Ethiopians' knowledge of and attitudes toward epilepsy: A systematic review and meta-analysis

Abstract

BackgroundEpilepsy remains one of the world's most common neurological diseases, but it appears to be widely misunderstood, particularly in under-resourced countries like Ethiopia. Improving individuals' knowledge and attitude toward epilepsy is critical for reducing the multifaceted impacts of epilepsy. Therefore, in this study, we sought to estimate the pooled levels of good knowledge and a favorable attitude toward epilepsy and also identify the associated factors using available data collected from different segments of the population.MethodsArticles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked via Higgins and Thompson's I2 statistics (0–100%), and Cochran's Q test at P < 0.10. Subgroups, based on the study regions, and sensitivity analyses were also performed. Publication bias was examined subjectively using funnel plots and objectively using the nonparametric rank correlation test of Begg and the regression-based test of Egger for small study effects with P < 0.05 considered to indicate potential publication bias. Furthermore, the Trim-and-fill method of Duval and Tweedie was used to explore sources of publication bias for the favorable level of attitudes toward epilepsy.ResultA total of 12 studies with 6,373 study participants and 10 studies with 5,336 study participants were included to estimate the pooled level of good epilepsy knowledge and favorable attitudes respectively. The overall estimated levels of good epilepsy knowledge and favorable attitudes toward epilepsy among Ethiopians were 47.37% [(95% CI: 35.00, 59.74), I2 = 99.2, P < 0.001] and 46.83%[(95% CI: 32.75, 60.90), I2 = 99.2, P < 0.001] respectively. Subgroup analysis revealed that the pooled level of good epilepsy knowledge was 48.51% [(95% CI: 38.95, 58.06), I2 = 95.6%, P < 0.001] in the Amhara region.ConclusionIn the current review, we found out that there is a huge knowledge gap and an unfavorable level of attitudes towardepilepsy, which demand immediate public health action as well as a targeted policy intervention.

Drug therapy problems and contributing factors among patients with epilepsy

“…The availability and affordability of antiseizure medications, which are crucial for managing epilepsy, often face challenges [ 34 ]. Additionally, misconceptions and cultural beliefs contribute to stigmatizing individuals with epilepsy, which hinders their acceptance and access to healthcare services [ 12 , 13 , 35 ]. As a result, epilepsy management in Ethiopia is suboptimal, leading to inadequate seizure control and negatively impacting the affected individuals’ quality of life [ 6 , 11 ].…”

“…Different cultural backgrounds influence the treatment of epilepsy by shaping beliefs, stigmas, and cultural practices, which in turn impact medical accessibility, treatment adherence, and social integration [ 10 , 11 ]. In Ethiopia, cultural beliefs and practices often result in the use of traditional medicine, religious rituals, or misconceptions about epilepsy, which can hinder access to appropriate medical treatments and result in the stigmatization of individuals living with epilepsy [ 6 , 8 , 12 , 13 ]. Additionally, resource-limited countries face challenges related to climate change, such as global warming, that can adversely affect the accessibility and availability of antiseizure medications and hinder seizure control [ 14 ].…”

Unfavorable public attitude toward people with epilepsy in Ethiopia: A systematic review and meta‐analysis study

“…Three of the studies reported that 47.5% of participants did not want to allow PWE to study at school with healthy people 37,39,40 . The unfavorable attitudes and practices might be directly attributed to the participants' educational level and sociocultural influences and their low access to health educational programs 47–49 . People's preference for traditional and cultural practices likely originates from their beliefs in unearthly/mystic causes of epilepsy to be intervened through educational campaigns.…”