Public perception and attitude towards people living with epilepsy in Nigeria

This study aimed to assess the community knowledge, awareness, and attitude towards people living with epilepsy (PLWE) in Lagos, Nigeria. This was to provide background information for formulating evidence-based campaign and intervention to reduce stigma and improve health-related quality of life amongst PLWE and their families. Adult respondents (n = 1614) selected via multistage probability sampling completed a set of questionnaires. A case vignette was used to depict epilepsy. The respondents' knowledge of, familiarity with, perceived cause, and preferred treatment option for epilepsy were assessed. Their attitude towards people's attitude was measured with Attitudes and Beliefs about Living with Epilepsy (ABLE) scale. While a total of 1258 (67.6%) could correctly name the illness as epilepsy, only 945 (58.5%) had witnessed an epileptic seizure episode before. The most endorsed causes of epilepsy were brain injury/infection (75.8%), evil spirit/witchcraft (73.0%), God's will (70.0%), and infection by contact (64.9%). Only 67.6% believe that epilepsy is treatable, and 42.5% preferred treatment by spiritualist. Generally, there was a positive attitude to PLWE; however, there were serious risk and safety concerns. The factors associated with negative attitude towards PLWE include male gender (adjusted odds ratio [AOR]: 2.44, 95% confidence interval [CI]: 1.98–3.00), lower educational status (AOR: 1.69, 95% CI: 1.32–2.16), poor knowledge of epilepsy (AOR: 1.74, 95% CI: 1.36–2.22), poor familiarity with epilepsy (AOR: 1.65, 95% CI: 1.14–2.42), and endorsement of supernatural causes of epilepsy (AOR: 1.59, 95% CI: 1.28–1.97). Closing the treatment gap for epilepsy in Nigeria and other sub-Saharan Africa countries will involve steps to change the misconception of the Nigerian populace as regards the causes of epilepsy and help seeking pathway. There is need for nationwide educational programs for epilepsy that consider cognitive and affective processes and also involve all the major stakeholders like primary care workers, community leaders, and spiritual and traditional leaders. •Stigma and misconception are some of the important reasons for the huge treatment gap for epilepsy in sub-Saharan Africa•Belief in supernatural causation and the misconception that epilepsy is contagious is very common amongst lay public in Nigeria•Negative attitude towards PLWE is associated with male gender, low education and belief in supernatural causation of epilepsy•To maximise