Epilepsy-related knowledge, attitudes, and practices among Zambian police officers

Department of Paediatrics and Child Health, University of Zambia, Lusaka, Lusaka, Zambia
Epilepsy & Behavior (Impact Factor: 2.26). 06/2007; 10(3):456-62. DOI: 10.1016/j.yebeh.2006.12.010
Source: PubMed


In Zambia, where emergency medical services are very limited, the police are frequently called to the scene for unaccompanied people experiencing seizures or exhibiting disturbed behaviors during a seizure. Police officers receive no formal medical training to manage such encounters. We developed and administered a police-specific survey to assess knowledge, attitudes, and practices (KAP) regarding epilepsy among police officers in Zambia.
In 2004, a 28-item KAP questionnaire that included queries specific to police encounters with seizures and epilepsy was developed and delivered to a random sample of 200 police officers stationed in Lusaka. Descriptive data were reviewed and open text questions postcoded and categorized.
The response rate was 87.5% (n=175). Police were familiar with epilepsy, with 85% having witnessed a seizure. Although 77.1% recognized epilepsy as a brain disorder, almost 20% blamed spirit possession, 13.9% associated epilepsy with witchcraft, and more than half the respondents believed epilepsy is contagious. When asked how they would treat someone brought in for disturbing the peace during a seizure, most police provided supportive or neutral responses, but 8% reported taking harmful actions (arrest, detain, handcuff, restrain), and 14.3% indicated that people with epilepsy in police custody require quarantine.
A significant number of police officers in Zambia lack critical knowledge regarding epilepsy and self-report detrimental actions toward people with seizures. In regions of the developing world where the police provide emergency medical services, police officers need to be a target for educational and social intervention programs.

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    • "c o m / l o c a t e / y e b e h questions (see Appendix A). This was based on previous study tools developed by Birbeck and associates in Zambia regarding PWE [3] [4]. This tool was further refined with guidance from Dr. Elly Katabira, faculty neurologist at Mulago Hospital in Uganda. "
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    ABSTRACT: Epilepsy is associated with stigma throughout the world, which leads to poor treatment of people with epilepsy (PWE). In Uganda, there are more than 75,000 PWE and a large treatment gap. This study evaluated the knowledge, attitudes, and practices regarding epilepsy among first-year medical students at Mulago Hospital. A 22-question survey was developed based on the previous studies of Birbeck et al.'s regarding the stigma of epilepsy in Zambia. This was administered to first-year medical students (96 respondents) at Mulago Hospital in Uganda. More than 80% said that they would not allow their children to marry PWE. Most respondents believed that epilepsy was a mental illness, and many believed that PWE cannot have normal intelligence. Students reported that there was a negative perception and negative treatment of PWE in the community. Some students believed that epilepsy was caused by supernatural causes and was contagious. These misperceptions must be identified and corrected among medical students and other healthcare providers to allow for fair treatment of PWE; this should be incorporated into medical school curriculums in Uganda. Copyright © 2015 Elsevier Inc. All rights reserved.
    Full-text · Article · Aug 2015 · Epilepsy & Behavior
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    • "Large gaps have been found in awareness of the causes of the disease, and, even worse, widespread negative attitudes were documented, mainly associated with educational level, age, and sex. Large population surveys in people with epilepsy (PWE) in developing countries involve obvious difficulties ; nevertheless, studies have been done even in sub-Saharan Africa [33] [34] [35] [36] [37] [38] [39] [40] [41] [42] [43], where socially deprived groups and selected occupational categories could be investigated in particular [44] [45] [46] [47] [48] [49]. However, to our knowledge, few studies have compared the opinions and attitudes towards epilepsy of neighboring urban and rural populations. "
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    ABSTRACT: Misconception and stigma towards epilepsy have a profound impact on this disease in Africa. An unselected sample of Zambian people was interviewed to investigate their knowledge and attitudes towards epilepsy. Proper/improper answers were scored, and a composite score was developed with negative values for unsatisfactory awareness and high stigma levels. The sample comprised 231 people residing in urban (107) or in rural (124) areas. The median and interquartile range of scores for epilepsy awareness and stigma were, respectively, -1 (-3; +1) and +1 (-1; +6). Poor education was the only significant predictor of unsatisfactory awareness (p=0.0131), while education and residency were significantly associated with stigma (p<0.0001 and p=0.0004). Rural people were mostly in the highest stigma level (44.2%) and urban people in the lowest stigma level (60.4%). Misconception and negative attitudes towards epilepsy among Zambian people reflect poor education and rural residency.
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    • "Multiple studies have identified the knowledge of and attitudes towards people with epilepsy in this area [5]. However, results are based on nondisabled study populations such as clerics [6], teachers [7] [8] [9], police officers [10], health-care workers [11], and students [12] [13] [14]. An unanswered question is what people with disabilities in sub-Saharan Africa personally believe about their condition. "
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