title: Non-Attendance of Treatment Review Visits among Epileptic Patients in a Rural District, Zimbabwe.
abstract: Epilepsy is the most common condition reported through the psychiatric returns surveillance system in Gokwe South District. Review visits attendance is crucial to the successful control of seizures among epilepsy patients. We sought out to establish the attendance pattern of epileptic patients, prevalence of non-attendance and the associated factors. An analytic cross-sectional study was conducted where consenting respondents (N=110) were selected randomly from the district epilepsy register. Interviewer-administered questionnaires were used to collect data. Odds ratios were calculated to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables. A total of 110 epileptic patients were included in the study. The patients missed treatment review visits ranging from 1 to 11 of the expected 12 visits between June 2011 and June 2012. Most (70.9%) missed at least 2 visits in a 12month period while 46.4% missed 2 or more consecutive visits. Knowledge of treatment duration [prevalence odds ratio (POR) 0.24 (95% confidence interval (CI) 0.08-0.74)] and high risk perception [POR 0.14 (95% CI: 0.06-0.33)] were associated with a lower likelihood of missing review visits. Barriers such as shortage of drugs [POR 7.09 (95% CI: 3.00-16.72)] and long distances to health facilities [POR 6.63 (95% CI: 2.63-16.76)] were associated with high likelihood of missing two or more review visits consecutively. Shortage of drugs [adjusted odds ratio (AOR) 6.7336 (95% CI: 1.8538-24.4581)] and higher risk perception [AOR 0.1948 (95% CI: 0.0625-0.6071)] remained significant on logistic regression analysis. A high number of epileptic patients miss their review visits mainly owing to shortage of drugs, and long distances from health facilities.
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Midlands Province, Zimbabwe; Ministry of Health & Child Welfare, Provincial Medical Directorate, Midlands Province, Zimbabwe.
authors.forename: Evans
authors.initials: E
authors.lastname: Dewa
authors.affiliation: Department of Community Medicine, University of Zimbabwe , Midlands Province, Zimbabwe.
authors.forename: James
authors.initials: J
authors.lastname: January
authors.affiliation: Department of Community Medicine, University of Zimbabwe , Midlands Province, Zimbabwe.
authors.forename: Zibusiso
authors.initials: Z
authors.lastname: Nyati-Jokomo
authors.affiliation: Ministry of Health & Child Welfare, Provincial Medical Directorate , Midlands Province, Zimbabwe.
authors.forename: Patron T
authors.initials: PT
authors.lastname: Mafaune
authors.affiliation: Department of Community Medicine, University of Zimbabwe , Midlands Province, Zimbabwe.
authors.forename: Shamiso
authors.initials: S
authors.lastname: Muteti
authors.affiliation: Department of Community Medicine, University of Zimbabwe , Midlands Province, Zimbabwe.
authors.forename: Julita
authors.initials: J
authors.lastname: Maradzika
keywords: Gokwe South; epilepsy; non-attendance; review visits