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Difficulties and Challenges in the Management of Childhood Epilepsy: An Experience in an Epilepsy Clinic of Dhaka Shishu (Children) Hospital

Humaira Rafiqa Quaderi , Humaira Rafiqa Quaderi1 , Shayla Imam Kanta2 , Shaoli Sharker3

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Indian Journal of Trauma and Emergency Pediatrics 12(1):p 21-27, January-March 2020. | DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.12120.3

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Humaira Rafiqa Quaderi, Shayla Imam Kanta, Shaoli Sharker. Difficulties and Challenges in the Management of Childhood Epilepsy: An Experience in an Epilepsy Clinic of Dhaka Shishu (Children) Hospital. Indian J Trauma Emerg Pediatr. 2020;12(1): 21–27.

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Abstract

Introduction: Epilepsy is the commonest chronic neurologic disorder in children, affecting about 10.5 million children in the world. Successful management of epilepsy begins with an accurate diagnosis, followed by treatment with an appropriate antiepileptic drug (AED) with proper dose and duration. Treatment gap and dropout is a barrier to control this disease. Objectives:To asertain the difficulties and challenges for the optimum management of childhood epilepsy. Methods: This retrospective observational study was conducted in an epilepsy clinic of Paediatric Neuroscience Department of Dhaka Shishu (Children) Hospital (DSH) over a period of 3 years from January 2013 to December 2015. During this period 1 year follow up record of each patient was analyzed. Information on biodemographic data, clinical and developmental assesment made by a multidisciplinary team was analyzed. Result: Out of 120 patients, 37 (31%) were reported with controlled epilepsy, whereas 40 (33%) were uncontrolled. The major difficulties among total respondents were found non adherence (50%) to drugs and dropped out (35.8%) from the treatment. After association of different predictors with drop out from treatment only medium adherence 16.9%, low adherence 69.8% to drug found as significant predictor (p < 0.001). Among the challenges feeding difficulties (28%), malnutrition (24%) and ignorance (20%) were the leading causes. Conclusion: Management of childhood epilepsy in underdeveloped country is very challenging. To overcome the difficulties appropriate counseling and education is needed at first. Secondly, by ensuring the cheap and high-quality drugs, this difficulty can be overcome.

Keywords: Antiepileptic drug (AED); Epilepsy; Drug non-compliance; Dropout.

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Humaira Rafiqa Quaderi, Shayla Imam Kanta, Shaoli Sharker. Difficulties and Challenges in the Management of Childhood Epilepsy: An Experience in an Epilepsy Clinic of Dhaka Shishu (Children) Hospital. Indian J Trauma Emerg Pediatr. 2020;12(1): 21–27.

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DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.12120.3

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