Public attitudes toward epilepsy in Denmark

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

OBJECTIVE

This systematic review and meta-analysis aims to show the pooled prevalence of unfavorable public attitude toward people with epilepsy (UPATPWE) as well as the effect estimates of associated factors in Ethiopia.

METHODS

Between December 1 and 31, 2022, we searched for the English version of published research reports on public attitude toward epilepsy in Ethiopia in PubMed/Medline, Science Direct, Cochrane Library, Google Scholar, and PsycINFO. The research reports' quality was assessed using the Newcastle-Ottawa Scale. We extracted the relevant information from the searched papers in a Microsoft Excel format and imported it to STATA version 15.0, for analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reports guideline was used. A random-effects meta-analysis model was used to estimate the Der Simonian and Laird's pooled prevalence of unfavorable public attitude and its associated factors.

RESULTS

Nine out of the accessed 104 research papers meeting the pre-specified criteria were included in this study. The overall pooled prevalence of UPATPWE in Ethiopia is 52.06 (95% CI: 37.54, 66.59), resulting in excommunication, physical punishments, and assaults against people with epilepsy as well as frequent lack of diagnosis and proper treatment. The pooled effect estimates for witnessing a seizure episode were done and it was (AOR = 2.70 [95% CI: 1.13, 6.46]).

SIGNIFICANCE

As interventions and new strategies to change attitudes and facilitate a supportive, positive, and socially inclusive environment for PWE may root in education and scientific research outputs, our result hopefully evokes the policy makers' attention for building a well-designed and comprehensive health education and campaign strategy.

Assessment of knowledge, attitude and practice (KAP) of parents/caregivers towards epilepsy in children - A cross- sectional observational study

Objectives

The study aimed to assess the knowledge, attitude, and practice (KAP) of parents/caregivers toward epilepsy in paediatric patients at a tertiary care centre of North India.

Methods

A cross sectional study was carried out among 418 parents or caregivers using convenience sampling technique with 16-item questionnaire in English language and also translated to local language that is Hindi. Children with epilepsy who visited the paediatric outpatient department within a year were included in the study (January 2021-22). A total of 450 children visited the clinic, 32 of whom were excluded for various reasons, and the final analysis was conducted among the 418 parents or caregivers who completed the questionnaire.

Results

The male and female patients were 56.7% (n = 237) and 43.3% (n = 181) respectively. The age distribution of patients with less than 5 years, 6-10 years and more than 10 years were 35.6% (n = 149), 54.5% (n = 228), 9.8% (n = 41) respectively. Only one third of parents and caregivers did not consider epilepsy as psychiatric illness. Most of the parents and caregivers think that epilepsy affects school performance (77.2%) and hinders family life (71.0%). More than half of the parents or caregivers believes that the society discriminates against person with epilepsy and around 46.6% consider that alternative medicine can cure epilepsy. The parents or caregivers felt financial burden due to epilepsy was in 72.5% and approximately 78.5% perceived that their work is affected because of their child's epilepsy. Perception of epilepsy as a psychiatric illness was found to be significantly higher in parents with primary and secondary level education, when compared to parents who were graduates. The practice of the parents or caregivers towards administration of drugs to their child was good, however around 36.6% (n = 153) missed the dose of anti-seizure medications.

Conclusion

The study highlights the substantial knowledge, attitude and practice gap amongst parents and caregivers for children with epilepsy which indirectly has huge impact on the management of epilepsy. Thus it becomes utmost important to educate the family as well as the community regarding epilepsy which will help in improving the therapeutic outcomes, overall quality of life and interpersonal and social relationships of these children.

Assessment of epilepsy awareness, knowledge, and attitudes among preclinical and clinical medical students in the West Bank of Palestine

OBJECTIVE

The purpose of this research was to evaluate the level of epilepsy-related awareness, knowledge, and attitude exhibited by medical students at a specific medical school in Palestine, as well as the students' reactions to the treatment and social activities provided to patients with epilepsy.

METHODS

A cross-sectional, observational research of 306 medical students at An-Najah National University in the West Bank, Palestine, was conducted. We used a validated survey taken from previous publications. We split the medical students into preclinical (2nd and 3rd year) and clinical (4th, 5th, and 6th year) groups to see if there were significant differences in their awareness, knowledge, attitude, and their practices toward patients with epilepsy. Several elements, such as sociodemographics, awareness, knowledge, attitude, and practices regarding epilepsy, were included in the survey. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 29.0. Quantitative data were expressed as mean and standard deviation, whereas qualitative data as frequencies and percentages. The chi-square test was used to compare groups.Any P-value below 0.05 was considered statistically significant.

RESULTS

In general, clinical medical students exhibited better epilepsy awareness, knowledge, and attitude than preclinical students. Of note, 73.6% of clinical students believe epilepsy is a treatable disorder, compared to 44.6% of preclinical students (P-value < 0.001). Some students believe that depression/anxiety (39.6%), psychosis (35.7%), jinns (evil spirit) (7.8%), evil eye (5.8%), and punishment from God (4.5%) cause epilepsy. Clinical students were more likely than preclinical students to have rotated in a neurology clinic or department (40% vs. 4.6%, P-value < 0.001). In total, 95.5% of clinical students and 86.9% of preclinical students (P-value = 0.006) thought patients with epilepsy should marry. Clinical stage students were more likely than preclinical stage students to think that patients with epilepsy can have children (92.7% vs. 83.1%, P-value = 0.009). Preclinical stage students were more likely than clinical stage students to believe that students with epilepsy should not play sports (22.3% versus 13%, P-value = 0.030). Generally, there were no significant gender differences in awareness, knowledge, and attitudes.

CONCLUSION

The study found that medical students knew little about epilepsy types, causes, triggers, and first aid. Negative attitudes toward people with epilepsy living alone and discrimination against people with epilepsy were also observed. Students' perceptions of this prevalent disease must be improved through educational programs that provide increased opportunities for clinical exposure to this condition as well as proper inclusion of epilepsy in the regular curriculum.

Sociodemographic determinants of epilepsy and treatment-seeking behavior among patients with epilepsy - A hospital-based study from western India

BACKGROUND

Epilepsy ranks among the major noncommunicable diseases that confer significant morbidity and mortality. A lack of knowledge about epilepsy, coupled with negative attitude and false practices, has been shown to be influenced by sociodemographic parameters and in turn impacts healthcare-seeking behavior.

METHODS

An observational single-center study was conducted at a tertiary care center in western India. Data on sociodemographic parameters, clinical and healthcare-seeking patterns were recorded from all patients above 18 years with a diagnosis of epilepsy. A pre-validated questionnaire was then administered to assess the knowledge, attitude, and practices related to epilepsy. Data collected were evaluated.

RESULTS

A total of 320 patients with epilepsy were recruited for the study. Majority of the study subjects were young Hindu males from urban and semi-urban areas. Idiopathic generalized epilepsy was the most common diagnosis with significant number of patients showing poor seizure control. The knowledge, attitude, and practice (KAP) responses showed serious gaps in various aspects. Prevalent misconceptions were that epilepsy is a mental problem (40%), is a hereditary disorder (24.1%), is contagious (13.4%), and is a result of previous life sin (38.8%). With respect to discrimination in epilepsy using KAP questionnaire, most of the respondents (>80%) did not object to sitting or playing with a child with epilepsy. A significant proportion of patients (78.8%) feared from the side effects of long-term antiepileptic drug treatment. Almost one-third persons (31.6%) did not know the correct response in terms of first aid measures. The mean KAP score was 14.33 (±3.017 SD), significantly higher in better educated people from urban areas (p < 0.001 for both). Healthcare-seeking behavior with preference for early allopathic care had a positive correlation with various sociodemographic characteristics as well as with higher mean KAP scores.

CONCLUSION

Despite improved literacy and urbanization, knowledge regarding epilepsy still remains poor with wide prevalence of traditional wisdom and practices. Though better education, employment, and awareness may partially overcome the impediments resulting in delay in seeking early appropriate healthcare after first seizure, the issue is more complex and multifactorial, and a multipronged approach is need of the hour.

Have attitudes toward epilepsy improved in Germany over the last 50 years?

OBJECTIVE

In Germany, six previous representative surveys on attitudes toward epilepsy (AE) have been conducted between 1967 and 2008 using the four original Caveness questions (CQs) from 1949 to 1980. The aims of this study were (1) to investigate changes in AE over the time span of 50 years, including the current survey in 2018 (2) to investigate the first-time emotional reactions measured with the Scales of Attitudes toward People with Epilepsy (SAPE) (3) to identify predictors of AE.

METHODS

A representative face-to-face survey with CQ, in addition with the SAPE scales of Social Distance, Stereotypes, Personal Concerns, and Emotional Reactions was carried out in Germany in 2018. One thousand and twenty-six persons who ever had heard of epilepsy participated. Respondents who answered "don't know" in the CQs were subsequently asked to answer only yes/no. The analysis of trends from 1967 to 2018 was based on the pooled data of the surveys. The four CQs in the 2018 survey were included in the SAPE item pool and an exploratory principal axis factor analysis was performed. General linear models were performed to identify predictors.

RESULTS

For all four CQs, the trend of improved AE was significant over the past 50 years. In the 2018 survey, excluding the "don't know" answer option increased the proportion of negative responses for contact of one's own children with a person with epilepsy (PWE) from 6.9% to 11.4% and for the marriage of one's own children with a PWE from 13.9% to 23.8%. When encountering a PWE, 30.1% would feel insecure or uncomfortable and nearly 60% were concerned that the PWE might be injured in case of a seizure. Knowing what to do in case of a seizure, knowing that seizures can be treated successfully, personal contact with a PWE along with younger age, and higher education were found to be the strongest predictors for positive AE identified by multivariate analyses. Exploratory principal axis factor analysis revealed that three of the four CQs items loaded > 0.30 at the factors of Social Distance and Stereotypes of SAPE but none on the factors measuring emotional reactions.

SIGNIFICANCE

AE measured by CQs have markedly improved in Germany over the last 50 years. Germany is to our knowledge the only country with such a long-term trend investigation in AE. Negative AE may be underestimated by survey questions with "don't know" answer option. Emotional aspects of attitudes are underexposed resp. neglected in the CQs, which are used worldwide for measuring AE. Additional tools like SAPE can close this gap. The identified predictors may help to derive interventions against negative AE.

Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy

OBJECTIVE

To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors.

METHODS

Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy.

RESULTS

Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status.

SIGNIFICANCE

Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.

Awareness and attitude of first-year medical students toward epilepsy in University of Khartoum, Sudan

PURPOSE

Very little is known about the knowledge and attitude of students about epilepsy at Sudanese universities. Therefore, we aimed to assess knowledge and attitude of undergraduate medical students toward epilepsy.

METHODS

A 35-items standardized questionnaire was self-administered to 320 students between December 2020 and February 2021 with a recorded response rate of 61.8%. Google form was used to collect the data. The data was analyzed using R software.

RESULTS

Overall, our findings showed a negative trend in the awareness and attitude towards epilepsy. While the majority of students (84.8%) had read or heard about epilepsy, only 43.9% of them had seen someone with epilepsy. Epilepsy was considered contagious and psychological by 1.7% and 56%, respectively. About 62.2% of students believed head / birth trauma is a cause of epilepsy. On the other hand, 15.7 % and 5.1 % of students thought evil eye and divine retribution are also causes of epilepsy, respectively. The latter beliefs were more uniform among participants from rural background (p < .05). Regarding attitude, 19.7% of students considered it inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother's education as the percentage was higher for students whose mothers had a lower education (pre-college education) (p < .05). The majority of students were aware that certain people with epilepsy need long-term drug treatment; this belief was more uniform among females than in males (p < .05). The vast majority of students (93.9%) thought that a child with epilepsy could succeed in a normal class. Compared to the corresponding group, this belief was found more common in students whose mothers had a higher education (university level and above) (p < .05).

CONCLUSION

This study concludes that Sudanese undergraduate students' understanding of epilepsy was minimal, necessitating a well-directed educational campaign to develop a well-informed and tolerant society.

Awareness, attitude, and understanding toward epilepsy among workers in a State Specialist Hospital in Maiduguri, Northeastern Nigeria

Background

Epilepsy is a common presentation at clinics in Psychiatric Hospitals, Teaching Hospitals, and general practice. In developing countries and Africa especially, awareness, attitude, and understanding are generally poor. People still believe in spirits as the cause of epilepsy.

Objectives

The objectives were to assess the awareness; attitude and knowledge of Hospital workers in general practice concerning epilepsy.

Methodology

The respondents were workers of all cadres who were working at a State Specialist Hospital and the study used a survey method proposed by Caveness and Gallup, with modifications and adaptations on the self-administered questionnaire.

Results

One hundred and forty-four staffs of State Specialist Hospital completed the questionnaire containing items addressing demographics, awareness, attitude, and knowledge. Of these respondents, 89 were males and 55 were females. The mean age was 34.34 years. 96.5% heard of the disease, 77.8% knew someone with the disease, 64.6% will not object to their children playing with someone with epilepsy and 37.5% will not allow a relative to marry someone with epilepsy. Fifty-five percent (55%) of the respondents said; they will not employ such patients, and that patients with epilepsy should not be employed with others. Knowledge towards epilepsy was good, where 71.5% felt it was caused by a brain disorder.

Conclusion

We found out that awareness and knowledge of epilepsy among Hospital staff were generally good. However, the attitude of healthcare workers had reservations towards patients with epilepsy (PWE) either working for them or working with other people. This attitude arose from deeply ingrained cultural misconceptions acquired over time. Thus, there is a need for consistent hospital staff education, aimed at allaying fears, mistrust as well as to lessen the stigma towards epileptics.

Beliefs and attitudes towards child epilepsy: A structural equation model

PURPOSE

To analyze the possibly influencing factors of the beliefs and attitudes towards childhood epilepsy among users of the Family Health Strategy.

METHODS

The participants were 300 users from three units of the Family Health Strategy in one city of northeastern Brazil. This primary health care service has a multidisciplinary team and operates close to the community, seeks to provide comprehensive care with actions to promote health, prevention, recovery, rehabilitation of diseases and frequent injuries in the community. Data were collected through a socioeconomic questionnaire and the Brazilian version of The Epilepsy Beliefs and Attitudes Scale - Adult Version, analyzed using descriptive statistics and structural equation analysis.

RESULTS

Various associations were significant (p < 0.05), religion positively influences beliefs and attitudes (β: 1.040; p: 0.044); an increase in educational level negatively influences beliefs and attitudes (β: -0.723; p: 0.040); being the parent of a child negatively influences beliefs and attitudes (β: 1.120; p: 0.043), but also positively influences beliefs (β: -0.244; p: 0.028).

CONCLUSION

This research contributed to identifying that having a religion, an increased educational level and being the parent of a child were factors that influence the beliefs and attitudes towards childhood epilepsy, aiming to contribute to a better implementation of actions directed to education in epilepsy.

Knowledge, attitude and traditional practices towards epilepsy among relatives of PWE (patients with epilepsy) in Marrakesh, Morocco

Epilepsy remains one of the most common neurological diseases in the world but seems to be widely misunderstood, especially in low-income countries. Patients with epilepsy (PWE) can face considerable stigma in society, and there have been various studies that evaluate the knowledge and attitude of the population towards epilepsy. However, there was no study of this kind in Morocco.

PURPOSE

Our aim was thus to assess knowledge, attitudes, and traditional practices specifically among relatives and caregivers of PWE in our community, in order to better evaluate their educational needs.

METHODS

This cross-sectional and descriptive study was carried out over a year long period in the outpatient neurology clinic of the Mohammed 6 University Hospital, a tertiary referral center in Marrakesh, Morocco. The respondents were relatives of PWE (usually parents and siblings) or spouses who attended the outpatient clinic alongside them. The interviews were carried out by the same investigator at the outpatient clinic during patient's visits, face-to-face using Moroccan Arabic or Darija, with an 18-item questionnaire.

RESULTS

Responses of 100 participants were analyzed. The mean age was 40 years old and 5 months. Sixty-six percent of the respondents were women, 50% of rural origin and 76 % lived in an urban area. Forty-one percent were illiterate, and 74% were of low income. Only 65% of the participants knew the Arabic term for epilepsy. For 48%, epilepsy was linked with witchcraft or demonic possession. Seventy-five percent of the respondents had at least one prior consultation to a traditional healer. Only 5% in our study knew the first-aid basics to apply in case of a seizure.

CONCLUSION

Despite having a relative with epilepsy, our participants' knowledge was very poor. The level of education and income seem to be the two major contributing factors. Cultural beliefs and superstition are very pervasive, and the majority of our sample had already used traditional healing and alternative medicine. Our study highlights the need for a more global intervention in Morocco encompassing healthcare policies, awareness campaigns, and educational reforms.

Awareness and attitudes toward epilepsy among medical and allied healthcare students - A survey study in a teaching hospital in Jeddah

PURPOSE

Epilepsy affects individuals of all ages and genders and places high physical, mental, financial, and social burdens on these individuals. In Saudi Arabia, its prevalence is 6.5 cases per 1000 individuals. Physicians and healthcare professionals have a key role in increasing the knowledge and awareness of the general population about epilepsy. The purpose of this study was to assess the level of awareness of different aspects of epilepsy, such as, presentation; causes; social aspects of epilepsy in school, work, and social life; treatment options; and attitudes toward epilepsy of students at King Abdulaziz University (KAU) in medical and allied healthcare specialties. We also aimed to assess if the level of knowledge and attitude improves throughout the study years by comparing preclinical-year students to clinical-year students.

METHOD

This cross-sectional study included 255 participants from multiple health specialties studying at KAU. Surveys from prior validated publications were used. We divided the respondents into two categories (preclinical [2nd, 3rd, 4th-year students] and clinical [5th, 6th, and internship year]) to evaluate if knowledge and attitude are different among these two groups.

RESULTS

In general, medical students had more awareness than did students from other specialties about what to do if someone was having a seizure. A total of 17.3% of medical students answered that they would put a spoon or cloth in the mouth of someone having a seizure, whereas 21% of nursing students thought this answer was appropriate (p = .04). The proportion of clinical-year students who were knowledgable of the symptoms and causes of epilepsy was significantly higher than that of students in preclinical years (p < .0001). Only 12.3% of the clinical-year students thought epilepsy was an untreatable disease versus 35.5% of preclinical-year students (p = .02). Interestingly, nursing students had the highest percentage of respondents who answered yes to surgical options (p = .009) (57.9%, n = 11), followed by dental students (50%, n = 6), medical students (46.4%, n = 78), and finally clinical pharmacy students (45.5%, n = 20).

CONCLUSION

The level of awareness among medical students was higher than that among students of other specialties, with progressive improvement over the study years. However, knowledge about surgical options was minimal. Thus, further emphasis is needed in teaching and educational campaigns, particularly for allied healthcare students.

Knowledge, attitude, and believes of epilepsy in local communities of Saudi Arabia

Aim of the Study

To assess public knowledge, attitude, and believes toward the epilepsy among local community populations in Shaqra Area, Kingdom of Saudi Arabia.

Methods

An organized 14 questionnaire was prepared to analyze public knowledge attitudes and believes about epilepsy. Study was conducted randomly in common public places in Shaqra City, Saudi Arabia, during the months of April and May 2016. Sample size includes 155 males and 130 females from Shaqra City of Saudi Arabia.

Results

The study analyzed the 285 local public including 155 male and 130 female contributors. About 68.38% male contributors and 63.07% female contributors studied Diploma or Bachelor education program. Female contributors (71.53%) were aware about epilepsy as compared with male contributors (58.70%). Maximum number of female contributors (82.30%) believes that epilepsy is treated by medication as compared with male contributors (58.70%).

Conclusion

The knowledge, awareness, and attitudes of the epilepsy are found to be much improved in local community of Saudi Arabia. In the modern era, people assume that epilepsy is still due to evil spirit. Many contributors think there should be restrictions on driving and getting jobs in epilepsy patient. Public awareness and educational campaigns should be included in modern methods of education to develop well-knowledged community, which will improve the quality of life of epileptic patients.

Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys

BACKGROUND

Knowledge, attitudes, and practice (KAP) questionnaire-based surveys have captured negative attitudes towards marriage involving people with epilepsy (PWE). The attitudes may vary according to the nature of the question posed, whether personal or generic, in addition to many other covariates.

METHODS

We carried out meta-proportion and -regression analyses of epilepsy-related KAP surveys published between 1970 and 2016 in the medical literature analysis retrieval system online (MEDLINE) database.

RESULTS

The pooled estimate of the proportion of those responding positively to the marriage question was 0.45 (95% confidence interval (_95%CI): 0.35 to 0.54; I²_res = 99.89%). The pooled proportion of positive responders to a personal question (0.40; _95%CI: 0.35 to 0.46) was significantly lower than those responding positively to a generic question (0.64; _95%CI: 0.57 to 0.70) (P = 0.001). When modeled individually in regression analyses, only the continent of origin of the survey (P = 0.001; tau²: 0.06; I²_res: 99.8%; adjusted R²: 11.4%) and subject population type (P = 0.02; tau²: 0.07; I²_res: 99.9%; adjusted R²: 4.2%) were associated with the pooled estimate of positive responders to the question on marriage.

CONCLUSIONS

Personal questions probing the possibility of marriage of self or family members to someone with epilepsy bring about negative attitudes more often than generic questions inquiring the marriage-worthiness of PWE.

Sociocultural aspects and different types of stigmatization in epilepsy

This literature review deals with knowledge and beliefs about epilepsy and with the attitude of patients, relatives, and society as a whole towards epilepsy. It discusses the stigma that is associated with the  disease and has a strong impact on patients with epilepsy and their  families. The problems of stigma or related concepts in different countries are analyzed.

Knowledge, attitudes, and practices towards epilepsy among general practitioners in rural Bolivia: Results before and after a training program on epilepsy

INTRODUCTION

Epilepsy represents a major health problem in low- and middle-income countries where treatment gap (TG) levels are high. The reduction of epilepsy TG in the rural area of the Chaco region, Plurinational State of Bolivia, has been the aim of many projects based on the reinforcement of the primary care setting. To plan educational campaigns directed to the healthcare professionals, it is necessary to establish their baseline knowledge level. The objective of our study was to assess the baseline level of knowledge, attitudes, and practices (KAP) towards epilepsy among general practitioners (GPs) of the rural communities of the Chaco region.

METHODS

The study was conducted in three departments of Bolivia. All the GPs living in these areas were invited to participate in the study consisting of two training modules six months apart from each other, each with two-day duration. They answered a validated questionnaire to evaluate the KAP towards epilepsy before and after the courses.

RESULTS

Fifty GPs [30 men (60%); mean age: 32.1±5.8years] participated in the first training course. After six months, 31 GPs (62%) [19 men (61.3%); mean age: 33±5.0years] participated in the second module. Before the training, the majority of GPs declared a low level of satisfaction about their epilepsy knowledge, which improved after the courses. A change in practices was recorded after the training, with an increased confidence to manage antiepileptic treatment.

CONCLUSION

Our study showed the significant impact of specific training programs on epilepsy among GPs.

Knowledge, attitude and practice of parents regarding pediatric antiepileptic drug therapy

Objectives To evaluate the parental knowledge, attitude and practice (KAP) regarding the antiepileptic medication therapy in childhood.

Methods This study was carried out over a period of 10 months in the division of Pediatric Neurology of Amrita Institute of Medical Sciences. The cohort of patients was selected randomly meeting the inclusion and exclusion criteria. Parents' KAP regarding epilepsy and antiepileptic drug therapy was assessed using a questionnaire prepared by the authors and patient adherence towards antiepileptic drug therapy by using Pediatric Epilepsy Self-Management Questionnaire (PEMSQ).

Results A total of 123 patients were selected and enrolled in the study. Seventy eight percent of the respondents knew that epilepsy is a brain disorder, while only 6% of them were aware about all the treatment options. The scoring in the domain of “Disease and Treatment Knowledge & Expectations of parents” was found to be significantly low (69.07%) when compared to other domains in the PEMSQ. Although socioeconomic status did not correlate with knowledge score of the parents (p = 0.216), it was significantly related to adherence (p = 0.042).

Conclusion In this cohort, even though the parents had a fair knowledge about the nature of epilepsy, they were found to be less aware about its characteristics, causes and prognosis. The awareness about the nature and duration of treatment, its objectives, use of drugs, their side effects and importance of adherence to drug regimen was found to be significantly low with a potential for affecting the therapeutic outcome. Special awareness programs for parents of children with epilepsy may be needed to reduce the knowledge gaps in the management of epilepsy and to ensure compliance and optimal therapeutic outcomes.

Attitudes towards people with epilepsy in Moscow

PURPOSE

To assess the knowledge and attitudes in Moscow towards people with epilepsy (PWE).

METHODS

Data were collected from 1167 adults, permanent residents of Moscow, who were interviewed. A 10-item questionnaire was used addressing three major domains: familiarity with epilepsy (2 questions), understanding of epilepsy (5 questions), and attitude towards the PWE (3 questions). Results were standardized to the Moscow population.

RESULTS

The study population was generally well informed about epilepsy. About 80% "has heard" of epilepsy; however, personal acquaintance with PWE was reported by less than half of the study participants. The level of understanding of the disease and its etiology was quite low. About 60% of the survey participants believed that epilepsy was a type of mental retardation. One-third (34%) of respondents were afraid to stay in the proximity of PWE. Only 38% of the survey participants considered epilepsy to be curable; men significantly less frequently than women. Overall, the level of understanding of epilepsy was proportional to the level of education of respondents. Negative attitudes towards PWE were demonstrated in a significant part of the population. Almost half of the respondents would object to their child playing or studying with a child who has epilepsy and more than half (57%) were against the marriage of their daughter or son to a person with epilepsy. Two-fifths of the respondents ranked epilepsy as the "least preferred" of the six chronic diseases for a colleague.

CONCLUSION

This is the first study on awareness and attitudes to PWE in the adult population of Moscow. The study demonstrated that the general public is familiar with epilepsy, but has a rather low level of understanding of essential aspects of the disease. There is an overall high level of negative attitudes towards PWE in Russia, creating a need for targeted interventions. These results reinforced the importance of public education in reducing the stigma of epilepsy.

Knowledge and attitudes towards epilepsy in Saudi families

OBJECTIVES

Epilepsy is one of the most common paediatric neurological disorders. Lack of awareness regarding epilepsy among the general population influences the lives of epileptic children. Misconceptions and misinformation about epilepsy in children should be identified and corrected. The aim of this study was to assess the knowledge and attitudes towards epilepsy in families of epileptic children and families of normal children in Almadinah Almunawwarah, KSA.

METHODS

A cross-sectional study was conducted at Maternity and Children's Hospital from March 2015 to December 2015. A self-administered questionnaire was designed to collect data from the participant families.

RESULTS

Of 168 participants, 150 completed the questionnaire. These included 64 families of epileptic children and 86 families of normal children. Of all the responding families, 67 families (44.7%) thought that epilepsy was related to Jinn. Logistic regression analysis showed that this belief was dependent on the family education level (p = 0.004) and to the area of residence, either urban or rural (p = 0.04). In families of epileptic children, the link of epilepsy to Jinn was related to clinical factors, such as the type of epilepsy (p = 0.023), disease duration (p = 0.039), and duration of treatment (p = 0.028).

CONCLUSIONS

Our community still has misconceptions regarding epilepsy, even among families of epileptic children. Knowledge and attitudes toward epilepsy must be corrected. Planned programs and campaigns should be conducted in the form of mass society education.

The psychosocial impact of epilepsy on marriage: A narrative review

There have been many studies exploring quality of life as well as the impact of epilepsy on the affected individual. However, epilepsy affects more than the patients themselves, and there seems to be a paucity of data regarding the impact of epilepsy beyond the person with epilepsy (PWE). In particular, it is uncertain what the impact of epilepsy on marriage may be. We therefore performed a narrative review to evaluate work measuring the psychosocial effect of epilepsy on marriage. We reviewed the literature on epilepsy and marriage by searching PubMed (Medline) and EMBASE and thoroughly examining relevant bibliographies. Forty-two papers were identified that addressed the issue of the psychosocial effect of epilepsy on marriage. The different approaches used to assess the impact of epilepsy on marriage can be broadly grouped into three categories: assessment of the social effect of living with epilepsy, which includes the marital prospects of PWEs and how changes in martial status associate with seizure frequency; assessment of quality of life (QOL) of PWEs; assessment of the association of social support with the disease burden of epilepsy. Within each of these approaches, different research methods have been employed including questionnaires, qualitative methods, and scales. The studies reviewed indicate that epilepsy has a severe impact on individuals and their families. While many quality-of-life surveys do comment on the marital status of the patient, there is little expansion beyond this. The impact that seizures may have on the partner of a patient with epilepsy is barely addressed. With increasing incidence of epilepsy in older populations, potential changes in the dynamic of a long-term marriage with the development of epilepsy in older age are not known. Similarly, the impact of marriage on concordance with medication or proceeding to, for example, surgical treatment for pharmacoresistant epilepsy has not been studied in detail. We suggest ways in which to address these aspects in order to better deliver holistic care to patients with epilepsy and their partners.

Knowledge, attitude, and practice of people toward epilepsy in a South Indian village

Introduction:

People living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions, and misunderstandings that have persisted for many years. In the last decade, there has been an increase in individual literacy rate and increased access to technology in rural population. However, it is unclear if this has any effect on knowledge, attitude, and practice (KAP) attitude toward epilepsy.

Objective:

Our primary aim is to evaluate KAP toward epilepsy. In addition, we also estimated the prevalence of stroke and epilepsy in rural South India.

Materials and Methods:

Using a 14-item questionnaire, we assessed KAP toward epilepsy and identified determinants of inappropriate attitudes toward people with epilepsy and 10-item questionnaires to assess the prevalence of epilepsy and stroke among 500 randomly selected populations in a Pattaravakkam village (Tamil Nadu, India).

Results:

About 87.7% of the people had heard or read about epilepsy. Negative attitudes appeared to be reinforced by beliefs that epilepsy is hereditary (23.1%), kind of insanity (22.6%), or as contagious (12.0%). The knowledge about the clinical characteristics and first aid to a person during a seizure was 25.8%. About 36.5% of people think that society discriminates people with epilepsy. Moreover, our prevalence study showed that 8.7% people are suffering from epilepsy and 3.7% had stroke previously and at the day of survey, the stroke prevalence is 3.3%.

Conclusion:

Even with increased literacy, technology, and communication devices, the KAP of people toward epilepsy is relatively low. General public education campaigns and specific school education campaigns children should be encouraged to increase the KAP toward epilepsy. The prevalence and pattern of epilepsy and stroke is on the higher side in the village of Pattaravakkam. Future research regarding the value of targeted education in improving KAP will be worthwhile.

Knowledge and attitudes towards epilepsy in Zambia: a questionnaire survey

Misconception and stigma towards epilepsy have a profound impact on this disease in Africa. An unselected sample of Zambian people was interviewed to investigate their knowledge and attitudes towards epilepsy. Proper/improper answers were scored, and a composite score was developed with negative values for unsatisfactory awareness and high stigma levels. The sample comprised 231 people residing in urban (107) or in rural (124) areas. The median and interquartile range of scores for epilepsy awareness and stigma were, respectively, -1 (-3; +1) and +1 (-1; +6). Poor education was the only significant predictor of unsatisfactory awareness (p=0.0131), while education and residency were significantly associated with stigma (p<0.0001 and p=0.0004). Rural people were mostly in the highest stigma level (44.2%) and urban people in the lowest stigma level (60.4%). Misconception and negative attitudes towards epilepsy among Zambian people reflect poor education and rural residency.

Primary School Managers' Knowledge of and Attitude towards Epilepsy among Children in Erbil City, Iraq

OBJECTIVES

This study aimed to determine the knowledge and attitudes of primary school managers regarding epilepsy among school children in Erbil City, Iraq.

METHODS

A cross-sectional study was conducted in primary schools between 18 June and 18 August 2013. A total of 80 primary school managers were selected to answer a questionnaire covering three domains: socio-demographical characteristics, knowledge of epilepsy and attitudes towards epilepsy.

RESULTS

More than half of the participants (55%) had spent less than 10 years in school administration. More than one-third (37.5%) of the participants believed that epilepsy was an infectious disease, and over half of the respondents (53.75%) stated that epilepsy cannot be treated or prevented.

CONCLUSION

Although the respondents' attitudes towards pupils with epilepsy were generally positive, their knowledge of epilepsy was imperfect; thus, an epilepsy education campaign is required. This should focus on the causes of epilepsy and its management.

Knowledge, attitude and practices of school teachers towards epileptic school children in Karachi, Pakistan

Objective: To assess the knowledge and attitude of school teachers towards an epileptic child.

Methods: This cross-sectional study was conducted among teachers of primary, middle and high schools from different communities in Karachi, Pakistan. A total of 120 self-administered KAP questionnaires were distributed in schools selected through convenience sampling. Data was analyzed using SPSS version 19.

Results: Out of the total sample size, 90.9% (n=100) had heard about epilepsy. Sixteen (14.5%) teachers considered epilepsy to be contagious while 72.7% (n=80) teachers were of the view that epileptics can succeed as other normal children and sixty nine (62.7%) teachers were willing to help a child experiencing a fit, though only 15.5% (n=17) received knowledge about epilepsy during their training years.

Conclusion: The research was conclusive for assessing the knowledge and attitude of teachers towards epileptic children. It highlighted the lack of awareness and negative attitude still existing among teachers. However, many were in the favor of mass education through awareness programs.

Epilepsy: What do health-care professionals in Riyadh know?

PURPOSE

The objective of this study was to report on the knowledge of epilepsy, as well as attitudes and practices toward individuals with epilepsy, among health-care professionals in Riyadh, the capital city of Saudi Arabia.

METHODS

A survey consisting of 23 questions pertaining to epilepsy awareness was distributed to health education workers (n=51), nutritionists (n=56), physicians (n=265), dentists (n=58), pharmacists (n=41), nurses (n=224), physiotherapists (n=65), and fifth-year medical students (n=62) in three tertiary hospitals in Riyadh.

RESULTS

Of the 822 respondents who completed the questionnaire, 100% had heard about epilepsy, and 92.6% would allow their children to interact with an individual who has epilepsy. However, 67% of respondents would not want their children to marry an individual with epilepsy, 97.9% of respondents believed that individuals with epilepsy should have the same employment opportunities as the general population, 10.5% believe that supernatural power is the cause of epilepsy, 67.2% did not know how to deal with an individual experiencing an epileptic episode, and 56% did not know that surgery was a treatment option for individuals with epilepsy in Saudi Arabia. Of the 822 respondents, 39% would not abide by a physician's advice not to operate a motor vehicle because of their illness, 91% of whom cited problems with the public transportation system as a reason for disregarding the doctor's advice. When asked if the participants had access to any information on how to deal with epilepsy during their professional training, 60.3% had access to such information during their graduate studies. Ninety-eight percent of those with access to this information were physicians and health-care educators (p<0.001). Physicians and health-care educators were significantly more aware of epilepsy than any of the other groups.

CONCLUSION

The level of epilepsy awareness among health-care professionals in Riyadh needs improvement.

A five-year follow-up study of the general public awareness and perception of epilepsy in Croatia

Public reception of epilepsy in Croatia was re-assessed in 2009, 5 years after an initial survey, by interviewing 1000 randomly selected adults. Ninety-two percent (-5.0%) of the respondents had heard about epilepsy, 47% (-7.9%) knew someone with epilepsy, and 38.6% (-6.0%) had witnessed a seizure. Interviewees were quite ready to accept a person with epilepsy. Almost 8% (+1.1%) would object if their child played with a child with epilepsy, and 77.8% (+1.8%) believed that a child with epilepsy could succeed as well as a child without epilepsy. Although 45.9% (-6.6%) would approach a person having a seizure and help, 36.1% (+3.0%) would also call "911." Citizens of Croatia re-declared a high tolerance toward people with epilepsy and positive attitude toward children with epilepsy. Experiential factors remained strong predictors of more positive attitudes. A more prominent role of patients and implementation of social marketing in addressing a large persisting degree of prejudice and stigmatization worldwide are warranted.

Knowledge and attitudes towards epilepsy among inhabitants of Silesia. A questionnaire study

BACKGROUND AND PURPOSE

Epilepsy is one of the most frequent neurological diseases. Social acceptance is very important for people with epilepsy and their relatives. The aim of the study was to assess public knowledge and attitudes towards epilepsy in Silesia.

MATERIAL AND METHODS

We examined 419 people, inhabitants of Silesia, at the mean age of 34 ± 15 years. The study was performed using a questionnaire containing 15 questions evaluating knowledge about epilepsy and attitudes towards people with epilepsy.

RESULTS

43.2% of the respondents knew an epileptic person themselves. 44.7% had witnessed an epileptic seizure; 68.8% would help a person during an epileptic seizure, but most of them (73.4%) would do it incorrectly (by putting an object into the mouth to prevent biting the tongue). 94.5% of respondents had nothing against friendship with an epileptic person, but 12.1% suggested that children with epilepsy should attend special schools. 85.9% of all those examined said that people with epilepsy should inform others about their disease, 81.9% would mention the existence of an epileptic person in their family. 40.5% of respondents believe that people with epilepsy can do the same jobs as healthy people, 75.3% would employ an epileptic person themselves.

CONCLUSIONS

The knowledge about epilepsy and first aid during epileptic seizure is still insufficient among inhabitants of Silesia. Most of the responders, especially better educated ones, declare acceptance and tolerance of people with epilepsy. More effort should be made to improve public knowledge of epilepsy by preparing wide-spread educational programmes.

Awareness, knowledge, and attitudes with respect to epilepsy: an investigation in relation to health-related quality of life within a Malaysian setting

The influence of awareness, knowledge, and attitudes (AKA) on the health-related quality of life (HRQoL) of patients with epilepsy has not been widely established. The aims of this preliminary study were to (1) assess general AKA and HRQoL levels, (2) correlate AKA and HRQoL levels, and (3) compare the HRQoL of patients with epilepsy with different AKA levels. A cross-sectional sample of outpatients with epilepsy were recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. Data analysis was carried out using the Statistical Package for Social Sciences Version 15 employing descriptive and nonparametric statistics. On written consent, included patients completed the Malay AKA Epilepsy and the Malay Quality of Life in Epilepsy-30 (MQOLIE-30) instruments. Across all patients, both AKA levels (median: 80.0, range: 0-170) and overall HRQoL (median 51.5; range 15-97) were moderate. Awareness was significantly correlated only with Seizure Worry (r(s)=+0.29, p<0.05), whereas Knowledge was not significantly linked to any domain. However, Attitudes was significantly correlated with all domains (r(s)=+0.35 to +0.47, p<0.01) except Medication Effects and Seizure Worry. Patients with good AKA levels (Total Score ≥ median) experienced significantly better Overall Quality of Life and Cognitive Functioning (p<0.05). Findings showed that AKA may play an important role in influencing patients' HRQoL, suggesting that epilepsy treatment efforts should also focus on enhancing AKA through epilepsy awareness to improve health outcomes.

Social-cultural aspects of epilepsy in Kilimanjaro Region, Tanzania: knowledge and experience among patients and carers

OBJECTIVE

Understanding the social-cultural aspects of epilepsy in sub-Saharan Africa will help to improve the situation of people with epilepsy (PWE) in this region.

METHODS

This qualitative study comprised interviews with 41 PWE and their carers. Participants were identified from a large community-based epidemiological study of epilepsy conducted in 2009.

RESULTS

Epilepsy was commonly ascribed to witchcraft and curses. Nearly all PWE demonstrated pluralistic care-seeking behavior, including the use of prayers and traditional healers alongside modern care. PWE reported discrimination as a result of their condition. The majority of PWE had suffered burns during seizures.

CONCLUSIONS

Poor knowledge and strong cultural and religious beliefs characterize the experience of PWE in this population. Epilepsy-related stigma contributes to overall disease burden, and PWE face exclusion across major life domains. There is a need to educate communities and inculcate perceptions and attitudes that promote early detection of epilepsy and early care-seeking behavior.

Effectiveness of a first aid information video in reducing epilepsy-related stigma

The effectiveness of a knowledge-based intervention in increasing levels of knowledge about epilepsy and reducing negative stereotypes toward people with epilepsy was examined. University psychology students (N=131) completed measures of knowledge of and familiarity with epilepsy and attitudes toward people with epilepsy before and after watching a first aid educational video. Results showed that the video was effective in both enhancing the level of knowledge of epilepsy and improving attitudes toward epilepsy. The video was rated highly on measures of acceptability. This study illustrates the effectiveness of using a simple, cost-effective educational intervention, with specific knowledge-based information incorporating the viewer's emotional involvement, to improve knowledge and reduce stigma regarding epilepsy in a targeted influential group. Presenting this first aid educational video to the public, specifically those who are most likely to encounter someone with epilepsy (e.g., teachers, future health professionals), may be particularly fruitful.

Past and present public knowledge and attitudes toward epilepsy in Italy

A nationwide survey was performed in Italy to assess awareness and attitudes of the public about epilepsy. Knowledge about epilepsy, its clinical features, and attitudes towards its social/individual implications were tested in a telephone interview. Included were 819 women and 737 men aged 18+years. 93.4% declared they knew epilepsy, 56.6% knew a person with epilepsy, and 45.1% saw someone seizing. Only 29.2% gave an exact estimate of the prevalence of the disease. 50.4% were unaware of the causes, 56.1% indicated that epilepsy was a psychological/psychiatric disease, 36.5% a form of insanity, and 4.1% an evil spirit possession. Epilepsy was incurable according to 35.5%. Moderate-to-severe restrictions to driving, regular employment, military career, and leisure activities were suggested by 79.8, 57.0, 71.1, and 57.6%. Limitations included marriage and procreation for 46.2 and 38.7%. Knowledge and attitudes varied with education, age and gender. These findings are partly in keeping with other worldwide reports.

Knowledge of, perception of, and attitudes toward epilepsy of schoolchildren in Ankara and the effect of an educational program

Epilepsy is one of the most common serious chronic brain disorders of childhood and carries a strong social stigma. It has been generally accepted that educational programs can be beneficial in reducing the stigma of a number of chronic diseases such as epilepsy. In this article, we describe the first Turkish survey of primary school students' knowledge of and attitudes toward epilepsy and the effect of an epilepsy education program on the understanding of epilepsy in schoolchildren attending three different upper-middle schools in the city of Ankara. The epilepsy education program was found to be associated with a significant increase in knowledge of and positive attitudes toward epilepsy. In addition, students at higher socioeconomic levels performed better on both pre- and posttests. This emphasizes the importance of an educational program and the need for continued information and support for education about epilepsy.

Knowledge of epilepsy in the general population based on two French cities: implications for stigma

The objective of this study was to assess the knowledge and attitudes of people living in two French counties. The data were collected from 1777 adults in the general population who were interviewed. Knowledge of and attitudes toward epilepsy in these French samples proved largely favorable: 90.6% identified epilepsy as different from a mental disorder or lunacy, and 79.2% correctly identified epilepsy as a brain disorder. The majority agreed with the statements that people with epilepsy should have the opportunity to get married and that children with epilepsy should be allowed to go to school with others. However, gaps in knowledge and erroneous beliefs prevailed, notably among men, old people, and individuals with low levels of education. This study yielded encouraging results. However, further studies are needed to confirm these findings and gain a better understanding of the contribution of French public knowledge to the causative factors generating stigma in France.

Health-related quality of life of patients with epilepsy in Turkey

The aim of this study was to measure the health related quality of life (HRQOL) of epilepsy patients and to compare it with that of a healthy control group. The evaluation included the effects of the type of seizure, duration of seizure and medical treatment on the quality of life of the patients. The group studied consisted of 221 participants (121 epilepsy patients and 100 healthy control individuals) who completed a sociodemographic data form and who were administered the World Health Organization Quality of Life (WHOQOL-100) scale. The epilepsy patients had statistically lower physical health, psychological well-being, level of independence and global HRQOL than participants in the control group (p<0.05). The analysis of variance showed that the partial epilepsy subgroup had significantly lower averages for all the quality-of-life subfields except for the social relationship dimension. On regression analysis, being married, having a generalized type of seizure and being treated with fewer medications were all related to higher scores on the HRQOL. Epilepsy is a disease that has neurological, psychiatric and psychosocial dimensions that should be evaluated using a multidisciplinary approach.

Remembering the first seizure and the diagnosis of epilepsy: how much impact do they have in our lives?

The aim of the study described here was to investigate what people with epilepsy (PWE) remember about their first seizures and the diagnoses they received, as well as what healthy control participants (HCP) remember about the first seizure they witnessed. Forty PWE were asked to recall in detail their first seizures and their diagnoses, and 40 HCP were asked to recall the first seizure they witnessed. All participants also rated aspects of their subjective reactions to these experiences. Although the first seizure was more surprising and received more covert rehearsal than the diagnosis, PWE recalled equal numbers of details about the two events. Free recall protocols showed that the memory narratives were longer for the first seizure than for the diagnosis. HCP also showed almost perfect recall for the personal circumstances of the first seizure they witnessed. These findings, combined with strong emotional reactions to these experiences, suggest that they lead to detailed and lasting memories.

First population study of the general public awareness and perception of epilepsy in Croatia

Public knowledge of, perception of, and attitudes toward epilepsy in Croatia were assessed for the first time by asking 1000 randomly selected adults 12 questions. Ninety-seven percent of respondents had heard about epilepsy, 55% knew someone with epilepsy, and 44.6% had witnessed a seizure. Interviewees were quite ready to accept a person with epilepsy. Approximately 7% would object if their child played with a child with epilepsy, and 76% believed that a child with epilepsy could succeed as well as a child without epilepsy. Although 52.5% would approach a seizing person and help, 33.1% would call "911." Positive attitude correlated with knowing someone with epilepsy and/or witnessing a seizure. General awareness of epilepsy in Croatia approaches that of other developed countries, and the majority of the population expressed acceptance of and readiness to help people with epilepsy. These results are more favorable than expected and an encouraging foundation for further improvements in social acceptance of persons with epilepsy.

Awareness and attitudes on epilepsy among undergraduate health care students in Southern Brazil

OBJECTIVE: To evaluate the awareness on epilepsy among undergraduate health care students in a private university. METHODS: A self-administered questionnaire about epilepsy was applied to 417 students at Universidade de Caxias do Sul. The answers were analyzed in two groups: group 1, medical and nursing students; group 2, psychology, physiotherapy and nutrition students. RESULTS: Most of the students were familiar with the disease. Although many of them recognize brain disease as a cause of seizure, it was observed that a quarter of them linked epilepsy with mental disease. Besides, a relevant portion of the sample presents mistaken attitudes on seizure management. CONCLUSION: There is lack of information on epilepsy among these students. The students and the health care professionals are important vectors of information. Therefore, further discussion on this subject is necessary in health care training to demystify some aspects concerning the disease.

First population study of the general public awareness and perception of epilepsy in Bosnia and Herzegovina

Public knowledge of, perception of, and attitudes toward epilepsy in Bosnia and Herzegovina (BH) were studied for the first time. One thousand randomly selected adults were asked 12 questions about epilepsy. Ninety-one percent (91%) of respondents had heard about epilepsy, 41% knew someone with epilepsy, 32.5% had witnessed a seizure, and 33.1% did not know any of the symptoms of epilepsy. On average, interviewees were ready to accept a person with epilepsy. Approximately 15% would object if their child played with a child with epilepsy, and 39% believed that a child with epilepsy could not succeed as well as a child without epilepsy. Although 55.9% would approach a person experiencing a seizure and help, 25.9% would call "911." Positive attitudes correlated with knowing someone with epilepsy and/or witnessing a seizure. General awareness of and attitudes toward epilepsy in BH approach those of developed countries. These results are somewhat more favorable than expected and an encouraging foundation for a necessary public health awareness campaign.