CO-MORBIDITY OF ATTENTION DEFICIT HYPER ACTIVITY DISORDER AND ASSOCIATED FACTORS AMONG CHILDREN WITH SEIZURE DISORDERS ATTENDING SEIZURE CLINIC AT GONDAR UNIVERSITY HOSPITAL,NORTHWEST ETHIOPIA APRIL 2015

Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common mental disorders that develop in children and becomes apparent in the preschool and early school years. It is characterized by pervasive and impairing symptoms of in-attention, hyperactivity, and impulsivity. When ADHD present in epileptic children it makes the treatment complicated and the prognosis poor. ADHD among epileptic children in Ethiopia particularly in the study area has poorly understood. Hence, understanding the magnitude of ADHD and associated factors would be important to have a policy intention to wards   these people and to design appropriate interventions.

Objective: The aim of the study is to assess the co-morbidity of attention deficit hyperactivity disorder (ADHD) and associated factors in children with epilepsy, Gondar university hospital.

Methods: A hospital based cross-sectional study was conducted in a total of  260 children followed in pediatric seizure clinic in four months time was included in the study. Data were collected from parents or caregivers by using interview technique with the standard disruptive behavioural disorder (DBD) rating scale 18 item was used to investigate the presence of ADHD. Patients chart also revised to get information about clinical variables and to see the detection rate of the disorder by the attending clinician.

Data was coded, entered and cleaned by using EpiData version 3.1 and exported to SPSS version 20 for further analysis. Variables with p value less than 0.2 in Bivariate analysis were fitted in to Multivariate binary Logistic regression model. Finally the variables which have significant association will be identified on the basis of OR, with 95%CI and p-value, p value less than 0.05 will considered as statistically significant association

Result

A total of 260 children attending seizure clinic to follow for different types of seizure disorders predominantly grandmal seizure were involved in the study. The mean age of participants was 10.5+ 2.7 years. More than half 158(60.8%) were males. In 135(51.9%) of individuals seizure starts suddenly and Seizure is not controlled in more than half 142(54.6%) of the participants.

Prevalence of ADHD among epileptic children is 115(44.2); out of which only 3(2.6%) were detected as having mental health problems by the clinician

Being male, having family history of seizure disorder, having family history of other mental illness, sudden onset of seizure and uncontrolled seizure with the odds of

[AOR= 2.70 95%CI (1.46-4.97)], [AOR=2.4295%CI(1.26-4.65)], [AOR=4.14(1,76-9.68)], [AOR=2.37 95% CI (1.32-4.27)], [AOR=2.55 95% CI(1.41-4.61)] accordingly have significant association with ADHD.

Conclusion and recommendation: prevalence of ADHD is high among children with seizure disorder but detection rate was very low. being male, having family history of seizure disorder, having family history of other mental illness, sudden onset of seizure and uncontrolled seizure were found to be significantly associated with ADHD. Assessing all epileptic children who have follow up at seizure clinic for ADHD is vital to improve the outcome of their seizure treatment and early detect and treat ADHD.