Main Article Content
Abstract
ABSTRACT
Introduction. Negative socio-cultural perceptions of epilepsy,can lead to stigmatization. The aim of our study is to examine the knowledge, attitudes, and behaviors of Brazzaville residents regarding epilepsy. Methodology. This analytical cross-sectional epidemiological study was conducted from 15 May to 15 August 2023 in households in Brazzaville, Republic of Congo. The study cohort consisted of individuals aged 18 and data were collected through a questionnaire covering variables related to knowledge about epilepsy and attitudes towards patients living with epilepsy, as well as those experiencing an epileptic seizure. Results. Among the 320 participants, a low level of knowledge on epilepsy was observed (81.2%). The participants had the greatest gaps in knowledge regarding the disease itself, specifically its symptoms, aetiologies, treatment, and prognosis. The absence of previous contact with a patient living with epilepsy (OR = 2.99; p = 0.003) and the absence of previous observation of an epileptic seizure (OR = 6.36; p < 0.001) were identified as factors that influenced this knowledge. Regarding attitudes towards individuals experiencing epileptic seizures, 60.9% of cases exhibited an accepting attitude. Conversely, attitudes towards people living with epilepsy were generally positive (73.3%) and correlated with good knowledge of the social aspects of epilepsy (OR = 0.11; [0.02-0.39], p = 0.004). Positive aspects of attitude were observed in relation to intimate relationships and social interactions with patients living with epilepsy. Conclusion. Our study reveals a general lack of knowledge about epilepsy among the studied cohort. It is urgent to raise awareness to promote more effective management of epilepsy in Brazzaville.
RÉSUMÉ
Introduction. Les perceptions socioculturelles négatives de l'épilepsie peuvent conduire à la stigmatisation. L'objectif de notre étude est d'examiner les connaissances, les attitudes et les comportements des résidents de Brazzaville concernant l'épilepsie. Méthodologie. Cette étude épidémiologique analytique transversale a été menée du 15 mai au 15 août 2023 dans des ménages à Brazzaville, en République du Congo. La cohorte d'étude était composée d'individus âgés de 18 ans et les données ont été collectées à l'aide d'un questionnaire couvrant des variables liées aux connaissances sur l'épilepsie et aux attitudes envers les patients atteints d'épilepsie, ainsi que ceux qui vivent une crise épileptique. Résultats. Parmi les 320 participants, un faible niveau de connaissance sur l'épilepsie a été observé (81,2%). Les participants présentaient les plus grandes lacunes de connaissance concernant la maladie elle-même, notamment ses symptômes, étiologies, traitement et pronostic. L'absence de contact précédent avec un patient atteint d'épilepsie (OR = 2,99 ; p = 0,003) et l'absence d'observation préalable d'une crise épileptique (OR = 6,36 ; p < 0,001) ont été identifiés comme des facteurs influençant ces connaissances. En ce qui concerne les attitudes envers les personnes vivant une crise d'épilepsie, 60,9% des cas ont manifesté une attitude positive. En revanche, les attitudes envers les personnes atteintes d'épilepsie étaient généralement positives (73,3%) et corrélées avec une bonne connaissance des aspects sociaux de l'épilepsie (OR = 0,11 ; [0,02-0,39], p = 0,004). Des aspects positifs d'attitude ont été observés en ce qui concerne les relations intimes et les interactions sociales avec les patients atteints d'épilepsie. Conclusion. Notre étude révèle un manque général de connaissance sur l'épilepsie parmi la cohorte étudiée. Il est urgent de sensibiliser pour promouvoir une gestion plus efficace de l'épilepsie à Brazzaville.
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References
- Fisher RS, Boas W van E, Blume W, Elger C, Genton P, Lee P, et al. Epileptic Seizures and Epilepsy: Definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia.2005 ;46(4):470-2.
- Fabrice Quet. Outils épidémiologiques pour l'étude de l'épilepsie en zone tropicale, intérêts et applications, PhD Thesis in Public Health, Limoges; 2010.
- Debrock C, Preux PM, Houinato D, Druet-Cabanac M, Kassa F, Adjien C, et al. Estimation of the prevalence of epilepsy in the Beninese region of Zinvié using the capture-recapture method. Int J Epidemiol. 2000 ;29(2):330-5.
- Ngoungou EB, Koko J, Druet-Cabanac M, Assengone-Zeh-Nguema Y, Launay MN, Engohang E, et al. Cerebral Malaria and Sequelar Epilepsy: First Matched Case-Control Study in Gabon. Epilepsia. 2006 ;47(12):2147-53.
- Key facts about epilepsy, [cited Oct 12, 2023], https://www.who.int/fr/news-room/fact- sheets/detail/epilepsy
- Bony KE, Karidioula HA, Tanoh AC, Gnazegbo A, Kouame-Assouan AE,Diakite I, et al .African Journal of Neurological Sciences. Epidemiological, clinical and therapeutic profile of epilepsy in Bouake. 2020;39(1).
- Kamaforo M. Delegation of epilepsy management tasks to relays/community health workers using a telemedicine platform in the Kolokani health district in 2019-2021, Mali. Doctor of Medicine thesis, Bamako,2022.
- Picot MC, Jallon P. Epilepsy and mortality. Epilepsies, 2007 ;19(3):151-6.
- Feigin VL, Nichols E, Alam T, Bannick MS, Beghi E, Blake N, et al. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459-80.
- Brissart H, Maillard L. Neuropsychologie des épilepsies de l'adulte : Approche clinique et pratique. De Boeck Supérieur; 2018. 210 p.
- Sogoba Y, Maiga Y, Kanikomo D, Maiga A, Issa A, Momar CB. Surgical treatment of epilepsy in sub- Saharan Africa: Issues and Perspectives. Afr Middle East Epilepsy J.2013;2(5).
- Tekle-Haimanot R, Forsgren L, Ekstedt J. Incidence of epilepsy in rural central Ethiopia. Epilepsia. 2006;38(5):541-6.
- Jilek-Aall L, Rwiza HT. Prognosis of epilepsy in a rural African community: A 30-Year Follow-Up of 164 Patients in an Outpatient Clinic in Rural Tanzania. Epilepsia. 20;33(4):645-50.
- Apetse K, Assogba K, Belo M, Kombate D, Kumako V, Guinhouya KM, et al. Perception of childhood and adult epilepsy by the population and healthcare personnel in Togo. Epilepsies. 2010;22(2):160-6.
- Adoukonou T, Tognon-Tchegnonsi F, Gnonlonfoun D, Djidonou A, Sego-Sounon D, Gandaho P, et al. Sociocultural aspects of epilepsy in a rural community in northern Benin in 2011. Bull Société Pathol Exot. 2015;108(2):133-8.
- Assi B, Diarra EAA, Kouamé-Assouan A, Akani F, Doumbia M, Tano C, et al. Épilepsie : enquête sur les aspects socioculturels et attitudes, menée dans une population de 300 étudiants vivant sur un campus universitaire à Abidjan (Côte-d'Ivoire).2009 ;21(3):296-306.
- Diatewa JE. Epilepsy in the school environment in Brazzaville. Doctor of Medicine thesis, Brazzaville; 2013.
- Sounga Bandzouzi, P, Mpandzou G, Diatewa, J E, Motoula-Latou, D, Obondzo-aloba, L, Doumbi,M, et al. Knowledge, attitudes and practices relating to epilepsy and associated factors in the student population of Brazzaville. 2021; 10(4):19.
- Koné H. Epidemiology of epilepsy in community settings in the Sikasso health district in 2019. Thesis for Doctorate in Medicine, Bamako; 2021
- Doumbi ML. Sociocultural representations of epilepsy in the student population of Brazzaville. Thesis for Doctorate in Medicine, Brazzaville; 2017.
- Diatewa, J.E., Kwama-Matiti, C.O., Mpandzou, G.A., Motoula-Latou, D.H.B., Sounga-Banzouzi, E.P.G.and Ossou-Nguiet, P.M. (2022) Knowledge about Stroke among Workers in Public and Private Enterprises in Brazzaville and Their Attitudes towards Stroke Victims. World Journal of Neuroscience, 12, 163-180. https://doi.org/10.4236/wjns.2022.124018
- Institut de la statistique du Québec. Health status, use of health services and unmet needs of immigrants in Quebec.2015 ;53 [cited Nov 12, 2023]. Available from: https://statistique.quebec.ca/fr/document/no- 53-etat-de-sante-utilisation-des-services-de-sante-et-besoins-non-combles-des-immigrants-au-quebec
- Morgado FF da R, Silveira EMKX da, Nascimento LPR do, Sales AM, Nery JA da C, Sarno EN, et al. Psychometric assessment of the EMIC Stigma Scale for Brazilians affected by leprosy. 2020 [cited 12 Nov 2023]; Available from: https://www.arca.fiocruz.br/handle/icict/45071
- Kamble BD, Singh SK, Jethani S, Chellaiyan VGD, Acharya BP. Social stigma among tuberculosis patients attending DOTS centers in Delhi. J Fam Med Prim Care. 2020;9(8):4223-8.
- Rafael F, Houinato D, Nubukpo P, Dubreuil CM, Tran DS, Odermatt P, et al. Sociocultural and psychological features of perceived stigma reported by people with epilepsy in Benin. Epilepsia. June 2010;51(6):1061-8.
- Emmanuel Y, Mbelesso P. Sociocultural aspects of epilepsy in rural Central Africa: data from a general population CAP survey. Rev Neurol (Paris).2019; 175:S13.
- African Journal of Neurological Sciences: knowledge, attitudes and practices of a semi-urban population on epilepsy: case of djougou in benin in 2019. [cited 1 Dec 2023]. Available from: https://ajns.paans.org/connaissances-attitudes-et-pratiques-dune-population-semi-urbaine-sur-
- lepilepsie-cas-de-djougou-au-benin-en-2019/
- Mbelesso P, Tabo A, Aliamus V, Kamayengue-Guembo F, Yangatimbi E, Preux PM, et al. Sociocultural representations of epilepsy in schools in Bangui, Central African Republic. 2009;21(3):307-12.
- Arborio S, Jaffre Y, Farnarier O, Doumbo O, Dozon Jean-Pierre. Study of kirikirimasien (epilepsy) in Mali: etiological and nosographic dimensions- fdi:010019383- Horizon. 1999;59(2):176-80.
- Yapo FB, Doumbia-Ouattara M, Kouame LK, Diakite I, Amon-Tanoh M, Sonan-Douayoua T. Socio-cultural approach to epilepsy in Côte d'Ivoire. Afr J Neurol Sci. 2015; 34 (2):6-12.
- Kabir M, Iliyasu Z, Abubakar IS, Kabir ZS& F. Knowledge, Attitude and Beliefs About Epilepsy Among Adults in a Northern Nigerian Urban Community. Ann Afr Med. 2005; 4(3):107-12.
- Kariuki SM, Matuja W, Akpalu A, Kakooza-Mwesige A, Chabi M, Wagner RG, et al. Clinical features, immediate causes and consequences of active convulsive epilepsy in Africa. 2014;55(1):76-85.
- Centre national de la statistique et des études économiques (Congo), editor. Deuxième enquête congolaise auprès des ménages pour le suivi et l'évaluation de la pauvreté (ECOM 2011): rapport d'analyse du volet quibb. République du Congo : Ministère de l'Économie, du plan, de l'aménagement du territoire et de l'intégration : Centre national de la statistique et des études économiques, Direction générale ; 2012. 147
- Rossetti AO, Seeck M. Current drug treatment of epilepsy. Swiss Medical Journal. 2010.
- Holzgraefe M. Epilepsy and sport. Aktuelle Neurol. 2000;27:480-3.
- Ziegler AL, Reinberg O, Deonna T. Epilepsy and accidents: what is the risk in children? [Epilepsy and accidents: what risk in children?] Serveur Académique Lausannois.
- Jovic NJ. Sports participation in children and adolescents with stabilized epilepsy. In 2004 [cited 3 Dec 2023]. Available from: https://www.semanticscholar.org/paper/La-pratique-sportive-des-enfants-et-des- adolescents-Jovic/f9502db82009ff0779ab459f59dc23dc8aad559e
- Kouassi ES, Bissouma AC, Adon KP, Moke BL. Social representations of epilepsy and therapeutic itineraries of children's parents in Abidjan. Santé Publique. 2018 ;30 (5):703-12.
- Survey of public awareness, attitudes and understanding of epilepsy in Hong Kong - Wong - 2003 - Epilepsia Wiley Online Library [cited 3 Dec 2023]. Available from: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2003.510023.x
- Njamnshi AK, Angwafor SA, Tabah EN, Jallon P, Muna WFT. Epilepsy knowledge, attitudes and practices of the general public in the health district of Batibo, Cameroon. Epilepsy Behav. 2009;14(1):83- 8.
- Fofana Tidiane. Etude de la perception communautaire de la population sur l'épilepsie : connaissance, attitude et pratique des parents d'enfants épileptiques dans le service de Pédiatrie du CHU Gabriel Toure [Doctoral thesis in Medicine]. [Bamako]: Université de Bamako, Mali; 2008.
- TRAN DUC SI. Epilepsy in the Democratic Republic of Laos [ Doctoral thesis in Medecine]. University of Limoges. France ; 2007
References
Fisher RS, Boas W van E, Blume W, Elger C, Genton P, Lee P, et al. Epileptic Seizures and Epilepsy: Definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia.2005 ;46(4):470-2.
Fabrice Quet. Outils épidémiologiques pour l'étude de l'épilepsie en zone tropicale, intérêts et applications, PhD Thesis in Public Health, Limoges; 2010.
Debrock C, Preux PM, Houinato D, Druet-Cabanac M, Kassa F, Adjien C, et al. Estimation of the prevalence of epilepsy in the Beninese region of Zinvié using the capture-recapture method. Int J Epidemiol. 2000 ;29(2):330-5.
Ngoungou EB, Koko J, Druet-Cabanac M, Assengone-Zeh-Nguema Y, Launay MN, Engohang E, et al. Cerebral Malaria and Sequelar Epilepsy: First Matched Case-Control Study in Gabon. Epilepsia. 2006 ;47(12):2147-53.
Key facts about epilepsy, [cited Oct 12, 2023], https://www.who.int/fr/news-room/fact- sheets/detail/epilepsy
Bony KE, Karidioula HA, Tanoh AC, Gnazegbo A, Kouame-Assouan AE,Diakite I, et al .African Journal of Neurological Sciences. Epidemiological, clinical and therapeutic profile of epilepsy in Bouake. 2020;39(1).
Kamaforo M. Delegation of epilepsy management tasks to relays/community health workers using a telemedicine platform in the Kolokani health district in 2019-2021, Mali. Doctor of Medicine thesis, Bamako,2022.
Picot MC, Jallon P. Epilepsy and mortality. Epilepsies, 2007 ;19(3):151-6.
Feigin VL, Nichols E, Alam T, Bannick MS, Beghi E, Blake N, et al. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459-80.
Brissart H, Maillard L. Neuropsychologie des épilepsies de l'adulte : Approche clinique et pratique. De Boeck Supérieur; 2018. 210 p.
Sogoba Y, Maiga Y, Kanikomo D, Maiga A, Issa A, Momar CB. Surgical treatment of epilepsy in sub- Saharan Africa: Issues and Perspectives. Afr Middle East Epilepsy J.2013;2(5).
Tekle-Haimanot R, Forsgren L, Ekstedt J. Incidence of epilepsy in rural central Ethiopia. Epilepsia. 2006;38(5):541-6.
Jilek-Aall L, Rwiza HT. Prognosis of epilepsy in a rural African community: A 30-Year Follow-Up of 164 Patients in an Outpatient Clinic in Rural Tanzania. Epilepsia. 20;33(4):645-50.
Apetse K, Assogba K, Belo M, Kombate D, Kumako V, Guinhouya KM, et al. Perception of childhood and adult epilepsy by the population and healthcare personnel in Togo. Epilepsies. 2010;22(2):160-6.
Adoukonou T, Tognon-Tchegnonsi F, Gnonlonfoun D, Djidonou A, Sego-Sounon D, Gandaho P, et al. Sociocultural aspects of epilepsy in a rural community in northern Benin in 2011. Bull Société Pathol Exot. 2015;108(2):133-8.
Assi B, Diarra EAA, Kouamé-Assouan A, Akani F, Doumbia M, Tano C, et al. Épilepsie : enquête sur les aspects socioculturels et attitudes, menée dans une population de 300 étudiants vivant sur un campus universitaire à Abidjan (Côte-d'Ivoire).2009 ;21(3):296-306.
Diatewa JE. Epilepsy in the school environment in Brazzaville. Doctor of Medicine thesis, Brazzaville; 2013.
Sounga Bandzouzi, P, Mpandzou G, Diatewa, J E, Motoula-Latou, D, Obondzo-aloba, L, Doumbi,M, et al. Knowledge, attitudes and practices relating to epilepsy and associated factors in the student population of Brazzaville. 2021; 10(4):19.
Koné H. Epidemiology of epilepsy in community settings in the Sikasso health district in 2019. Thesis for Doctorate in Medicine, Bamako; 2021
Doumbi ML. Sociocultural representations of epilepsy in the student population of Brazzaville. Thesis for Doctorate in Medicine, Brazzaville; 2017.
Diatewa, J.E., Kwama-Matiti, C.O., Mpandzou, G.A., Motoula-Latou, D.H.B., Sounga-Banzouzi, E.P.G.and Ossou-Nguiet, P.M. (2022) Knowledge about Stroke among Workers in Public and Private Enterprises in Brazzaville and Their Attitudes towards Stroke Victims. World Journal of Neuroscience, 12, 163-180. https://doi.org/10.4236/wjns.2022.124018
Institut de la statistique du Québec. Health status, use of health services and unmet needs of immigrants in Quebec.2015 ;53 [cited Nov 12, 2023]. Available from: https://statistique.quebec.ca/fr/document/no- 53-etat-de-sante-utilisation-des-services-de-sante-et-besoins-non-combles-des-immigrants-au-quebec
Morgado FF da R, Silveira EMKX da, Nascimento LPR do, Sales AM, Nery JA da C, Sarno EN, et al. Psychometric assessment of the EMIC Stigma Scale for Brazilians affected by leprosy. 2020 [cited 12 Nov 2023]; Available from: https://www.arca.fiocruz.br/handle/icict/45071
Kamble BD, Singh SK, Jethani S, Chellaiyan VGD, Acharya BP. Social stigma among tuberculosis patients attending DOTS centers in Delhi. J Fam Med Prim Care. 2020;9(8):4223-8.
Rafael F, Houinato D, Nubukpo P, Dubreuil CM, Tran DS, Odermatt P, et al. Sociocultural and psychological features of perceived stigma reported by people with epilepsy in Benin. Epilepsia. June 2010;51(6):1061-8.
Emmanuel Y, Mbelesso P. Sociocultural aspects of epilepsy in rural Central Africa: data from a general population CAP survey. Rev Neurol (Paris).2019; 175:S13.
African Journal of Neurological Sciences: knowledge, attitudes and practices of a semi-urban population on epilepsy: case of djougou in benin in 2019. [cited 1 Dec 2023]. Available from: https://ajns.paans.org/connaissances-attitudes-et-pratiques-dune-population-semi-urbaine-sur-
lepilepsie-cas-de-djougou-au-benin-en-2019/
Mbelesso P, Tabo A, Aliamus V, Kamayengue-Guembo F, Yangatimbi E, Preux PM, et al. Sociocultural representations of epilepsy in schools in Bangui, Central African Republic. 2009;21(3):307-12.
Arborio S, Jaffre Y, Farnarier O, Doumbo O, Dozon Jean-Pierre. Study of kirikirimasien (epilepsy) in Mali: etiological and nosographic dimensions- fdi:010019383- Horizon. 1999;59(2):176-80.
Yapo FB, Doumbia-Ouattara M, Kouame LK, Diakite I, Amon-Tanoh M, Sonan-Douayoua T. Socio-cultural approach to epilepsy in Côte d'Ivoire. Afr J Neurol Sci. 2015; 34 (2):6-12.
Kabir M, Iliyasu Z, Abubakar IS, Kabir ZS& F. Knowledge, Attitude and Beliefs About Epilepsy Among Adults in a Northern Nigerian Urban Community. Ann Afr Med. 2005; 4(3):107-12.
Kariuki SM, Matuja W, Akpalu A, Kakooza-Mwesige A, Chabi M, Wagner RG, et al. Clinical features, immediate causes and consequences of active convulsive epilepsy in Africa. 2014;55(1):76-85.
Centre national de la statistique et des études économiques (Congo), editor. Deuxième enquête congolaise auprès des ménages pour le suivi et l'évaluation de la pauvreté (ECOM 2011): rapport d'analyse du volet quibb. République du Congo : Ministère de l'Économie, du plan, de l'aménagement du territoire et de l'intégration : Centre national de la statistique et des études économiques, Direction générale ; 2012. 147
Rossetti AO, Seeck M. Current drug treatment of epilepsy. Swiss Medical Journal. 2010.
Holzgraefe M. Epilepsy and sport. Aktuelle Neurol. 2000;27:480-3.
Ziegler AL, Reinberg O, Deonna T. Epilepsy and accidents: what is the risk in children? [Epilepsy and accidents: what risk in children?] Serveur Académique Lausannois.
Jovic NJ. Sports participation in children and adolescents with stabilized epilepsy. In 2004 [cited 3 Dec 2023]. Available from: https://www.semanticscholar.org/paper/La-pratique-sportive-des-enfants-et-des- adolescents-Jovic/f9502db82009ff0779ab459f59dc23dc8aad559e
Kouassi ES, Bissouma AC, Adon KP, Moke BL. Social representations of epilepsy and therapeutic itineraries of children's parents in Abidjan. Santé Publique. 2018 ;30 (5):703-12.
Survey of public awareness, attitudes and understanding of epilepsy in Hong Kong - Wong - 2003 - Epilepsia Wiley Online Library [cited 3 Dec 2023]. Available from: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2003.510023.x
Njamnshi AK, Angwafor SA, Tabah EN, Jallon P, Muna WFT. Epilepsy knowledge, attitudes and practices of the general public in the health district of Batibo, Cameroon. Epilepsy Behav. 2009;14(1):83- 8.
Fofana Tidiane. Etude de la perception communautaire de la population sur l'épilepsie : connaissance, attitude et pratique des parents d'enfants épileptiques dans le service de Pédiatrie du CHU Gabriel Toure [Doctoral thesis in Medicine]. [Bamako]: Université de Bamako, Mali; 2008.
TRAN DUC SI. Epilepsy in the Democratic Republic of Laos [ Doctoral thesis in Medecine]. University of Limoges. France ; 2007