Febrile Seizures in Children in a Low-Resource Setting: A Hospital-Based Cross-Sectional Study from Eastern Libya

Abstract Febrile seizures (FSs) are the most common seizure disorder in early childhood, affecting approximately 2 to 5% of children under 5 years of age. Although generally benign, FSs cause significant parental distress and health care utilization and are commonly triggered by childhood infections. Data from low-resource health care settings remain limited. This study aimed to assess the hospital-based prevalence, clinical characteristics, and factors associated with FSs among children in eastern Libya. This retrospective cross-sectional study was conducted from August 1, 2022, to August 31, 2023, at Tobruk Medical Center, a tertiary referral hospital in eastern Libya. A total of 2,604 pediatric admissions of children aged 6 to 60 months were screened, and 140 children admitted with FSs were included. Demographic, clinical, and laboratory data were extracted from medical records and caregiver interviews. Statistical analyses were performed using SPSS version 27. The hospital-based prevalence of FSs was 5.7%, with equal sex distribution. Simple FSs accounted for 87.9% of cases, while complex FSs comprised 12.1%. The median age at seizure onset was 18 months. A family history of epilepsy was significantly more common among children with complex FSs than among those with simple FSs (29.4% vs. 6.5%, p = 0.009). Upper respiratory tract infections were the most frequent precipitating cause of fever (72.8%). Children with complex FSs experienced more frequent seizures during a single febrile illness and had higher white blood cell counts. In this hospital-based study from a resource-limited setting, FSs, predominantly simple FSs, were common among young children. A family history of epilepsy and elevated white blood cell counts were associated with complex FSs, highlighting the importance of risk stratification and context-appropriate management in low-resource health care environments.