Magnitude and factors associated with nonadherence to antiepileptic drug treatment in Africa: a cross-sectional multisite study

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Magnitude and factors associated with nonadherence to antiepileptic drug treatment in Africa : a cross-sectional multisite study

Ibinda, Fredrick (författare): Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya; Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana

Odermatt, Peter (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland

Kariuki, Symon M. (författare): Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya; Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana

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Kakooza-Mwesige, Angelina (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Iganga-Mayuge Health and Demographic Surveillance System, Kampala, Uganda; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda

Wagner, Ryan G. (författare): Umeå universitet,Epidemiologi och global hälsa,Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Owusu-Agyei, Seth (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Kintampo Health Research Centre, Kintampo, Ghana

Masanja, Honorati (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Ifakara Health Institute, Ifakara, Tanzania

Ngugi, Anthony K. (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Research Support Unit, Faculty of Health Sciences, Aga Khan University—East Africa, Nairobi, Kenya

Mbuba, Caroline K. (författare): Department of Public Health, School of Medicine and Health Sciences, Kenya Methodist University, Meru, Kenya

Doku, Victor C. K. (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Institute of Psychiatry, Kings College London, London, United Kingdom

Neville, Brian G. (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom

Sander, Josemir W. (författare): Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, United Kingdom; Epilepsy Society, Chalfont St. Peter, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), SW Heemstede, Netherlands

Newton, Charles R. J. C. (författare): Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya; Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)—INDEPTH Network, Accra, Ghana; Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom; Department of Psychiatry, University of Oxford, Oxford, United Kingdom

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2017-03-30
2017
Engelska.
Ingår i: Epilepsia Open. - : John Wiley & Sons. - 2470-9239. ; 2:2, s. 226-235

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://umu.diva-por... (primary) (Raw object); https://doi.org/10.1...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

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Objectives: The epilepsy treatment gap is large in low- and middle-income countries, but the reasons behind nonadherence to treatment with antiepileptic drugs (AEDs) across African countries remain unclear. We investigated the extent to which AEDs are not taken and associated factors in people with active convulsive epilepsy (ACE) identified in cross-sectional studies conducted in five African countries.Methods: We approached 2,192 people with a confirmed diagnosis of ACE for consent to give blood voluntarily. Participants were asked if they were taking AEDs, and plasma drug concentrations were measured using a fluorescence polarization immunoassay analyzer. Information about possible risk factors was collected using questionnaire-based clinical interviews. We determined factors associated with nonadherence to AED treatment in children and adults, as measured by detectable and optimal levels, using multilevel logistic regression.Results: In 1,303 samples assayed (43.7% were children), AEDs were detected in 482, but only 287 had optimal levels. Of the 1,303 samples, 532 (40.8%) were from people who had reported they were on AEDs. The overall prevalence of nonadherence to treatment was 63.1% (95% confidence interval [CI] 60.5–65.6%) as measured by detectable AED levels and 79.1% (95% CI 73.3–84.3%) as measured by optimal AED levels; self-reported nonadherence was 65.1% (95% CI 45.0–79.5%). Nonadherence was significantly (p < 0.001) more common among the children than among adults for optimal and detectable levels of AEDs, as was the self-reported nonadherence. In children, lack of previous hospitalization and learning difficulties were independently associated with nonadherence to treatment. In adults, history of delivery at home, absence of burn marks, and not seeking traditional medicine were independently associated with the nonadherence to AED treatment.Significance: Only about 20% of people with epilepsy benefit fully from antiepileptic drugs in sub-Saharan Africa, according to optimum AEDs levels. Children taking AEDs should be supervised to promote compliance.

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Av författaren/redakt...: Ibinda, Fredrick; Odermatt, Peter; Kariuki, Symon M ...; Kakooza-Mwesige, ...; Wagner, Ryan G.; Owusu-Agyei, Set ...; visa fler...; Masanja, Honorat ...; Ngugi, Anthony K ...; Mbuba, Caroline ...; Doku, Victor C. ...; Neville, Brian G ...; Sander, Josemir ...; Newton, Charles ...; visa färre...

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Magnitude and factors associated with nonadherence to antiepileptic drug treatment in Africa : a cross-sectional multisite study

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