Published in PLOS One on 2026-04-02, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Erneus Ernest
Source: PLOS One • DOI 10.1371/journal.pone.0344724
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
This study aimed to describe the clinical characteristics and treatment patterns of children with focal and generalized epilepsy and to identify factors associated with seizure control at a tertiary hospital in Tanzania. We conducted a hospital-based cross-sectional secondary analysis of 427 children and adolescents (aged 0–17 years) with a clinical diagnosis of epilepsy whose caregivers were enrolled in a primary study between June and October 2023 at the pediatric neurology clinic of a national referral hospital in Dar es Salaam. Primary outcomes included epilepsy type distribution, treatment patterns (monotherapy vs. polytherapy and specific antiseizure medications), and level of seizure control. The secondary outcome was the identification of factors associated with seizure control, analyzed using ordinal logistic regression and reported as adjusted odds ratios (aORs). Focal epilepsy was the predominant type (52.5%). Most children (65.8%) had infantile seizure onset (<1 year) and were receiving monotherapy (74.9%). Treatment patterns were consistent with guideline recommendations: carbamazepine was prescribed to 94.6% of children with focal epilepsy, while sodium valproate was used in 96.4% of those with generalized epilepsy (both p < 0.001). Seizure freedom in the preceding month was higher among children with focal epilepsy (73.7%) compared with generalized epilepsy (59.5%, p = 0.003). In multivariable analysis, generalized epilepsy was independently associated with worse seizure control (aOR=1.93, 95% CI: 1.28–2.92, p = 0.002). Focal epilepsy was the most common type in this tertiary referral cohort, and treatment largely aligned with international guidelines. Children with generalized epilepsy were more likely to have poorer seizure control. Further prospective studies incorporating detailed syndromic and etiologic classification are needed to better define predictors of seizure control and inform service planning.
Introduction
Over the decades, epilepsy has remained one of the most common neurological conditions affecting about 45 million people globally [1]. There remains a disproportionate distribution of the epilepsy burden, with low- and middle-income countries (LMICs) occupying the lion’s share [2].
Epilepsy remains more common in children and young adults [3], with the prevalence of childhood epilepsy ranging from 3.6–44/1000 in developing countries, while a lower prevalence (3.2–5.5/1000) is reported in developed countries [3].
The management of epilepsy is complex, with pharmacotherapy using antiseizure medication (ASM) being the mainstay. Other treatment modalities are indicated in patients refractory to pharmacotherapy and include immunotherapy, hormonal therapy, ketogenic diet, neurostimulation, and surgery [1].
Nearly half of the patients become seizure-free with the first ASM that is prescribed [4]. The selection of initial medication is complex and relies on several factors, including its effectiveness for a particular seizure type or syndrome, comorbidities, and potential drug interactions [5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Erneus Ernest. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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