Study Area and Population

The study was conducted at Amanuel Mental Specialized Hospital (AMSH) located in the western part of Addis Ababa in Addis Ketema Sub-city Kebele 08. It has been serving as the only public specialized psychiatric hospital since 1948 under the Ministry of Health. The hospital has 259 beds including 11 private wing beds and 23 emergency beds. The hospital has 13 outpatient departments. An average of 26,400 follow-up and new patients receive outpatient services annually, and most of the patients attend with family members. A total of 2200 patients with epilepsy are seen by the neuropsychiatry case team each month, and it ranks second in outpatient department patient volume in the hospital.

Adult patients of epilepsy on AED treatment follow-up between 1 July 2017 and 30 June 2019 in the hospital was the study population. Meanwhile, patients who initiated anti-epileptic medications between July 2017 and June 2019 and had at least two measurements for the outcome of interest were included. Whereas, patients who had incomplete records for major variables like the outcome of interest and had no follow-up sheets within their medical records were excluded. In addition, those patients who had been diagnosed to have SE were also excluded.