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Risk Factors Associated With the Frequency of Seizure Attack on People Living With Epilepsy at Felege Hiwot Referral Hospital; Application of A Linear Mixed Model

Yirga Mekonnen, Denekew Bitew Belay, Awoke Seyoum Tegegne

Background: The frequency of seizure attacks, in people living with epilepsy, is one of the most common and serious brain disorders. It affects more than 70 million people in the world, including approximately 10 million people annually in Sub-Saharan Africa. In Ethiopia, it affects about 29.5 per 1000 population. It has major physical, psychological, and economic effects by reducing an individual’s quality of life. The main objective of this study was to identify risk factors associated with the frequency of seizure attacks in people living with epilepsy in North-West Ethiopia.

Methods: A retrospective cohort study design was conducted on 131 people living with epilepsy who satisfied the inclusion criterion in the neurologic clinic at Felege Hiwot specialized and Referral Hospital, Bahir Dar, Ethiopia. A secondary data source was used for the current investigation. The data were collected using the patient’s chart whose follow-ups were between November 2014 and 31 December 2019. Based on the lowest AIC and BIC values, the appropriate linear mixed-effect model was selected for data analysis.


Results: Among the predictors, follow-up times (β= -0.088; 95% CI; (-9.395685e-02, -8.161152e-02), p-value<0.01), duration of time between seizure onset and diagnosis (β= 0.003; 95% CI; (0.002, 006), p-value=0.0042), and people living with epilepsy whose belief was can be cured from the disease at the start of taking antiepileptic medication reduced the frequency of seizure attack (β= -0.054; 95% CI; (-1.033209e-01, -4.189269e-2, p-value= 0.0338). Age at seizure onset (β= -0.003; 95% CI; (-5.095402e-03, -4.979875e-04), p-value=0.0175=) people with intellectual disability (β= 0.081; 95% CI; (2.479245e-02, 1.366274e-01), p-value= 0.0050), and people having a history of febrile convulsion (β= 0.071; 95% CI; (8.792496e-03, 1.324884e-01), p-value= 0.0255) statistically affected the frequency of seizure attack on people living with epilepsy. Poor adherent individuals and those having a family disease history were also highly affected by the repeated occurrence of seizure attacks.


Conclusion: One way to reduce the frequency of seizure attacks is free to access to anti-seizure medications. Attention should be given to patients with a history of head injury, patients who came later after seizure onset, those people having a high frequency of seizure attacks at the beginning of diagnosis, those with intellectual disabilities, and those who have a family seizure history.

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