04401nas a2200841   4500000000100000008004100001260004400042653001300086653001500099653001300114653001800127653001900145653001200164653001300176100001300189700001300202700001500215700001400230700001300244700001300257700001400270700001300284700001300297700001000310700001400320700001800334700001300352700001400365700001500379700000600394700001300400700001100413700001400424700001300438700001600451700001400467700001700481700001300498700001100511700001300522700001500535700001500550700001200565700001200577700001200589700001600601700001300617700001200630700001300642700001600655700001600671700001200687700001500699700001300714700001300727700001300740700001400753700001100767700001300778700001600791700001500807700001400822700001000836700001200846700001400858700001200872245016000884856008901044300000901133490000701142520239601149022001403545       2024                            d  bSpringer Science and Business Media LLC10aAttitude10aPerception10aEpilepsy10aSocial stigma10aonchocerciasis10aMahenge10aTanzania1 aMushi VP1 aKidima W1 aMassawe IS1 aMagili PF1 aBhwana D1 aKaaya RE1 aKimambo H1 aHyera HF1 aMatuja W1 aSen A1 aSander JW1 aColebunders R1 aMahone S1 aNewton CR1 aMmbando BP1 a 1 aAkpalu A1 aGodi A1 aMmbando B1 aSottie C1 aKadengye DT1 aMwanga DM1 aAbankwah DNY1 aMcDaid D1 aMuli D1 aDarkwa E1 aWekesah FM1 aManolova G1 aAsiki G1 aHyera H1 aCross H1 aSylvester I1 aSander J1 aBitta M1 aAtieno M1 aChowdhary N1 aChowdhary N1 aAdjei P1 aFaustine P1 aOtieno P1 aWalker R1 aWagner R1 aAsiamah S1 aIddi S1 aGrassi S1 aVallentin S1 aWaruingi S1 aKariuki S1 aDua T1 aKwasa T1 aDenison T1 aMushi V00aAttitudes and perceptions towards epilepsy in an onchocerciasis-endemic region of Tanzania: a mixed approach to determine the magnitude and driving factors  uhttps://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20108-5.pdf  a1-180 v243 a<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>
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