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Document Type

Original Article

Abstract

Unfounded beliefs regarding epilepsy are still common and widespread. Visits to shrines and seeking help from faith healers goes along with thesebeliefs.This creates a major barrier in the timely diagnosis and treatment of epilepsy. Objective: To determine the knowledge, beliefs and practices relating to epilepsy in the rural areas of Sind and how do they differ between educated and uneducated families of patients with epilepsy. Methods: This was an observational study conducted at the Neurology Out-Patient Department of the Peoples Medical University Hospital Nawabshah during the period 1.1.2015 to 30.6.2015. A pro forma was designed incorporating questions pertaining to knowledge,beliefs and practices regarding epilepsy amongpatients and accompanying family members.Each case was considered as representing the whole family.Educational background was ascertainedand the comparison of study variablesbetween educated and uneducated families was evaluated. The questions were translated into their native spoken language (Sindhi). Results: A total of 120 cases were included in this study. Sixty nine (57.7%)were male and 51 (42.5%) were female. Age ranged from 1 to 55 years. Eighty one (67.5%) were the residents of rural villages and 39(32.5%)were residing in Nawabshah and adjoining towns.Of the 120 cases 80 (66.7%)families were educatedand 40 (33.3%) were uneducated. Majority 76 (63.3%) believed that epilepsy is a disease whereas 44(36.7%) considered epilepsy a “super naturalforce” (‘alamaat’: a native term) or possession by a ‘fakir’ (Jinaat). Of the80 educated families 56 (70.0%) had knowledge about the disease and of the 40 uneducated families 20 (50%) had no knowledge about the disease.Better awareness about the disease among families having educational background was statistically significant (p<0.05). Of the 80 educated families 23 (28.8%) visited shrines and of the 40 uneducated families 26 (65.0%)visited shrines. Uneducated families visiting shrines wasstatistically significant (p<0.01). Families having younger individuals (11 -30 years) were more inclined towards visiting shrines. Out of 120 cases 44 (36.6%) were being treated by faith healers (dagho-phenu: a native term for this kind of practice) and 76 (63.%) were receiving medical therapy. Of the 44 cases receiving faith healing 28 (63.6%)also visited shrines and of the 76 caseswho were receiving medical therapy 21 (27.6%) visited shrines.Followers of faith healing practices significantly visited shrines compared to those who were receiving medical therapy (p<0.001). Those who went for faith healing at first place and did not get benefitout of it came to seek medical therapy. They also pledgedfor the strict complianceand thatin future they will not switch over to “other” forms of therapy. Conclusion: Misperceptions about epilepsy are common in the rural areas of Sindh, Possession by a “supernatural force” (Alamaat) was most common belief among those who did not consider epilepsy a disease.Knowledge about epilepsy was better among families having educational background. Uneducation and unawareness leads to unscientific practices like faith healingand visit to shrines. There iswillingness for receiving medical therapy once the proper guidelines are provid

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