Sociocultural determinants and patterns of healthcare utilization for epilepsy care in Uganda

The association of perceived stigma, religiosity, and paranormal beliefs in parents of children with epilepsy

OBJECTIVE

The aim of this study is to investigate the relationship between stigma perception, religiosity, and paranormal beliefs in parents of children with epilepsy.

METHODS

The sample of this cross-sectional study consisted of 103 parents of children with epilepsy registered at a state hospital in a city with middle socio-economic status located in southeastern Türkiye. The data were collected using descriptive information forms for parents and children with epilepsy, the Parent Stigma Scale, the Religious Attitude Scale, and the Paranormal Belief Scale. The Mann-Whitney U test, Kruskal-Wallis analysis of variance, and Spearman's correlation analysis were used to assess the data.

RESULTS

The results of the study revealed that while 78.6 % of the parents were female, 59.2 % of the children with epilepsy were boys. Total mean scores of the participants were 18.48 ± 4.84 in the Parent Stigma Scale, 51.73 ± 14.15 in the Classical (Non-Religious) Paranormal Beliefs Dimension, and 33.89 ± 6.55 in the Religious Attitude Scale. A weak positive correlation was found between total mean scores of the Parent Stigma Scale, the Paranormal Belief Scale and the Religious Attitude Scale (p < 0.05). However, there was no statistically significant correlation between the mean scores of the Paranormal Belief Scale and the Religiosity Attitude Scale (p > 0.05). All of the three scales were positively correlated with the age of the parents and the duration of the illness (p < 0.05).

CONCLUSION

In this study, it was observed that while the parents had high levels of stigma perception and religious attitudes, they had moderate attitudes toward paranormal beliefs. While no direct correlation was found between religious attitudes and paranormal beliefs, cognitive inclinations toward religion were negatively correlated with paranormal beliefs. Additionally, the parents who perceived a higher level of stigma were more likely to hold stronger religious attitudes and beliefs related to various aspects of paranormal events. In the light of these findings, it is recommended to design educational programs and information campaigns aimed at reducing social stigma and raising awareness about epilepsy in such a way as to take individual belief systems into considerations.

Safety of Janssen Ad26.COV.S and Astra Zeneca AZD1222 COVID-19 Vaccines among Mobile Phone Users in Malawi: Findings from a National Mobile-Based Syndromic Surveillance Survey, July 2021 to December 2021

The safety profiles of the Ad26.COV2.S and AZD1222 COVID-19 vaccines have not been described in the general population in Malawi. We present self-reported adverse events (AE) following the receipt of these vaccines in Malawi as part of a national syndromic surveillance survey. We conducted phone-based syndromic surveillance surveys among adults (≥18 years) with verbal consent. We used secure tablets through random digit dialing to select mobile phone numbers and collected data electronically. Survey questions included whether the respondent had received the COVID-19 vaccines, whether they had experienced any AE following vaccination, and the severity of the AE. We used multivariable analysis to identify factors associated with self-reported AE post-COVID-19 vaccination. A total of 11,924 (36.0%) out of 33,150 respondents reported receiving at least one dose of either Ad26.COV2.S or AZD1222 between July-December 2021; of those, 65.1% were female. About 49.2% of the vaccine recipients reported at least one AE, 90.6% of which were mild, and 2.6% were severe. Higher education level and concern about the safety of COVID-19 vaccines were associated with AE self-report (Adjusted Odds Ratio [AOR] 2.63 [95% CI 1.96-3.53] and 1.44, [95% CI 1.30-1.61], respectively), while male gender and older age were associated with reduced likelihood of AE self-report (AORs 0.81, [95% CI 0.75-0.88], 0.62 [95% CI 0.50-0.77], respectively). Ad26.COV2.S and AZD1222 vaccines are well-tolerated, with primarily mild and few severe AE among adults living in Malawi. Self-reporting of AE following COVID-19 vaccination is associated with gender, age, education, and concern about the safety of the vaccines. Recognizing these associations is key when designing and implementing COVID-19 vaccination communication messages to increase vaccination coverage.

Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers

Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda). Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories. Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes. Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.

Teachers' experiences of managing children with epilepsy in school: A qualitative study

BACKGROUND

School is the second most important environment for children second to the family. An increasing number of children with epilepsy (CWE) are able to go back to school to continue to study after treatment. In school, CWE can be involved in studies and activities, which is conducive to their growth. However, CWE have to face more barriers than other children in school, such as cognitive impairment, poor attendance, school absenteeism, and learning disability. What is more, even if CWE have been taking antiepileptic medicines, they still have a risk of seizure. Therefore, it is important to ensure the safety of CWE in the school. Teachers play a significant part in managing CWE in school, so we aimed to deeply explore the experiences of school teachers in managing CWE during school.

METHOD

Purposive sampling was used to recruit teachers (n = 17) who cared for children with epilepsy in their class. Semi-structured interviews were used to access qualitative data. Framework analysis was used to analyze qualitative data.

RESULT

Five major themes emerged after analyzing: the recognition of epilepsy, the attitude to children with epilepsy, the barriers to communicate with parents about epilepsy, the reaction to a seizure, and the need for training.

CONCLUSION

The findings of this qualitative study reported teachers' knowledge of and attitude toward epilepsy, the barriers for them to communicate with parents, the reaction to seizure, and the need for training. Although teachers know little about epilepsy, they have a positive attitude toward CWE. There are many obstacles in terms of the communication between teachers and parents. Parents' cover-ups and teachers' lack of professional training will put teachers and CWE at risk. In view of the fact that teachers and parents are not professionals, it is necessary for hospitals to play a coordinating role between the two.