Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda

Abstract Background Despite the advancement in medical knowledge, epilepsy is still one of the most highly misunderstood and stigmatized neurological conditions in Sub-Saharan Africa. It is widely believed to be a contagious disease, caused by demonic possession, witchcraft, or other spiritual pheno...

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Main Authors: Mayanja M. Kajumba, Paula Njeru, Neil S. Prose, Aryn Mason, Pratamesh Ramasubramanian, Joanita Berytah Tebulwa, Angelina Kakooza-Mwesige, Isabelle Andrews, Tyler Johnson, Sylvia Nshemerirwe, Peter Kalubi, Deborah Koltai
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-03030-2
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author Mayanja M. Kajumba
Paula Njeru
Neil S. Prose
Aryn Mason
Pratamesh Ramasubramanian
Joanita Berytah Tebulwa
Angelina Kakooza-Mwesige
Isabelle Andrews
Tyler Johnson
Sylvia Nshemerirwe
Peter Kalubi
Deborah Koltai
author_facet Mayanja M. Kajumba
Paula Njeru
Neil S. Prose
Aryn Mason
Pratamesh Ramasubramanian
Joanita Berytah Tebulwa
Angelina Kakooza-Mwesige
Isabelle Andrews
Tyler Johnson
Sylvia Nshemerirwe
Peter Kalubi
Deborah Koltai
author_sort Mayanja M. Kajumba
collection DOAJ
description Abstract Background Despite the advancement in medical knowledge, epilepsy is still one of the most highly misunderstood and stigmatized neurological conditions in Sub-Saharan Africa. It is widely believed to be a contagious disease, caused by demonic possession, witchcraft, or other spiritual phenomena, and in some cases attributed to both biologic and supernatural etiologies. These misconceptions and the associated stigma result in social rejection, emotional distress, and feelings of shame. Consequently, a large number of adolescents with epilepsy (AWE) avoid seeking medical treatment, resulting in increased seizure intensity and frequency, which in turn reinforces epilepsy stigma. This study sought to explore the experiences of AWE and their perceptions on health literacy interventions for minimizing misconceptions and stigma, and enhancing epilepsy management in Ugandan communities. Methods We recruited 30 AWE receiving treatment from one regional and two national referral hospitals. Data was collected using focus group discussions and analyzed using thematic analysis procedures. Results Despite the fact that our sample entirely comprised of AWE receiving biomedical care, the results revealed that the largest group of respondents (58.6%) believed that supernatural forces alone caused epilepsy, and another 20.7% attributed it to a combination of supernatural and biologic elements, while only 17.2% understood epilepsy to be an illness with a biomedical etiology. Among the most prominent misconceptions was that epilepsy is a contagious disease, and a number of the AWE reported that people around them, including teachers and family members, avoid touching them, do not allow them to share cutlery, cups, or other items, and that they are left unattended during seizures. Most of the AWE reported that they have to conceal their condition, and some reported that on discovering that they had epilepsy, they were expelled from school. Conclusion The misconceptions and stigma not only result in discrimination and emotional distress, but also hinder seeking and adhering to treatment. The AWE emphasized the need for health literacy interventions to minimize misconceptions and stigma and enhance epilepsy management in Ugandan communities.
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spelling doaj-art-d9a918f63ebc4f00a4e0e40b9a77080c2025-08-20T03:45:41ZengBMCBMC Psychology2050-72832025-07-0113111610.1186/s40359-025-03030-2Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in UgandaMayanja M. Kajumba0Paula Njeru1Neil S. Prose2Aryn Mason3Pratamesh Ramasubramanian4Joanita Berytah Tebulwa5Angelina Kakooza-Mwesige6Isabelle Andrews7Tyler Johnson8Sylvia Nshemerirwe9Peter Kalubi10Deborah Koltai11Department of Mental Health and Community Psychology, Makerere UniversityDuke Division of Global Neurosurgery and Neurology, Department of NeurosurgeryDuke University Global Health InstituteDuke Division of Global Neurosurgery and Neurology, Department of NeurosurgeryDuke University Global Health InstituteSupport Moms Project, Mbarara University of Science and TechnologyDepartment of Pediatrics and Child Health, Makerere University College of Health SciencesDuke University Trinity CollegeDuke University Trinity CollegeButabika National Referral HospitalDepartment of Paediatrics and Child Health, Mbarara University of Science and TechnologyDuke Division of Global Neurosurgery and Neurology, Department of NeurosurgeryAbstract Background Despite the advancement in medical knowledge, epilepsy is still one of the most highly misunderstood and stigmatized neurological conditions in Sub-Saharan Africa. It is widely believed to be a contagious disease, caused by demonic possession, witchcraft, or other spiritual phenomena, and in some cases attributed to both biologic and supernatural etiologies. These misconceptions and the associated stigma result in social rejection, emotional distress, and feelings of shame. Consequently, a large number of adolescents with epilepsy (AWE) avoid seeking medical treatment, resulting in increased seizure intensity and frequency, which in turn reinforces epilepsy stigma. This study sought to explore the experiences of AWE and their perceptions on health literacy interventions for minimizing misconceptions and stigma, and enhancing epilepsy management in Ugandan communities. Methods We recruited 30 AWE receiving treatment from one regional and two national referral hospitals. Data was collected using focus group discussions and analyzed using thematic analysis procedures. Results Despite the fact that our sample entirely comprised of AWE receiving biomedical care, the results revealed that the largest group of respondents (58.6%) believed that supernatural forces alone caused epilepsy, and another 20.7% attributed it to a combination of supernatural and biologic elements, while only 17.2% understood epilepsy to be an illness with a biomedical etiology. Among the most prominent misconceptions was that epilepsy is a contagious disease, and a number of the AWE reported that people around them, including teachers and family members, avoid touching them, do not allow them to share cutlery, cups, or other items, and that they are left unattended during seizures. Most of the AWE reported that they have to conceal their condition, and some reported that on discovering that they had epilepsy, they were expelled from school. Conclusion The misconceptions and stigma not only result in discrimination and emotional distress, but also hinder seeking and adhering to treatment. The AWE emphasized the need for health literacy interventions to minimize misconceptions and stigma and enhance epilepsy management in Ugandan communities.https://doi.org/10.1186/s40359-025-03030-2EpilepsyMisconceptionsStigmaSupernaturalBiomedicalHealth literacy
spellingShingle Mayanja M. Kajumba
Paula Njeru
Neil S. Prose
Aryn Mason
Pratamesh Ramasubramanian
Joanita Berytah Tebulwa
Angelina Kakooza-Mwesige
Isabelle Andrews
Tyler Johnson
Sylvia Nshemerirwe
Peter Kalubi
Deborah Koltai
Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
BMC Psychology
Epilepsy
Misconceptions
Stigma
Supernatural
Biomedical
Health literacy
title Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
title_full Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
title_fullStr Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
title_full_unstemmed Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
title_short Adolescents’ perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma, and enhancing epilepsy management in Uganda
title_sort adolescents perspectives on health literacy interventions for reducing epilepsy misconceptions and stigma and enhancing epilepsy management in uganda
topic Epilepsy
Misconceptions
Stigma
Supernatural
Biomedical
Health literacy
url https://doi.org/10.1186/s40359-025-03030-2
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