Epilepsy research · 2026
Study to improve success in paediatric epilepsy medical treatment - Seizure freedom as a primary outcome: A pre- post - quality improvement study in a tertiary teaching hospital, Bahir Dar, Ethiopia.
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Gelaw Tesfaye Taye, Gessesse Alamirew Alebachew, Alebachew Belaynew Zemed, Tilahun Shitahun Fentie, Mihretie Tena Mekonnen, Ewunetu Mulugeta Biyadgie, Yimer Yalemwork Anteneh, Melesse Werkie Shitaw, Yehuala Amare Aschalew, Getahun Mensur Azeze, Guadie Addisu Alene, Workie Yaregal Kindie, Etsub Michael Beka
Аннотация
BACKGROUND: Poor seizure control in paediatric epilepsy treatment is a significant challenge world-wide, particularly in low-income-countries, affecting the patients' quality of life.
OBJECTIVE: Our study evaluated the effect of a multi-pronged intervention on seizure control among paediatric epilepsy patients treated at Bahir Dar University Tibebe-Ghion-Hospital.
METHODS: A pre- post- quality improvement study from January 1, 2024, to June 30, 2025, compared two groups of 129 children with epilepsy: retrospective pre-intervention group and prospective intervention group. Interventions were improving epilepsy classification, selecting appropriate anti-seizure medication (ASMs), and ASM optimization. Outcome was measured by 24-week seizure freedom. Chi-squared test and logistic regression were used for analysis.
RESULTS: Our intervention is associated with increased 24-week seizure freedom from 37% to 84%. The composite intervention bundle - Improved epilepsy classification, appropriate ASM selection, and following an ASM optimization schedule - was associated with improved seizure freedom with adjusted Odds ratio of 0.008 (0.002, 0.032). Health insurance and lack of comorbidities were associated with 24-weeks seizure freedom with adjusted Odds ratio of 2.640 (1.175, 5.931) and 2.768 (1.205, 6.359) respectively.
CONCLUSION: Reinforcing epilepsy classification, along with tailored ASM selection and optimization, allows a significant proportion of patients to achieve 24-week seizure freedom.
OBJECTIVE: Our study evaluated the effect of a multi-pronged intervention on seizure control among paediatric epilepsy patients treated at Bahir Dar University Tibebe-Ghion-Hospital.
METHODS: A pre- post- quality improvement study from January 1, 2024, to June 30, 2025, compared two groups of 129 children with epilepsy: retrospective pre-intervention group and prospective intervention group. Interventions were improving epilepsy classification, selecting appropriate anti-seizure medication (ASMs), and ASM optimization. Outcome was measured by 24-week seizure freedom. Chi-squared test and logistic regression were used for analysis.
RESULTS: Our intervention is associated with increased 24-week seizure freedom from 37% to 84%. The composite intervention bundle - Improved epilepsy classification, appropriate ASM selection, and following an ASM optimization schedule - was associated with improved seizure freedom with adjusted Odds ratio of 0.008 (0.002, 0.032). Health insurance and lack of comorbidities were associated with 24-weeks seizure freedom with adjusted Odds ratio of 2.640 (1.175, 5.931) and 2.768 (1.205, 6.359) respectively.
CONCLUSION: Reinforcing epilepsy classification, along with tailored ASM selection and optimization, allows a significant proportion of patients to achieve 24-week seizure freedom.