund J, Bråthen G, Helde G, Reimers A. Treatment non-adherence in pseudorefractory epilepsy. Epilepsy Res. 2016;122:1-6.
Modi A, Rausch J, Glauser T. Patterns of nonadherence to antiepileptic drugtherapy in children with newly diagnosed epilepsy. JAMA. 2011;305(16):1669-76.
Scheffer I, Berkovic S, Capovilla G. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
Fisher R, Acevedo C, Arzimanoglou A. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.
Mwipopo E, Akhatar S, Fan P, Zhao D. Profile and clinical characterization of seizures in hospitalized children. Pan Afr Med J. 2016;24:313.
Pandey S, Singhi P, Bharti B. Prevalence and Treatment Gap in Childhood Epilepsy in a North Indian City: A Community-Based Study. J Trop Pediatr. 2013;60(2):118-23.
Poudel P, Parakh P, Mehta K. Clinical profile, aetiology and outcome of afebrile seizures in children. J Nepal Med Assoc. 2013;52(189):260-6.
Gadgil P, Udani V. Pediatric epilepsy: The Indian experience. J Pediatr Neurosci. 2011;6(3):126.
Goel D, Dhanai JS, Agarwal A, Mehlotra V, Saxena V. Neurocysticercosis and its impact on crude prevalence rate of epilepsy in an Indian community. Neurol India. 2011;59:37-40.
Poudyal P, Shrestha R, Shrestha P. Clinical Profile and Electroencephalogram Findings in Children with Seizure Presenting to Dhulikhel Hospital. Kathmandu Univ Med J. 2016;14(56):347-51.
El-Tallawy H, Farghaly W, Rageh T. Spectrum of epilepsy-prevalence, impact, and treatment gap: an epidemiological study from Al-Quseir, Egypt. Neuropsychiatr Dis Treat. 2016;12:1111-8.
Asghar M, Rehman A, Raza M, Shafiq Y, Asghar M. Analysis of treatment adherence and cost among patients with epilepsy: a four-year retrospective cohort study in Pakistan. BMC Health Serv Res. 2021;21(1):72.
Babiker M. Managing childhood epilepsy in resource-limited settings: A pragmatic approach. Sudan J Paediatr. 2015;15(1):9-20.
Faught E. Adherence to antiepilepsy drug therapy. Epilepsy Behav. 2012;25(3):297-302.
Mohammed I, Babikir H. Traditional and Spiritual medicine among Sudanese children with epilepsy. Sudan J Paediatr. 2013;13:31-7.
Nazziwa R, Mwesige A, Obua C, Ssenkusu J, Mworozi E. Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting. Pan Afr Med J. 2014;17:44.
