@article{101133,
  keywords = {Attitude, Perception, Epilepsy, Social stigma, onchocerciasis, Mahenge, Tanzania},
  author = {Mushi VP and Kidima W and Massawe IS and Magili PF and Bhwana D and Kaaya RE and Kimambo H and Hyera HF and Matuja W and Sen A and Sander JW and Colebunders R and Mahone S and Newton CR and Mmbando BP and   and Akpalu A and Godi A and Mmbando B and Sottie C and Kadengye DT and Mwanga DM and Abankwah DNY and McDaid D and Muli D and Darkwa E and Wekesah FM and Manolova G and Asiki G and Hyera H and Cross H and Sylvester I and Sander J and Bitta M and Atieno M and Chowdhary N and Chowdhary N and Adjei P and Faustine P and Otieno P and Walker R and Wagner R and Asiamah S and Iddi S and Grassi S and Vallentin S and Waruingi S and Kariuki S and Dua T and Kwasa T and Denison T and Mushi V},
  title = {Attitudes and perceptions towards epilepsy in an onchocerciasis-endemic region of Tanzania: a mixed approach to determine the magnitude and driving factors},
  abstract = {<p><strong>Background:</strong> 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.</p>

<p><strong>Methods:</strong> 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.</p>

<p><strong>Results:</strong> Of 778 participants, over half were women (425, 54.6%) with a median age of 41&nbsp;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.</p>

<p><strong>Conclusions:</strong> 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.</p>
},
  year = {2024},
  journal = {BMC Public Health},
  volume = {24},
  pages = {1-18},
  publisher = {Springer Science and Business Media LLC},
  issn = {1471-2458},
  url = {https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20108-5.pdf},
  doi = {10.1186/s12889-024-20108-5},
  language = {ENG},
}