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. 2025 Mar 5:16:1546911.
doi: 10.3389/fneur.2025.1546911. eCollection 2025.

Health-related quality of life and associated factors among epilepsy patients in sub-Saharan Africa: a systematic review and meta-analysis

Dessale Abate Beyene  1 , Desalegn Getnet Demsie  2 , Chernet Tafere  3 , Taklo Simeneh Yazie  4 , Destaw Endeshaw  5 , Tamrat Assefa Tadesse  6 , Zenaw Debasu Addisu  7
Affiliations

Health-related quality of life and associated factors among epilepsy patients in sub-Saharan Africa: a systematic review and meta-analysis

Dessale Abate Beyene et al. Front Neurol. .

Abstract

Background: Epilepsy is a major public health issue worldwide, often leading to physical and cognitive impairments that limit employment, independence, and social interaction. Health-related quality of life (HRQoL) is a crucial outcome in the treatment of chronic epilepsy as it is linked to reduced independence, treatment challenges, and lower life expectancy. HRQoL serves as an important health indicator for assessing the impact of the disease on daily living activities.

Objective: This study aimed to estimate the mean score of health-related quality of life (HRQoL) and factors associated with lower HRQoL in people living with epilepsy (PLWE) in sub-Saharan African (SSA) countries.

Methods: A comprehensive literature search was conducted using PubMed, Cochrane Library, Scopus, and Google Scholar databases. This review has been registered with PROSPERO (CRD42024620363). The eligibility criteria were established, and this review included cross-sectional and observational studies assessing HRQOL in PLWE in SSA countries, published in English from the inception of databases through November 2024. The pooled HRQoL was reported as the mean score with accompanying 95% confidence intervals. Finally, publication bias was evaluated using a funnel plot and Egger's regression test.

Results: The pooled mean score of HRQoL among PLWE in SSA was 63.79 (95% CI: 59.75-67.84%). Owing to significant heterogeneity across the studies, a random-effects model was utilized for the meta-analysis (I2 = 98.96%, p < 0.001). This meta-analysis indicated that anxiety (β = -4.762, p = 0.0029), depression (β = -4.591, p < 0.0001), uncontrolled seizures (β = -4.321, p < 0.0001), and a family history of epilepsy (β = -5.093, p = 0.0013) had statistically significant negative impacts on HRQoL in PLWE. Despite some asymmetry in the funnel plot, Egger's test showed no significant publication bias, with a p-value of 0.321.

Conclusion: This review found a moderate pooled mean score of HRQoL among PLWE in SSA countries. Factors that negatively affect HRQoL in these regions include anxiety, depression, uncontrolled seizures, comorbidities, and a family history of epilepsy.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/search, identifier CRD42024620363.

Keywords: associated factors; health-related quality of life; mean score; people living with epilepsy; sub-Saharan Africa.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow diagram for study selection for systematic review and meta-analysis.
Figure 2
Figure 2
Forest plot of the pooled mean score of HRQoL among patients with epilepsy in SSA.
Figure 3
Figure 3
Subgroup analysis based on regions in Africa for the mean score of HRQoL among epilepsy patients in SSA.
Figure 4
Figure 4
Subgroup analysis based on the tools used to assess HRQoL among epilepsy patients in SSA.
Figure 5
Figure 5
Leave-one-out sensitivity analysis.
See this image and copyright information in PMC

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