Abstract：
BACKGROUND: Childhood epilepsy causes a tremendous burden for the child, the family, society as well as the healthcare system. Adherence to anti-seizure medications (ASMs) is a key to treatment success. Poor adherence has been considered as one of the main causes of unsuccessful treatment for epilepsy and presents a potential ongoing challenge for achieving a key therapeutic goal of seizure control.
METHODS: A facility-based cross-sectional study design was conducted among children with epilepsy attending the Pediatrics neurology follow up clinic of Jimma Medical Center from June- 21 to September- 20, 2021. Data were collected by using a semi-structured pre-tested questionnaire. Epidata version 3.1 and SPSS version 26.0 were used for data entry and analysis respectively. Descriptive statistics and binary logistic regression analysis were employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while significance level at p-value of < 0.05 was determined using 95% confidence intervals.
RESULTS: A total of 170 children with epilepsy were included in this study. About 54.7% were male and 44.7% were in age range of 10-17 years. The overall adherence to anti-seizure medications was 54.1%. Those caregivers who were married [AOR = 7.46 (95% CI = 1.46, 38.20)], those children with controlled seizure status [AOR = 3.64 (95% CI = 1.51, 8.78)], those who got appropriate health care [AOR = 7.08(95% CI = 2.91, 17.24)], those caregivers who had good knowledge [AOR = 5.20(95% CI = 2.60,14.83)]; and positive attitude [AOR = 2.57 (95% CI = 1.06, 6.28)] towards epilepsy were significantly associated with adherence to anti-seizure medications.
CONCLUSIONS: More than half of the children/adolescents having epilepsy were adherent to their anti-seizure medication(s). Children\'s adherence to anti- seizure medications was influenced by current marital status of the parents/caregivers, controlled seizure status, getting appropriate healthcare in the hospital, caregiver\'s knowledge; and attitude towards epilepsy. More efforts are required to scale up the provision of client-centered service (provision of appropriate health care delivery, focus on quality of treatment and providing health education/counseling to improve caregivers\' knowledge and attitude towards epilepsy) to improve children\'s adherence status to their medication(s) and seizure control status.
METHODS: A facility-based cross-sectional study design was conducted among children with epilepsy attending the Pediatrics neurology follow up clinic of Jimma Medical Center from June- 21 to September- 20, 2021. Data were collected by using a semi-structured pre-tested questionnaire. Epidata version 3.1 and SPSS version 26.0 were used for data entry and analysis respectively. Descriptive statistics and binary logistic regression analysis were employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while significance level at p-value of < 0.05 was determined using 95% confidence intervals.
RESULTS: A total of 170 children with epilepsy were included in this study. About 54.7% were male and 44.7% were in age range of 10-17 years. The overall adherence to anti-seizure medications was 54.1%. Those caregivers who were married [AOR = 7.46 (95% CI = 1.46, 38.20)], those children with controlled seizure status [AOR = 3.64 (95% CI = 1.51, 8.78)], those who got appropriate health care [AOR = 7.08(95% CI = 2.91, 17.24)], those caregivers who had good knowledge [AOR = 5.20(95% CI = 2.60,14.83)]; and positive attitude [AOR = 2.57 (95% CI = 1.06, 6.28)] towards epilepsy were significantly associated with adherence to anti-seizure medications.
CONCLUSIONS: More than half of the children/adolescents having epilepsy were adherent to their anti-seizure medication(s). Children\'s adherence to anti- seizure medications was influenced by current marital status of the parents/caregivers, controlled seizure status, getting appropriate healthcare in the hospital, caregiver\'s knowledge; and attitude towards epilepsy. More efforts are required to scale up the provision of client-centered service (provision of appropriate health care delivery, focus on quality of treatment and providing health education/counseling to improve caregivers\' knowledge and attitude towards epilepsy) to improve children\'s adherence status to their medication(s) and seizure control status.
摘要：
背景：儿童癫痫给孩子带来了巨大的负担，家庭,社会以及医疗系统。坚持抗癫痫药物（ASM）是治疗成功的关键。依从性差被认为是癫痫治疗不成功的主要原因之一，并且对于实现癫痫发作控制的关键治疗目标提出了潜在的持续挑战。
方法：对2021年6月21日至9月20日在Jimma医学中心儿科神经科随访诊所就诊的癫痫患儿进行了基于设施的横断面研究设计。通过使用半结构化的预测试问卷收集数据。分别使用Epidata3.1版和SPSS26.0版进行数据录入和分析。采用描述性统计和二元逻辑回归分析。使用调整后的比值比确定因变量和相关变量之间任何关联的效应大小，而使用95％置信区间确定p值<0.05的显著性水平。
结果：本研究共纳入170例癫痫患儿。约54.7%为男性，44.7%为10-17岁。抗癫痫药物的总体依从性为54.1%。那些已婚的照顾者[AOR=7.46（95％CI=1.46，38.20）]，那些癫痫发作状态控制的儿童[AOR=3.64（95％CI=1.51，8.78）]，那些获得适当医疗保健的人[AOR=7.08（95％CI=2.91，17.24）]，对癫痫有良好知识[AOR=5.20(95%CI=2.60,14.83)]和积极态度[AOR=2.57(95%CI=1.06,6.28)]的护理人员与抗癫痫药物的依从性显著相关.
结论：一半以上患有癫痫的儿童/青少年坚持他们的抗癫痫药物。儿童对抗癫痫药物的依从性受到父母/照顾者当前婚姻状况的影响，控制癫痫发作状态，在医院得到适当的医疗保健，护理人员的知识和对癫痫的态度。需要做出更多努力来扩大以客户为中心的服务（提供适当的医疗保健服务，关注治疗质量，并提供健康教育/咨询，以改善护理人员对癫痫的知识和态度），以改善儿童对药物的依从性和癫痫发作控制状况。
方法：对2021年6月21日至9月20日在Jimma医学中心儿科神经科随访诊所就诊的癫痫患儿进行了基于设施的横断面研究设计。通过使用半结构化的预测试问卷收集数据。分别使用Epidata3.1版和SPSS26.0版进行数据录入和分析。采用描述性统计和二元逻辑回归分析。使用调整后的比值比确定因变量和相关变量之间任何关联的效应大小，而使用95％置信区间确定p值<0.05的显著性水平。
结果：本研究共纳入170例癫痫患儿。约54.7%为男性，44.7%为10-17岁。抗癫痫药物的总体依从性为54.1%。那些已婚的照顾者[AOR=7.46（95％CI=1.46，38.20）]，那些癫痫发作状态控制的儿童[AOR=3.64（95％CI=1.51，8.78）]，那些获得适当医疗保健的人[AOR=7.08（95％CI=2.91，17.24）]，对癫痫有良好知识[AOR=5.20(95%CI=2.60,14.83)]和积极态度[AOR=2.57(95%CI=1.06,6.28)]的护理人员与抗癫痫药物的依从性显著相关.
结论：一半以上患有癫痫的儿童/青少年坚持他们的抗癫痫药物。儿童对抗癫痫药物的依从性受到父母/照顾者当前婚姻状况的影响，控制癫痫发作状态，在医院得到适当的医疗保健，护理人员的知识和对癫痫的态度。需要做出更多努力来扩大以客户为中心的服务（提供适当的医疗保健服务，关注治疗质量，并提供健康教育/咨询，以改善护理人员对癫痫的知识和态度），以改善儿童对药物的依从性和癫痫发作控制状况。
