BackgroundIn Ethiopia where the burden of epilepsy is highest among school age children and teenagers, and where people with epilepsy (PWE) and their relatives suffers from high level of perceived stigma, there had not been any study that assessed the knowledge, attitude and practice of teachers towards PWE. This study aims to assess and understand the social and demographic determinants of knowledge, attitude and practice of teachers towards PLW in Addis Ababa, Ethiopia.MethodsMultistage cluster sampling procedure was used to identify twenty schools from three sub cities of Addis Ababa, Ethiopia. Standardized self administered questionnaire was used to collect data from 845 volunteer teachers in the pre identified schools. Frequencies were used to characterize the demographic variables while multiple response frequencies were used to characterize the multiple response variable sets. Non-parametric statistical methods were used to describe the association among the demographic variables of interest and the count sums of multiple response variables which were grouped into biologically and culturally plausible responses.ResultsThe most common biologically plausible responses were: brain diseases (26.5 %) from causes, allow my offspring to play with PWE (19.1 %) from attitude, protect the subject from injury (20.4 %) from first aid measures and seek help from medical doctors (52.2 %) from epilepsy treatment. On the contrary, the most common culturally plausible responses were: psychiatric illness (12.9 %) from causes, epilepsy be cured before attendance to school (21.6 %) from attitude, smelling the smoke of struck match (14.2 %) from first aid measures and Holy water treatment (20.3 %) from epilepsy treatment suggestions. The biologically and culturally plausible responses were negatively correlated. Level of education was positively associated with biologically plausible responses while teaching experience was negatively correlated with culturally plausible responses.ConclusionA high percentage of teachers in Addis Ababa considered epilepsy as a psychiatric illness closely linked to insanity. This explains their suggestions of Holy water treatment and Church healing sessions as epilepsy remedies. This is in agreement with Ethiopian culture, in which evil spirit and insanity are believed to be better treated by religious remedies than with modern medical treatments. Incorporating special needs educational training courses in the curriculum of teachers training may help them shift their knowledge, attitudes and practices from that of the culturally plausible to biologically plausible one.

Understanding clerics and healers' knowledge, attitude, and practice towards epilepsy are crucial to identify the mechanisms of epilepsy stigma in Ethiopia. The objective of this study is to characterize the social and demographic determinants of knowledge, attitude, and practices of clerics and healers towards people with epilepsy in Addis Ababa, Ethiopia. Methods: A total of 440 clerics and healers were interviewed by trained data collectors using a pretested structured questionnaire. The count sum of outcome variables was grouped into "biological and cultural" knowledge attitude and practice scores. Ordinal regression analysis was performed for each outcome variable against socio-demographic variables of interest. Results: The percentage of responses matching cultural causes (58%) surpassed biological causes. The most frequently mentioned cultural cause was an evil spirit (22.5%). While the most frequently mentioned biological cause was a head injury (12%). Consistent with the above findings, cultural treatment responses (77%) exceeded biological treatment responses. The most commonly referred cultural treatment response was Church healing session (12%). The type of faith followed by the study participants positively correlated with higher cultural knowledge, attitude, and practice score. Conclusions: Clerics and traditional healers in Ethiopia have a partiality to the cultural epilepsy explanation model. Cultural metaphors attached to an evil spirit, curse of God, and witchcraft have formed and fostered existing 'epilepsy societal norms' in Ethiopia. The findings of this study contribute to the understanding of epilepsy stigma and treatment gap. Besides, it provided direction to design and implement epilepsy stigma intervention programs in Ethiopia.

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Delegates of the 2022 Symposium on Dementia and Brain Aging in Low-and Middle-Income Countries, representing over 40 countries, met in Nairobi, Kenya, December 5-9 to highlight advances in dementia prevention, diagnosis, care, and research, as well as explore the future needs of the global community.Dementia poses a major threat to optimal brain health and remains a priority for the demographically ever-changing worldwide population.It incurs substantial individual, societal, and global costs. By 2030, the majority of the 78 million people with dementia will be living in low-and middle-income countries (LMICs). Upon consideration of these grave statistics and new diagnostic paradigms with available prevention and treatment strategies, we, the undersigned delegates of the symposium, including the Organizing Committee and speakers, and the African Dementia Consortium (AfDC), with frontline and lived experience, call upon the global community, including governments, policymakers, international economic forums, health and social care providers, together with private and public research funding agencies, researchfocused organizations such as universities, nongovernmental organizations, and technology and pharmaceutical companies, to act as follows:

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Background Cross-Cultural adaptation of a cognitive screening instrument requires careful planning and its implementation is complex, expensive and time consuming. This study aims to cross culturally adapt AD8 using the WHO translation and adaptation process guidelines in preparation for the development of a mobile health based dementia screening app at the primary care center of Ethiopia. Methods The panel discussed forward and backward translated AD8 instrument items alongside with the original English version of AD8 and Lawshe’s CVR critical value to adapt them to the interim final and the reconciled Amharic versions of AD8 respectively. The reconciled Amharic version was pilot tested, a cognitive interview was conducted, and the results were analyzed and a summary report was generated to adapt it to the final Amharic version of AD8. Results The Lawshe’s CVR value was less than the expected CVR critical value (0.75) for all of the forward translated items of AD8 except for the ‘Question items # 3 &7’. The panel substituted words and/or phrases in the title, instructions and ‘Question items # 1 & 6’; and added ‘Radio’ to the Question item # 4. The Lawshe’s CVR value (1.0) was greater than the expected CVR critical value (0.75) for all of the backward translated instrument items of AD8. The internal reliability of the reconciled Amharic version of AD8 was very good with a Cronbach’s alpha value of 0.875. Cognitive interview study participants verbalized lived experiences to reason and explain the way the reconciled Amharic version of AD8 question items was understood. The reconciled Amharic version was adapted without any modification as the final Amharic version of AD8. Conclusion changes made, reasons for change, and a vote of consensus for each question item of AD8 was documented at every step of deliberations of the panel. The Amharic version of AD8 demonstrated a very good internal reliability with strong item correlation. The Amharic version of AD8 fulfills the perquisite for the development of mobile health based AD8 dementia screening at primary care settings of Ethiopia and aligns with the WHO task-shifting strategy of dementia screening.