Prevalence, incidence, and trends of epilepsy among children and adolescents in Africa: a systematic review and meta-analysis.

BACKGROUND: Epilepsy contributes to a significant disease burden in children and adolescents worldwide. The incidence of childhood epilepsy is threefold higher in low and middle income countries compared in high-income countries. Epilepsy is a serious neurological condition associated with stigma and discrimination, an impaired quality of life, and other mental health related problems. OBJECTIVE: This study is aimed to synthesize existing evidence and estimate the pooled prevalence and incidence of epilepsy in children and adolescents in Africa. METHODS: A comprehensive and systematic search of relevant databases was conducted. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for meta-analysis. Two reviewers screened retrieved articles, conducted critical appraisals, and extracted the data. Heterogeneity between studies was assessed by visual inspection of forest plots and statistically using Cochran's Q statistics and the I2 test. Publication bias was checked by visual inspection of funnel plots as well as statistically using Egger's correlation and Begg's regression tests. Finally, the pooled prevalence and incidence of childhood epilepsy were computed with 95% confidence intervals. RESULT: In this review and meta-analysis 42 studies with 56 findings were included to compute the pooled prevalence of childhood epilepsy. On the other hand, 6 studies were included to estimate the combined incidence. The pooled prevalence of cumulative epilepsy was 17.3 per 1000 children. Whereas the pooled prevalence of active and lifetime epilepsy was 6.8 and 18.6 per 1000 children respectively. The pooled incidence of childhood epilepsy was 2.5 per 1000 children. CONCLUSION: Nearly 1 in 50 children are suffering from epilepsy in Africa. However, little attention has been paid to the prevention and treatment of childhood epilepsy. Mass epilepsy screening, scaling up treatment coverage, and designing strict treatment follow up and monitoring mechanisms are recommended.

Prevalence of Acute Malnutrition and Associated Factors among Children aged 6-59 months in South Wollo Zone, East Amhara, Northeast Ethiopia: a Community-based cross-sectional study.

OBJECTIVE: The aim of this study is to determine the prevalence of acute malnutrition and associated factors in South Wollo zone, East Amhara, Northeast Ethiopia. DESIGN: A community-based cross-sectional study was conducted among 504 children aged 6-59 months who were selected by using a multistage sampling technique. The mid-upper-arm-circumference and Z-scores for weight-for-height were used to determine the nutritional status of the participants. A semi-structured interview questionnaire was used to collect the data. Then data was entered into EpiData V.3.1 and exported to SPSS software V.25 for analysis. Binary logistic regression was used to identify factors associated with acute malnutrition and variables with p value<0.05 were declared as statistically significant. SETTING: The study was conducted in South Wollo zone, Northeast Ethiopia from 1 August 2020 to 30 September 2020. PARTICIPANTS: Children aged 6-59 months with their mothers were the study subjects. RESULTS: The prevalence of acute malnutrition among children aged 6-59 months was 31.0%. Child aged 6-11 months (adjusted OR (AOR)=3.92; 95% CI: 1.74 to 8.82), illiterate mothers (AOR=3.01; 95% CI: 1.92 to 7.01), single mother (AOR=3.06; 95% CI: 1.32 to 7.07), lack of latrine (AOR=2.39; 95% CI: 1.12 to 5.11), diarrhoea (AOR=4.18; 95% CI: 2.02 to 8.65), respiratory tract infection (AOR=2.31; 95% CI: 1.08 to 4.94), family size (≥5) (AOR=3.29; 95% CI: 1.53 to 7.09) and cessation of breast feeding before 2 years (AOR=3.79; 95% CI: 1.71 to 8.23) were the independent predictors of acute malnutrition. CONCLUSION: Acute malnutrition is highly prevalent in the study area which is more than the national figure. Thus, improving maternal education, access to the latrine, improved breastfeeding practice, improved family planning usage and early detection and treatment of diarrhoea and respiratory tract infections will enhance children's nutritional status. In addition, nutritional diversity education needs to be strengthened.

The effect of conflict on child and adolescent health in Amhara region, Ethiopia: Cross-Sectional Study.

BACKGROUND: Currently, conflict become common phenomenon in the world affecting the lives of millions of children. Due the continued conflict in Ethiopia millions of children are suffering from extreme levels of violence, lack of basic humanitarian needs, and lack of health services. OBJECTIVE: This study was designed to assess the effect of conflict on child and adolescent health in Amhara region, September 2022. METHODS: A community-based cross-sectional study was employed among children agedd < 18 years in conflict affected areas of Amhara region. The sample size was determined using a single population proportion formula. Data was collected through face-to-face interviews of children or child legal guardians. Data was cleaned, verified, and entered into EpiData version 3.1 and analysis was done using SPSS version 24 statistical software. RESULT: Seven hundred and ninety-eight children agedd less than 18 years were involved with a response rate of 94.33 percent. More than one thirds (276, 34.59%) of children were displaced due to the conflict. Three hundred and thirty one (41.48%) children get diseased with the majority didn't receive treatment. More than two thirds (557, 69.80%) of children had experienced violence of different types. One hundred and thirty four (41.23%) children had acute malnutrition with two third (66.42%) of them had severe acute malnutrition. CONCLUSION: Conflict had deadly impacts on the lives of children and adolescents. It causes massive displacement, lack of basic humanitarian needs, extreme level of violence, hunger and malnutrition, and lack of health services. The government and other national and international humanitarian aids should give special attention to children living in war zone of Amhara region. In addition, rehabilitation services and resilience training should be designed and provided to children affected by the conflict.

Breastfeeding Practice of Children Age Less than Two Years in South Wollo Zone, Northeast Ethiopia.

BACKGROUND: Suboptimal breastfeeding causes substantial numbers of child morbidity and mortality in Ethiopia. This study was designed to assess suboptimal breastfeeding practice and its associated factors among children age less than two years in South Wollo, northeast Ethiopia. METHOD: A community-based cross-sectional study was conducted among 636 women-child pairs. The study participants were selected by a multi sage random sampling technique. Data were collected using a structured interviewer-administered questionnaire, then it was entered into Epi-Data version 3.1, and exported into SPSS version 24.0 for analysis. A Binary Logistic Regression Model with a backward elimination method was used to determine the association of factors and suboptimal breastfeeding practice of babies at a 95% confidence interval. RESULT: Six hundred and thirty-six participants were included with a response rate of 99.7%. The study showed that 36.3% babies age less than 2 years were received suboptimal breastfeeding. Cesarean delivery [AOR: 8.81; 95% CI (4.92-15.77)], lack of breastfeeding counseling [AOR: 3.22; 95% CI (1.93-5.36)], maternal feeding less than 5 times/day during breastfeeding [AOR: 2.01; 95% CI (1.20-3.34)], child health problems [AOR: 3.57; 95%CI (2.17-5.85)], and babies age less than 6 months [AOR:1.92; 95%CI (1.24-2.97)] were positively associated with suboptimal breastfeeding practice. CONCLUSION: Suboptimal breastfeeding practice is highly prevalent in Ethiopia. Health service-related and socio-cultural factors were associated with the high prevalence of suboptimal breastfeeding practice. Emphasis should be given to the breastfeeding practices of children age less than years in Ethiopia. Moreover, counseling regarding the importance of breastfeeding practices should be strengthened.

Knowledge, Practice, and Factors Affecting Sunlight Exposure of Infants Among Mothers at Governmental Health Facilities in Dessie Town, Ethiopia, 2021.

Background: Human being needs sunlight for physical and mental well-being. Sunlight helps the body to produce vitamin D, an important vitamin for skeletal development, immune function, and blood cell formation. So, the community should be counseled to get sufficient sun exposure and vitamin D supplementation to uphold the serum 25 (OH) D levels. This study designed to assess the mothers' knowledge, practice, and factors affecting the sunlight exposure of their infants. Methods: A facility-based cross-sectional study was conducted at governmental health facilities in Dessie Town, 2021. A total of 398 mothers were interviewed using semi structured questionnaires. Data were entered into the EPI data version 3.1 and analyzed using SPSS 23. Binary and multivariate logistic regression analyses were also performed. In multivariate analysis, a significant association was considered at P-value of <.05. Results: Response rate was 98.9%. About 76.6% and 58.9% of the mothers had poor knowledge and poor practice regarding sunlight exposure of infants respectively. Mothers' occupation (aOR = 0.124, 95% CI = 0.042, 0.365), mothers' source of information (aOR = 18.604, 95% CI = 7.564, 45.75), and attitude (aOR = 2.773, 95% CI = 1.474, 5.215) had showed a significant association with mothers' knowledge. On the other hand, mothers' age (aOR = 3.191, 95% CI = 1.334, 7.633), mothers occupation (aOR = 4.226, 95% CI = 2.321, 7.694), and baby age (aOR = 1.989, 95% CI = 1.260, 3.140) had a significant association with their practice about sunlight exposure of infants. Conclusion: Mothers' knowledge and practice of sunlight exposure of infants are poor in Dessie Town. Hence measures should be taken to increase and improve mothers' responsiveness of sunlight exposure of infants.

Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study.

Introduction: Around the world, tuberculosis (TB) is the most common cause of mortality and morbidity in both adults and children. The incidence of tuberculosis (TB) is increased worldwide by co-infection with the human immunodeficiency virus (HIV), particularly in Sub-Saharan Africa. As a result, the study aimed to determine the incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia Comprehensive Specialized Hospitals. Methods: An institution-based retrospective follow-up study was carried out in northeast Ethiopia's Comprehensive Specialized Hospitals, among 362 children on antiretroviral therapy from January 1, 2007, to September 30, 2021. The data were entered into Epi Data version 4.6.1 and then exported to STATA version 16 for analysis. Bivariate and multivariable Cox proportional hazards model was used to discover tuberculosis predictors. Variables with a p-value of <0.05 at 95% confidence intervals in the multivariable Cox proportional hazard model were considered statistically significant. Results: Among the 358 Human Immunodeficiency Virus-infected children, two-thirds (69.3%) were over ten years old. The overall tuberculosis incidence rate was 2.0 (95%CI: 1.5-2.6) per 100 person-years with a total of 2452 years of observations. WHO clinical stages III and IV [AHR: 3.2 (95% CI 1.8-5.5)], being severely stunted [AHR = 2.1 (95% CI, 1.5-358)], and "Fair" and "poor" adherence levels to antiretroviral therapy [AHR = 4.0 (95% CI 1.5-10.8)] were independent predictors of tuberculosis. Conclusion: The incidence of tuberculosis in children infected with HIV/AIDS was high in this study. The risk of tuberculosis (TB) in HIV/AIDS-infected children has been linked to WHO stages III and IV, severe stunting, and "Fair" and "Poor" ART adherence. As a result, children with HIV/ADIS should be evaluated on a regular basis in order to improve the quality of ART services and reduce the incidence rate of tuberculosis among children.

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria. METHODS: The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger's and Begg's statistical tests. RESULTS: Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria. CONCLUSION: More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.

Magnitude of birth trauma and its associated factors in South Wollo public hospitals, northeast Ethiopia, August 2021: Institutional-Based Cross-Sectional Study.

OBJECTIVE: The institutional-based cross-sectional study was designed to assess the magnitude of birth trauma and its associated factors in South Wollo, northeast Ethiopia. SETTING: This study was conducted in the public hospitals of South Wollo, northeast Ethiopia. South Wollo is one of the 12 zones in the Amhara regional state with a total population of >3 million. There are 13 hospitals in South Wollo, of these 4 hospitals were selected randomly. PARTICIPANTS: A total of 612 mother-newborn pairs were selected to conduct the study. However, data were collected from 594 mother-neonate pairs giving a response rate of 97%. The study participants were selected by applying a simple random sampling technique after proportional allocation of the total sample to each study hospital. Live neonates delivered during the study period were included, whereas stillborn, neonates born with major congenital malformation and neonates whose mothers died during the birth process were excluded. RESULT: A total of 594 mother-newborn pairs were involved with a response rate of 97%. Seventy-eight newborns 13.13% (95% CI: 10.30 to 16.00) had experienced birth trauma. Prolonged labour (AOR: 5.78, 95% CI: 3.00 to 11.15), birth weight >4 kg (AOR: 9.18, 95% CI: 3.92 to 21.50), vacuum delivery (AOR: 6.74, 95% CI: 2.01 to 22.56), forceps delivery (AOR: 7.36, 95% CI: 1.96 to 27.58) and shoulder dystocia (AOR: 9.83, 95% CI: 4.13 to 23.50) were risk factors of birth trauma. CONCLUSION: The prevalence of birth trauma was higher than the report from most of the African countries. Prolonged labour, instrumental deliveries, large birth weight and shoulder dystocia were the identified risk factors of birth trauma. The ministry of health and the local healthcare system should give attention to the maternal health services.

Practice Level and Associated Factors Towards the Preventive Measures of COVID-19 Among the General Population; A Systematic Review and Meta-Analysis.

Background: Studies conducted on the practice of COVID-19 preventive methods across the world are highly inconsistent and inconclusive. Hence, this study intended to estimate the pooled preventive practice and its determinants among the general population. Methods: This study was conducted using online databases (PubMed, HINARI, Scopus, EMBASE, Science Direct, and Cochrane library database), African Journals online, Google Scholar, open gray and online repository accessed studies. The quality of the included studies was assessed using Newcastle-Ottawa Quality Assessment Scale (NOS). STATA 14.0 software for analysis. The existence of heterogeneity between studies was checked using Cochran Q test and I2 test statistics and then, the presence of publication bias was detected using both funnel plot and Egger's test. Results: 51 studies were included and the pooled level of practice toward the preventive measures of COVID-19 was 74.4% (95% CI: 70.2-78.6%, I2 = 99.7%, P < 0.001] using a random effects model. Being female [OR = 1.97: 95% CI 1.75, 2.23; I2 = 0.0%, P < 0.698], rural residence [OR = 0.53: 95% CI 0.44, 0.65; I2 = 73.5%, P < 0.013], attending higher education level [OR = 1.47: 95% CI 1.18, 1.83; I2 = 75.4%, P < 0.001], being employed [OR = 2.12: 95% CI 1.44, 3.12; I2 = 91.8%, P < 0.001], age < 30 [OR = 0.73: 95% CI 0.60, 0.89; I2 = 73.9%, P < 0.001], and knowledgeable [OR = 1.22: 95% CI 1.09, 1.36; I2 = 47.3%, P < 0.077] were the independent predictors of adequate practice level. Conclusions: nearly three-fourths of the general population has an adequate preventive practice level toward COVID-19. Thus, the global, regional, national, and local governments need to establish policies and strategies to address the identified factors.

Incidence and Predictors of Opportunistic Infections Among Adult HIV Infected Patients on Anti-Retroviral Therapy at Dessie Comprehensive Specialized Hospital, Ethiopia: A Retrospective Follow-Up Study.

Background: Opportunistic infections are the major causes for morbidity and mortality due to HIV infections. Despite advances in HIV diagnosis and management, the incidence of opportunistic infections remains high. This study aimed to assess the incidence and predictors of opportunistic infections among persons living with HIV/AIDS in Ethiopia. Methods: A retrospective follow-up study was conducted on 354 samples of adults living with HIV on antiretroviral therapy at Dessie Comprehensive Specialized Hospital. Simple random sampling technique was used to select study participants. The data collection format was taken from national antiretroviral intake and follow-up forms. Epi-data Version 4.6.1 and STATA Version 16 software were used for data entry and data analysis respectively. The Cox-proportional hazards regression model was fitted. Kaplan-Meier survival curve was used to estimate opportunistic infections-free survival time. Both bi-variable and multivariable Cox-proportional hazard regression analysis were done to identify predictors of opportunistic infections. Results: Of the total 354 peoples living with HIV, 114 (32.2%) developed OI, with an incidence rate of 13.5 per 100 person-year (95% CI: 10.8-15.6). Advanced World Health Organization clinical disease stage (IV) (AHR: 2.1 (95% CI: 1.16, 3.8)), being bedridden (AHR: 1.66 (95% CI: 1.04, 2.65)), poor adherence (AHR: 1.7 (95% CI: 1.1-2.63), and low CD4 count (AHR: 1.92 95% CI: 1.14-3.22) were significant predictors of OIs. Conclusion: Opportunistic infection among HIV/AIDS continues to be a significant public health concern in Ethiopian health care setting. Our results indicate that the incidence of OI is high. Besides, Stage IV HIV status, being bedridden, low CD4 count and poor adherence independently predicts an increased incidence/decreased survival time of OIs among PLWHIV. Early care-seeking and initiation of HAART and continuous follow-up of patients to take their drug timely are essential to curb the incidence of opportunistic infections and improve overall health. Further research on this area is highly recommended.

Post-traumatic stress disorders among children and adolescents in conflict-affected zones of Amhara region, February 2022.

Background: To date, conflict is causing extreme social crises worldwide, with children representing the most vulnerable group, often experiencing severe trauma and violence in conflict-ridden areas. Posttraumatic stress disorders (PTSDs) are the most widely reported psychological problem in the aftermath of conflict. However, less attention has been given to children living in conflict-prone areas of the world. Objective: The present study aimed to assess posttraumatic stress disorders among children and adolescents in conflict-affected zones of the Amhara region in Ethiopia from January to February 2022. Method: A community-based cross-sectional study was employed from January to February 2022. A multistage random sampling technique was employed to recruit the study participants. A structured interviewer-administered questionnaire was designed to collect the desired data. Data were verified, coded, and entered into EpiData version 3.1 and analyzed using SPSS version 24 statistical software. Result: A total of 846 children with a response rate of 94.33% were screened for trauma. Subsequently, 557 (69.80%) children had experienced trauma. Of these 557 children who had experienced trauma, 203 (36.45%) developed posttraumatic stress disorders. Based on these results, this study recommends that mass screening of children and adolescents for posttraumatic stress disorders and rehabilitation services be undertaken, including resilience training and psychosocial support.

Psychological problems and the associated factors related to the COVID-19 pandemic lockdown among college students in Amhara Region, Ethiopia: a cross-sectional study.

OBJECTIVE: The central aim of this study was to assess the level of psychological problems among college students during school closure due to the emerging COVID-19 pandemic. DESIGN: Institution-based, cross-sectional study. SETTING: Colleges in the Amhara regional state of Ethiopia. PARTICIPANTS: Participants were college students (N=422, >18 years) who were actively enrolled in the selected colleges preceding the survey. METHODS: Data entry was done using Epi Info V.7.02 and data analysis was done using SPSS V.24.0. Variables with a p value less than 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. Model fitness was checked using the Hosmer-Lemeshow model fitness test. Statistically significant level was declared at p<0.05. OUTCOME: Level of psychological problem. RESULTS: This study involved 408 students, with a response rate of 96.6%. In this study, 77.2%, 71.8% and 48.5% of students experienced depression, anxiety and stress-related psychological problems during the lockdown, respectively. The multivariable logistic regression model showed that being female (adjusted OR (AOR)=1.68, 95% CI 1.09 to 2.91), inadequate practice of prevention measures (AOR=1.74, 95% CI 1.01 to 3.02) and living in an urban residency (AOR=0.76, 95% CI 0.48 to 0.94) were independent predictors of psychological problems among students. CONCLUSIONS: The study revealed that the level of anxiety, stress and depression disorders is optimally high among college students. Therefore, local governments should develop effective psychological interventions for students. Moreover, it is important to consider the educational enrolment type and the academic year of students.

Menstrual hygiene practice among female adolescents and its association with knowledge in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Previous studies on menstrual hygiene practice were largely inconsistent and single national evidence is required. Thus, this study aimed to assess the pooled prevalence of menstrual hygiene and its association with knowledge about menstrual hygiene among female adolescents in Ethiopia. METHODS: The study was designed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-2015 Guidelines). This systematic review included studies conducted on female adolescents in Ethiopia irrespective of their publication and study period until the end of July 1, 2020. The data extracted in the Microsoft Excel sheet format was exported into the STATA/SE14 version statistical software for further analysis. I2 test was used to test heterogeneity and publication bias was assessed by using Egger's weighted regression test. RESULTS: Thirteen full-text articles including 6907 participants were included in this systematic review and meta-analysis. Using the random effect model, the pooled prevalence of poor menstrual hygiene practice was 48.98% [95% CI: (36.42, 61.53)]. Those female adolescents who had poor knowledge were 2.6 times more likely to have poor menstrual hygiene practice as compared to counterparts [AOR = 2.61, 95% CI: (1.45, 4.72)]. CONCLUSIONS: The prevalence of poor menstrual hygiene practice was high and knowledge regarding menstrual hygiene was significantly associated with poor menstrual hygiene practice. Information education communication and behavioral change communication at all levels of education should be the primary focus area of the government.

Full immunization coverage and associated factors among children age 12-23 months in Ethiopia: systematic review and meta-analysis of observational studies.

Background: Millions of children in developing countries remained unvaccinated and under-vaccinated. This study was aimed to determine the pooled full vaccination coverage and associated factors in Ethiopia.Methods: This review and meta-analysis were included observational studies conducted from 2013 to 2020. The international online databases as well as gray literatures were retrieved from April 15 to 30/2020. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using Microsoft excel 2016 and analyzed using STATA 11.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval.Result: Sixteen studies with 8305 children aged 12-23 months were included. The overall pooled full vaccination coverage was 65% (95% CI: 56%-74%). Institutional delivery (OR: 2.12, 95% CI: 1.78-2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97-3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46-4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82-4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02-3.2), living in urban areas (OR: 2, 95% CI: 1.54-2.6), and a household visit by health-care providers during the postnatal period (OR: 2.23, 95%CI: 1.22-4.09) were the independent predictors of full immunization coverage among children age 12-23 months.Conclusion: The study showed that the pooled full immunization coverage is still far from the national target (90%). Therefore, the government should strengthen both the outreach and facility-based immunization services.

Epilepsy treatment outcomes in the referral hospitals of northeast Ethiopia.

BACKGROUND: Globally, more than half of the epileptic patients have uncontrolled seizures despite treatment with the appropriate antiepileptic drugs. However, the problem has been remained under-reported especially in developing countries. Therefore, this study was designed to assess the treatment outcomes of epileptic patients in the referral hospitals of the Amhara region. METHODS: An institutional-based cross-sectional study was conducted among 420 epileptic patients in the referral hospitals of Amhara region. The study participants were selected by a systematic random sampling method using the patient registration logbook as a sampling frame. An interviewer-administered questionnaire and abstraction checklist were used to collect data. The data was entered into Epi-Data software version 3.1 and analyzed using the Statistical Package for Social Science) version 24.0. The Descriptive statistics were done and presented using the descriptive summaries and frequency tables. Bivariate and Multivariate Binary Logistic Regression Models with a Backward Elimination Method were done to identify the factors associated with the treatment outcome of epilepsy. The odds ratio with a 95 % confidence interval was used to determine the significance level of association. RESULT: In this study, the magnitude of uncontrolled seizure was 44 % (95 % CI: 39%-48.6%). Being male [AOR = 0.39: 95 % CI 0.25,0.62], high medication necessity beliefs [AOR = 0.34: 95 %CI 0.2,0.57], positive medication beliefs [AOR = 0.23: 95 % CI: 0.13-0.4], and good medication adherence [AOR = 0.21: 95 % CI: 0.1-0.46] were the preventive factors of uncontrolled seizure. In contrast, the presence of co-morbidities [AOR = 2.22, 95 %CI:1.38-3.57] and poor social support [AOR = 1.7: 95 %CI:1.07-2.69] were a risk factors of uncontrolled seizures. CONCLUSION: Uncontrolled seizure was found to be higher than the expected seizure frequency, which is preferably zero after one year of treatment. The clinical and treatment related factors were the factors associated with uncontrolled seizure. Emphasis should be given to the treatment strategies of epileptic patients. The health extension packages should integrate community-based counseling to enhance social support and early detection of comorbidities, increase medication adherence, and medication belief among epileptic patients.