Evidence map›Paper›PMID 40836609›Full record

Observational studyDevelopmental medicine and child neurology2026

Personalized care of paediatric drug-resistant epilepsy in Africa: A single-centre pilot study utilizing mobile health and genetic testing.

Ian S Olivier, Karen Fieggen, Sandra Komarzynski, Elin H Davies, Irene Muchada, Caitlin McIntosh, Alina Esterhuizen, Richard J Burman, Jo M Wilmshurst, University of Cape Town (UCT) Human Genetics Precision Medicine Epilepsy Group

Abstract readObservational Study
In one paragraph

Observational study in Developmental medicine and child neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ian S OlivierNeuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-8013-070X
Karen FieggenDivision of Human Genetics, Department of Medicine, University of Cape Town, Observatory, South Africa.
Sandra KomarzynskiAparito Ltd, Wrexham, UK.
Elin H DaviesAparito Ltd, Wrexham, UK.
Irene MuchadaDivision of Human Genetics, Department of Medicine, University of Cape Town, Observatory, South Africa.
Caitlin McIntoshDivision of Human Genetics, Department of Medicine, University of Cape Town, Observatory, South Africa.
Alina EsterhuizenNeuroscience Institute, University of Cape Town, Cape Town, South Africa.
Richard J BurmanDivision of Human Genetics, Department of Medicine, University of Cape Town, Observatory, South Africa.ORCID 0000-0003-3107-7871
Jo M WilmshurstNeuroscience Institute, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-7328-1796
University of Cape Town (UCT) Human Genetics Precision Medicine Epilepsy Group

Funding

Newton FundSouth African Medical Research Council
6 · The paper itself

Abstract

aimTo evaluate personalized care or precision medicine initiatives, including mobile health (mHealth) technology and genetic screening, in a South African paediatric epilepsy clinic.

methodThis exploratory prospective observational pilot study included 39 children aged 4 years or older with drug-resistant epilepsy (ongoing seizures despite at least two antiseizure medications at adequate doses). Participants were recruited from the epilepsy service at the Red Cross War Memorial Children's Hospital in Cape Town, the largest paediatric hospital in sub-Saharan Africa. mHealth technology - a wearable device and mobile application - allowed recording of seizures, medication, sleep, mobility, quality of life, and health visits. Genetic testing included a customized gene panel and pharmacogenomic arrays.

resultsSeizure frequency, but not duration, was significantly greater in clinical records before and during the study period (8.0 and 5.5 median seizures per month respectively) compared with mHealth records of 2.0 median seizures per month (n = 28, p < 0.001, r = 0.64, 95% confidence interval [CI] 2.62-14.25, Wilcoxon signed-rank test, and n = 21, p < 0.001, r = 0.76, 95% CI 2.25-15.75, Wilcoxon signed-rank test respectively). Wearable devices detected decreased activity and sleep in patients compared with age-matched typically developing peers (both p < 0.001, Mann-Whitney U test). Structural abnormalities were the most common aetiology. Pathogenic variants occurred in two different probands in SCN1A, one likely pathogenic variant in GRIN2A, and two variants of unknown significance in GABRG2 and GRIN2B. Pharmacogenomic analyses identified variants of interest in CYP2D6, EPHX1, and SCN1A.

interpretationPrecision medicine for drug-resistant epilepsy using mHealth and genetics may show use in a resource-limited setting. This study, the first demonstration of precision medicine in an African paediatric setting, informs the development of diagnostic testing and provides novel insights into the lives and genetics of affected children.

Indexed as

Drug Resistant EpilepsyGenetic TestingPrecision MedicineTelemedicineAdolescentAnticonvulsantsChildChild, PreschoolFemaleHumansMalePilot ProjectsProspective StudiesSouth AfricaAnticonvulsants

Identifiers

PMID40836609
PMCPMC12875146

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.