Community attitudes towards epilepsy in a rural Ethiopian setting: a re-visit after 15 years

Despite being a common disorder, epilepsy is perhaps the neurological condition least well understood by the general public and most likely to be associated with a wide range of misconceptions.

A cross-sectional community-based survey was conducted in a predominantly rural area of central Ethiopia where there has been a continuous supply of anticonvulsant medications for the last 15 years. Our objective was to assess the impact of this treatment upon the attitudes of rural people towards epilepsy by comparing our findings to a community attitude survey conducted between 1986 and 1988. The method used is a cross-sectional survey.

The belief that epilepsy is a contagious illness is significantly less prevalent compared to earlier days, 30.7% vs. 44.6% (P < 0.0001). Considering epilepsy to be a form of mental illness has increased in the current sample 40.9% vs. 1.9% (P < 0.0001). Attribution of the aetiology to supernatural factors is significantly diminished and the belief that epilepsy is hereditary has significantly increased. Modern anticonvulsant medications are more favoured in the current study 4.5% vs. 0.9% (p < 0.0001), although they remained unpopular with the majority who still prefer traditional treatment. In general, female respondents' knowledge about how to help a convulsing person, ways of preventing further epileptic attacks, and causes of epilepsy was significantly less than that of the male respondents. Rural dwellers also showed more negative attitudes with regard to marriage and working with a person suffering from epilepsy. Positive attitudinal changes in the past few years were reported by 119 (19%) of the respondents, and the changes were attributed to the availability of medication in the area and increased awareness through health education given at clinics.

The results show ongoing negative attitudes towards epilepsy within the community. In addition to attempts to improve seizure control, our findings highlight the importance of ongoing educational programmes directed towards community misconceptions and negative attitudes about epilepsy.