Ethiopian teachers: their knowledge, attitude and practice towards epilepsy

BACKGROUND In Ethiopia where the burden of epilepsy is highest among school age children and teenagers, and where people with epilepsy (PWE) and their relatives suffers from high level of perceived stigma, there had not been any study that assessed the knowledge, attitude and practice of teachers towards PWE. This study aims to assess and understand the social and demographic determinants of knowledge, attitude and practice of teachers towards PLW in Addis Ababa, Ethiopia. METHODS Multistage cluster sampling procedure was used to identify twenty schools from three sub cities of Addis Ababa, Ethiopia. Standardized self administered questionnaire was used to collect data from 845 volunteer teachers in the pre identified schools. Frequencies were used to characterize the demographic variables while multiple response frequencies were used to characterize the multiple response variable sets. Non-parametric statistical methods were used to describe the association among the demographic variables of interest and the count sums of multiple response variables which were grouped into biologically and culturally plausible responses. RESULTS The most common biologically plausible responses were: brain diseases (26.5 %) from causes, allow my offspring to play with PWE (19.1 %) from attitude, protect the subject from injury (20.4 %) from first aid measures and seek help from medical doctors (52.2 %) from epilepsy treatment. On the contrary, the most common culturally plausible responses were: psychiatric illness (12.9 %) from causes, epilepsy be cured before attendance to school (21.6 %) from attitude, smelling the smoke of struck match (14.2 %) from first aid measures and Holy water treatment (20.3 %) from epilepsy treatment suggestions. The biologically and culturally plausible responses were negatively correlated. Level of education was positively associated with biologically plausible responses while teaching experience was negatively correlated with culturally plausible responses. CONCLUSION A high percentage of teachers in Addis Ababa considered epilepsy as a psychiatric illness closely linked to insanity. This explains their suggestions of Holy water treatment and Church healing sessions as epilepsy remedies. This is in agreement with Ethiopian culture, in which evil spirit and insanity are believed to be better treated by religious remedies than with modern medical treatments. Incorporating special needs educational training courses in the curriculum of teachers training may help them shift their knowledge, attitudes and practices from that of the culturally plausible to biologically plausible one.