Epilepsy beliefs and misconceptions among patient and community samples in Uganda.

Journal: Epilepsy & behavior : E&B

Volume: 114

Issue: Pt B

Year of Publication: 2021

Affiliated Institutions:  School of Medicine, College of Health Sciences, Makerere University, P.O. Box , Kampala, Uganda. Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC Box ; Trent Drive, Durham, NC, USA. School of Medicine, College of Health Sciences, Makerere University, P.O. Box , Kampala, Uganda; Department of Medicine, Mulago National Referral Hospital, Neurology Unit, Kampala, Uganda. Department of Mental Health and Community Psychology, Makerere University School of Psychology, P.O. Box , Kampala, Uganda. Section of Neurosurgery, Rady Faculty of Health Sciences, University of Manitoba, GB- Sherbrook Street, Health Sciences Centre, Winnipeg, MB RA R, Canada. University of Wisconsin - Madison, Department of Neurology, Highland Avenue, Madison, WI -, USA. Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box , Duke University Medical Center, Durham, NC , USA; Duke Global Health Institute, Trent Dr, Durham, NC , USA. Duke University Trinity College of Arts & Sciences, Durham, NC , USA. Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, P.O. Box , Kampala, Uganda. Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O.Box , Kampala, Uganda; Department of Paediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda. Duke University Medical Center, Clinical Neuropsychology Service, Box , Durham, NC, USA. Butabika National Referral Mental Hospital, P.O.Box , Kampala, Uganda. Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box , Duke University Medical Center, Durham, NC , USA; Makerere University School of Public Health, Department of Epidemiology and Biostatistics, New Mulago Complex, P.O. Box , Kampala, Uganda. Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box , Duke University Medical Center, Durham, NC , USA; Duke Global Health Institute, Trent Dr, Durham, NC , USA; Duke University, School of Medicine, Tower Blvd, Durham, NC , USA. Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC Box ; Trent Drive, Durham, NC, USA; Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box , Duke University Medical Center, Durham, NC , USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA. Electronic address: koltair@duke.edu.

Abstract summary 

The objective of the study was to characterize and compare the attitudes, beliefs, and perceptions about epilepsy across community and patient cohorts in Uganda.This was a descriptive study utilizing two samples: a randomly selected, national survey community sample and a hospital-based patient sample of people with epilepsy (PWE) and their caregivers attending clinic settings in Kampala and Mbarara, Uganda for epilepsy care. Both samples were surveyed about their beliefs about epilepsy, its treatment, and people who have the illness. Multivariate linear regression was used to examine group differences and variables associated with specific beliefs.Among the 15,818 community survey participants who participated in this study, 435 study participants reported symptoms suggestive of recurrent seizures, and all 626 subjects in the hospital-based sample had confirmed epilepsy. Results revealed significant differences across groups in their endorsement of epilepsy as a contagion; 37% of people in the community unaffected by epilepsy, and 39% of people with suspected epilepsy who did not seek care believed that epilepsy was contagious by touch, in contrast to 8% of PWE or their caregivers attending regular hospital-based care. Higher educational attainment and income, and seeking regular hospital-based medical care were associated with less endorsement of epilepsy as a contagion, while age, education, income, area of residence, and presence of seizure symptoms, were significant predictors of support or belief in the basic rights of PWE. Study participants within the community who screened negative for seizures placed the most restrictions on rights for PWE. To varying degrees, the samples all endorsed the effectiveness of allopathic, traditional, and religious providers, and the use of pharmaceutical drugs, traditional rituals and herbs, and prayer.People with epilepsy who are attending biomedical care for routine epilepsy care think differently about epilepsy, its treatment, and the rights of those with the disease than the general population. Within the community setting, more erroneous beliefs and negative attitudes about epilepsy and PWE persist, and they not only contribute to stigma but also interfere with the patients' health-seeking behavior. Further confounding the care of PWE, the pluralistic healthcare system in Uganda is evident in endorsements spanning biomedical, traditional, and religious treatment methods. Focused awareness campaigns utilizing local epilepsy societies are needed to promote epilepsy health literacy, to favorably impact acceptance and opportunities for PWE in Uganda, and to facilitate efficient uptake of biomedical care. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".

Authors & Co-authors:  Kaddumukasa Mark M Smith Patrick J PJ Kaddumukasa Martin N MN Kajumba Mayanja M Almojuela Alysa A Bobholz Samuel S Chakraborty Payal P Sinha Drishti D DD Nakasujja Noeline N Kakooza-Mwesige Angelina A Gualtieri Alex A Onuoha Erica E Nakku Juliet J Sanchez Nadine N Muhumuza Christine C Fuller Anthony T AT Haglund Michael M MM Koltai Deborah C DC

Study Outcome 

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Statistics
Citations : 
Authors :  18
Identifiers
Doi : 10.1016/j.yebeh.2020.107300
SSN : 1525-5069
Study Population
Male,Female
Mesh Terms
Epilepsy
Other Terms
Beliefs;Contagion;Epilepsy;Misconceptions;Rights
Study Design
Descriptive Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States