RESUMEN
Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.
Asunto(s)
Epilepsia/etnología , Epilepsia/psicología , Conocimientos, Actitudes y Práctica en Salud , Estigma Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Benin/epidemiología , Estudios Transversales , Cultura , Epilepsia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: We sought to determine the prevalence of epilepsy and the factors associated with it in Tourou in northern Benin. METHODS: We conducted a door-to-door survey in the village of Tourou, in Parakou in northern Benin from March 1-31, 2011. It included 1031 subjects older than 15 years selected by two-stage cluster sampling. The diagnosis of epilepsy was based on the definition of the International League against Epilepsy, and the subjects were interviewed with its diagnostic questionnaire. The data were analyzed with SPSS 16.0 software. The associations between epilepsy and various factors were estimated by calculating their odds ratios and their 95% confidence intervals. RESULTS: The study included 1031 adults with a mean age of 44.03 ± 18.26 years; 682 were men. Seven subjects had epilepsy. Its prevalence was thus 7, 95% CI [0.2 to 20]. In the univariate analysis the factors associated with epilepsy were age (p<10(-4)), not working (p = 0.002), and length of residence in Tourou (p = 0.013). In the multivariate analysis, only age less than 25 years was significantly associated with epilepsy (OR: 11.2 [2.1; 60.9]. Generalized tonic-clonic seizures were the more frequent form of epilepsy (71.4%). All patients had had at least one seizure in the last six months. Only one patient of the 7 had used antiepileptic drug therapy (phenobarbital). CONCLUSION: This study, like others in Africa, suggests that epilepsy is not rare among young adults at Tourou in Northern Benin and that treatment of epilepsy in this area is inadequate.