Quality of life and associated factors among people with epilepsy in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Epilepsy is a global health and economic burden with major problems that have an impact on physical, psychological, and social activities. Quality of life (QoL) is often disturbed and can be influenced by many factors, like anti-seizure medication side effects, the sociocultural environment, and various disease-related factors. The aim of this systematic review and meta-analysis is to provide an overview of the most recent information available regarding the pooled prevalence of poor quality of life and associated factors among adult people with epilepsy in Ethiopia.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is an appropriate set of guidelines for reporting systematic reviews and meta-analyses. This systematic review and meta-analysis protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with CRD42024527914. To find publications for the systematic review and meta-analysis, we used both manual and electronic searches. The publications were searched by PubMed, MEDLINE, EMBASE, Cochrane Library, Scopus, and other grey publications were searched by Google Scholar. The Joanna Briggs Institute (JBI) for cross-sectional study quality assessment was employed to evaluate the methodological quality of the studies included in this review. The data was extracted in Microsoft Excel, and then it was exported into STATA 11.0 for analysis. A funnel plot and an objective examination of Egger's regression test were used to check for publication bias.

Results: We have included 7 studies conducted in Ethiopia with 2123 study participants, of whom 1163 (54.78%) were male individuals, and 1196 (56.34%) of the participants were living without marriage (either single, divorced, or widowed). The pooled prevalence of poor quality of life among people with epilepsy in Ethiopia is 45.07 (95% CI: 39.73-50.42%). Further, in subgroup analysis regarding the assessment tool of poor quality of life of people with epilepsy, QOLIE-31 accounted for 50.05% (95%CI: 46.65-53.45) and WHO QOL BREF accounted for 39.72% (95%CI: 27.67-51.78). Among the associated factors, being unable to read and write, anxiey and depression were significantly linked to the quality of life of people with epilepsy.

Conclusion: This review found that there was a high pooled prevalence of poor quality of life related to people with epilepsy in Ethiopia. This study may provide further information to concerned bodies that do early screening and manage the quality of life of individuals with epilepsy. Also, screening and intervention for anxiety and depression problems should be considered in regular epilepsy care management.

Keywords: Associated factors; Ethiopia; Patients with epilepsy; People with epilepsy; Prevalence; Quality of life.

Fig. 1

PRISMA flowchart of a review search on the prevalence and associated factors of quality of life among people with epilepsy

Fig. 2

Forest plot of the pooled prevalence of poor quality of life among people with epilepsy in Ethiopia

Fig. 3

Forest plot, based on subgroup analysis based on the study region, of the pooled prevalence of poor quality of life among people with epilepsy in Ethiopia

Fig. 4

Forest plot, based on subgroup analysis based on the assessment tool, of the pooled prevalence of poor quality of life among people with epilepsy in Ethiopia

Fig. 5

Funnel plot showing publication bias of the prevalence of poor quality of life among people with epilepsy in Ethiopia

Fig. 6

Sensitivity analysis of the prevalence of quality of life of people with epilepsy in Ethiopia, a study being removed at a time: prevalence and 95% CI (the analysis is based on a random effect model)

Fig. 7

Forest plot showing a narrative synthesis of the findings regarding the associated factors