Multiple anti-seizure medications use and pattern of seizure control in children with epilepsy at neurology follow up clinic, Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia.

Back ground: Antiseizure drug treatment is the mainstay of the management of epilepsies. Thirty percent of individuals with epilepsy experience refractory or drug resistant seizures which often require treatment with combinations of antiseizure drugs. Methods: This was a cross sectional descriptive study of three hundred fifty-five children with epilepsy attending Tikur Anbessa hospital in Addis Ababa, Ethiopia. Children with epilepsy who had been on Antiseizure medications for six months and more were consecutively enrolled from October 1 2018 to December 30 2018 to reach the calculated sample size. The history and laboratory result information were extracted from patient's records and was supplemented by direct inquiry. Data was analyzed using SPSS for windows version 24. Multivariate logistic regression analysis was done for those that had P-value (<0.05) on bivariate analysis and adjusted odds ratio were used to explore the association. Results: One hundred twenty nine of the 355 children (36.3 %) were on multiple AEDs; 114(32.1%) were on dual therapy while 15(4.1%) were on three anti epileptic drugs. Conclusion: One third of children with epilepsy attending the pediatric neurology clinics were being managed with multiple Anti-seizure drug therapy. Almost half of the participants had achieved seizure freedom in the past six months.

Child disability and family-centred care in East Africa: Perspectives from a workshop with stakeholders and health practitioners

Our understanding of child disability has undergone major changes over the last three decades transforming our approach to assessment and management. Globally there are significant gaps in the application of these 21st century models of care. There is recognition that economic, cultural, and social factors influence transitions in care and there is need to consider contextual factors.Objectives: A two-day workshop brought together key stakeholders to discuss current models of care and their application in the East African context. This article summarises workshop proceedings and identifies a broadly supported set of recommendations that serve to set a direction for health professionals, families, family-based disability organisations, communities and government. Method: Presentations followed by facilitated round-table sessions explored specific themes with participants reporting their responses communally. Future actions were agreed upon by relevant stakeholders. Results: Many barriers exist to care for children with disabilities in East Africa, including stigma and a lack of human and infrastructural resources. In addition, significant disparities exist with regard to access to medication and specialist care. The International Classification of Functioning framework needs to be translated to clinical practice within East Africa, with due recognition of the importance of family- centred care and emphasis on the life course theory for disability care. Family- centred care, educational initiatives, advocacy on the part of stakeholders and involvement of government policymakers are important avenues to improve outcomes. Conclusion: Further education and data are needed to inform family-centred care and multidisciplinary team implementation across East African care contexts for children with disabilities.

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. METHODS: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020, and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. CONCLUSION: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors

The Impact of COVID-19 on Care Seeking Behavior of Patients at Tertiary Care Follow-up Clinics: A Cross-Sectional Telephone Survey. Addis Ababa, Ethiopia.

BackgroundCOVID-19, the disease caused by the new coronavirus SARS-CoV-2 is among the most obscure global pandemics resulting in diverse health and economic disruptions. It adversely affects the routine health care delivery and health service uptake by patients. However, its impact on care-seeking behaviour is largely unknown in Ethiopia. ObjectiveThis study was to determine the impact of the pandemic on care-seeking behaviour of patients with chronic health condition at Tikur Anbessa Specialized hospital in Addis Ababa. MethodsA cross-sectional hospital-based survey conducted between May and July 2020 on patients whose appointment was between March to June 2020. Sample of 750 patients were approached using phone call and data collection was done using a pretested questionnaire. After cleaning, the data entered in to IBM SPSS software package for analysis. ResultsA total of 644 patients with a median age of 25 years, and M: F ratio of 1:1.01 was described with a response rate of 86%. A loss to follow up, missed medication and death occurred in 70%, 12%, and 1.3% of the patients respectively. In the multivariable logistic regression analysis, patients above 60 years old were more likely to miss follow-up (OR-23.28 (9.32-58.15), P<001). Patients who reported fear of COVID-19 at the hospital were 19 times more likely to miss follow-up (adjusted OR=19.32, 95% CI:10.73-34.79, P<0.001), while patients who reported transportation problems were 6.5 times more likely to miss follow-up (adjusted OR=6.11, 95% CI:3.06-12.17, P<0.001). ConclusionsCOVID-19 pandemic affected the care-seeking behaviour of patients with chronic medical condition adversely and the impact was more pronounced among patients with severe disease, fear of COVID19 and with transportation problems. Education on preventive measures of COVID-19, use of phone clinic and improving chronic illness services at the local health institutions may reduce loss to follow-up among these patients. What is already known?O_LIAs a result of COVID-19, an essential maternal, newborn and child health (MNCH) services in Addis Ababa city showed that first antenatal attendance and under-five pneumonia treatment decreased by 12 and 35%. C_LIO_LIA drop in client flow was ascribed to fear of acquiring COVID-19 at health facilities, limited access due to movement restrictions, and dedication of health facilities as COVID-19 treatment centers. C_LI What are the new findings?O_LIA cross-sectional hospital-based telephone survey indicated that a loss to follow up, missed medication and death occurred in 70%, 12%, and 1.3% of patients with chronic medical conditions respectively. C_LI What do the new findings imply?O_LIFear of COVID-19 and transportation problems are the most commonly stated reasons thus, the finding implies that since health care services to patients with chronic medical conditions is concentrated in specialized referral hospitals mostly aggregated in big cities, patients who travel long distance to get the service are at high risk of Loss to follow up. C_LIO_LIStrengthening the chronic care service at a local health institutions, and promoting COVD-19 preventive measures, may help decrease the LTFU and associated complications. C_LI

Seroprevalence and associated risk factors for HIV, Hepatitis B and C among blood Donors in South Gondar District blood Bank, Northwest Ethiopia.

BACKGROUND: Despite the undeniable significance of blood transfusion in saving a millions life in emergencies and medical treatment, the quality of blood faced challenges from transfusion-transmitted infections (TTIs) such as HIV (human immunodeficiency virus), HBV (hepatitis B virus) and HCV (hepatitis C virus). This cross-sectional study was undertaken with the aim of determining the seroprevalence and risk factors of HIV, HBV, and HCV among blood donors. METHODS: An institutional based cross-sectional study was conducted at Debre Tabor district hospital from January 2017 to February 2018. Blood samples from volunteer donors collected; serum separated and screened with ELISA tests for detection of anti-HIV, hepatitis-B surface antigen (HBsAg) and anti-HCV. Fishers' exact test was employed to see the association between variables as well logistic regression tests were applied to identify potential risk factors. P-value of less than 0.05 was considered as statistically significant. RESULT: A total of 310 volunteer donors were included in the study. The proportion of blood donors having at least one viral-TTI was 12.6% while the magnitudes of HIV, HBV, and HCV were 2.6, 5.8 and 4.2%, respectively. Educational status and multiple sexual behaviors are significantly associated with HIV acquisition whilst marital status was significantly associated with HBsAg seropositivity. CONCLUSION: Seroprevalence of transfusion-transmissible infections was high and alarming therefore proper screening of donated blood with test methods having better diagnostic performance should be employed. Also encouragement of blood donation from voluntary donors and creating awareness on the general public regarding HIV, HBsAg and HCV transmission and prevention should be strengthen.