title: Adherence to antiepileptic drugs among children attending a tertiary health unit in a low resource setting.
abstract: BACKGROUND
  Epilepsy is one of the neglected and highly stigmatised diseases, yet it is very common affecting about 70 million people worldwide. In Uganda, the estimated prevalence of epilepsy is 13% with about 156 new cases per 100,000 people per year. Adherence to antiepileptic drugs is crucial in achieving seizure control yet in Uganda; there is lack of information on adherence to antiepileptic drugs and the factors that affect this among children. This study was therefore designed to determine the level of adherence to antiepileptic drugs and the factors that are associated with non adherence.
  
  
  METHODS
  In a cross sectional study, 122 children who met the inclusion criteria were enrolled and interviewed using a pretested questionnaire. Assessment of adherence to antiepileptic drugs was done by self report and assay of serum drug levels of the antiepileptic drugs. Focus group discussions were held to further evaluate the factors that affect adherence.
  
  
  RESULTS
  Age range was 6 months - 16 years, male to female ratio 1.3:1 and majority had generalised seizures 76 (62.3%). Adherence to antiepileptic drugs by self report was 79.5% and 22.1% by drug levels. Majority of the children in both adherent and non adherent groups by self report had inadequate drug doses (95/122). Children were found to be more non-adherent if the caregiver had an occupation (p-value 0.030, 95%CI 1.18-28.78).
  
  
  CONCLUSIONS
  Majority of children had good adherence levels when estimated by self report. The caregiver having an occupation was found to increase the likelihood of non adherence in a child.
authors.affiliation: Department of Pediatrics and Child Health, College of Health Sciences, Makerere University.
authors.forename: Rose
authors.initials: R
authors.lastname: Nazziwa
authors.affiliation: Department of Pediatrics and Child Health, College of Health Sciences, Makerere University.
authors.forename: Angelina Kakooza
authors.initials: AK
authors.lastname: Mwesige
authors.affiliation: Department of Pharmacology, College of Health Sciences, Makerere University.
authors.forename: Celestino
authors.initials: C
authors.lastname: Obua
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Ssenkusu
authors.affiliation: Department of Pediatrics and Child Health, College of Health Sciences, Makerere University.
authors.forename: Edison
authors.initials: E
authors.lastname: Mworozi
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D005260:Female; D006295:Health Resources; D006801:Humans; D007223:Infant; D008297:Male; D011203:Poverty; D062606:Tertiary Care Centers; D016903:Drug Monitoring
chemical_list: D000927:Anticonvulsants
keywords: Adherence; Epilepsy; Low resource setting; antiepileptic drugs; children