The Stigma of Epilepsy among Outpatients in a Tertiary Hospital in South-East Nigeria

Abstract

Background: The stigma of epilepsy is pervasive in developing country contexts and negatively affects the psychological and social wellbeing of its sufferers. The experience of stigma varies across settings and probably relate to disease severity and social characteristics. This study sought to describe the extent and correlates of perceived and enacted stigma among outpatients with epilepsy. Methods: The participants were consecutively presenting epilepsy outpatients in a tertiary facility that attended clinic regularly and had no overt medical or psychiatric co-morbidities. The patients were interviewed with a semi-structured questionnaire. Results: There were 93 participants with a mean age of 30.2 ± 10.3 years and 57.0% were males. The experience of stigma was reported by 46.2% and 67.7% of the participants for perceived and enacted stigma, respectively. Over one-third of the patients had suffered burns or a similar injury in the past. The correlates of perceived stigma were rural residence, lower levels of education, and longer duration of illness. Gender, age and frequency of seizures were not statistically significant determinants. The correlates of enacted stigma were being single, older age, rural residence, and longer duration of epilepsy. A past history of burns and disclosure of epilepsy to individuals outside the family added to the likelihood of experiencing stigma. Conclusion: The burden of epilepsy related social stigma is high in Nigeria. Cultural stereotypes and misconception add to this. There is need for appropriate culture-congruent educational interventions to provide the right information about epilepsy and debunk the misconceptions and myths associated with the condition. This will need to be coupled with astute clinical management of cases and active case finding. Both qualitative and longitudinal quantitative studies would be required to deepen our understanding of the How to cite this paper: Achor, J.U.,

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

“…[ 10 11 ] PWE has been stigmatized and discriminated against for centuries. [ 12 13 14 ] They have been treated as insane, evil, being possessed of evil spirits or as a contagious disease. [ 7 14 ] Stigma has long been recognized as a major burden of PWE and their families.…”

“…[ 11 15 16 17 18 ] PWE living in Sub-Saharan Africa (SSA), where epilepsy rates far exceed that of developed countries, experience more stigma and discrimination than their counterparts in developed countries and other parts of the world. [ 12 19 20 21 ] The combination of poverty, social role expectations, poor medical care, and traditional beliefs place significant limitations on the lives of PWE in SSA. Other factors, such as public attitude, prejudice, stigma, and discrimination are probably more devastating than the disease itself.…”

Depression, Anxiety and Well-Being Among HIV-Positive Adolescents in Lagos, Nigeria

“…A higher score is indicative of a high level of perceived stigma. This scale has been used typically to measure perceived stigma in people with chronic health conditions, with an internal consistency greater than 0.70 in sub-Saharan Africa [25,26] and especially in Nigeria [27,28].…”

Determinants of Felt Stigma among Patients Living with Epilepsy Attending a Tertiary Neurology Clinic in South East Nigeria

“…In Kenya[14], a prevalence rate of 33%was reported and in Benin Republic 68.7% was reported[17]. Achor et al[16] reported a prevalence of 46.2% in Enugu using the same instrument. Outside the continent, prevalence of felt stigma has been reported.…”