Attitudes and perceptions towards epilepsy in an onchocerciasis-endemic region of Tanzania: a mixed approach to determine the magnitude and driving factors

Epilepsy remains a significant public health concern in Tanzania, with affected individuals enduring stigma, whether through actions or perceptions. Myths, misunderstandings, and misconceptions about epilepsy have persisted due to a multitude of factors. Here, we assessed attitudes and perceptions t...

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Bibliographic Details
Published in:	BMC public health Vol. 24; no. 1; pp. 2608 - 18
Main Authors:	Mushi, Vivian P, Kidima, Winifrida, Massawe, Isolide S, Magili, Pendo F, Bhwana, Dan, Kaaya, Rahel Elishilia, Kimambo, Henrika, Hyera, Herieth F, Matuja, William, Sen, Arjune, Sander, Josemir W, Colebunders, Robert, Mahone, Sloan, Newton, Charles R, Mmbando, Bruno P
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 27-09-2024 BioMed Central BMC
Subjects:	Adolescent Adult Attitudes Chi-square test Community Community involvement Complications and side effects Cross-Sectional Studies Data collection Education Endemic Diseases Epilepsy Epilepsy - epidemiology Epilepsy - psychology Female Focus Groups Health Knowledge, Attitudes, Practice Humans Knowledge Low level Mahenge Male Middle Aged Onchocerciasis Onchocerciasis - epidemiology Onchocerciasis - psychology Perceptions Population Public health Public opinion Qualitative analysis Qualitative Research Questionnaires Risk factors Sample size Social interactions Social Stigma Statistical analysis Stigma Surveys and Questionnaires Tanzania - epidemiology Towns Young Adult Tanzania Mahenge Stigma Epilepsy Tanzania Attitudes Perceptions Onchocerciasis
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Summary:	Epilepsy remains a significant public health concern in Tanzania, with affected individuals enduring stigma, whether through actions or perceptions. Myths, misunderstandings, and misconceptions about epilepsy have persisted due to a multitude of factors. Here, we assessed attitudes and perceptions toward epilepsy in Mahenge. A cross-sectional study utilising a mixed-methods approach was undertaken in eight villages in the Ulanga district of Mahenge, integrating a semi-structured questionnaire and focus group discussions (FGDs). The questionnaire involved 778 community members, and 15 FGDs were conducted (seven groups with people with epilepsy and eight without). Descriptive statistics, chi-square, and logistic regression were used for quantitative analysis, while we used NVivo version 14 for thematic analysis of qualitative data. Of 778 participants, over half were women (425, 54.6%) with a median age of 41 years (IQR: 30-55) and most had completed primary education (79.9%). The majority of participants were aware of epilepsy (96.8%), yet they displayed low knowledge (51%), negative attitudes (45.5%), and perceptions (42.1%) towards the disorder. A low level of understanding was significantly associated with negative attitudes (Adjusted Odds Ratio [AOR] = 1.89, 95%CI: 1.41-2.53) and perceptions (AOR = 3.22, 95%CI: 2.05-5.04) towards epilepsy. In the qualitative analysis, often hereditary factors and infections were named as causes of epilepsy, along with misconceptions involving witchcraft and divine punishment. There was also a misconception about the contagiousness of epilepsy. Traditional healers were often the initial point of treatment. Epilepsy-related stigma was evident, with individuals with epilepsy facing derogatory labels, social isolation, and barriers to education. Lastly, there was a lack of understanding regarding a possible association between epilepsy and onchocerciasis. Despite high awareness of epilepsy, there is insufficient understanding, negative attitudes, and perceptions, including misconceptions and stigma about this neurologic condition. Community-based education programmes are essential for promoting proper healthcare-seeking behaviour and dispelling myths.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2458 1471-2458
DOI:	10.1186/s12889-024-20108-5