Abstracts

Rationale: The Jamaican League Against Epilepsy (JLAE) and the Jamaican Epilepsy Association (JEA) have been working to advance care of persons with epilepsy (PWE). Much done has been based on perceived needs derived from individual and collective opinions of the executive members. There are few knowledge, attitudes and practice (KAP) studies from developing countries and given varying circumstances, these may not necessarily be applicable to Jamaica. To facilitate better future resource utilization a KAP study in Jamaica was felt necessary.Methods: A large middle-income community in suburban Kingston was selected for a door-to-door survey. The development consists of a variety of property types, encompassing a wide range of acquisition costs and is serviced by employees in elementary occupations including security guards, domestic helpers, gardeners and construction workers. All individuals, aged 15 years and over were interviewed, including employees, with parental permission to interview minors. A 20-item questionnaire was utilized, information obtained by direct interview or self-completion. Data was analyzed on Epidata software.Results: 172 individuals were interviewed.65.3% were 31-50 years old.65% were female. 4.5% were minors. 66.4% were educated to the tertiary level with 39.5% employed as professionals and 22.4% as legislators, senior officials or managers. 11.9% were in elementary occupations. Overall, 94.8% indicated pre-existent knowledge of epilepsy. 43.4% of respondents knew of an unrelated PWE and 13.8% said they had a close family member with epilepsy. 64.2% had seen a seizure. 12.1% thought that epilepsy was a mental disorder and 6.9% that it was due to demonic possession. 61.7% thought that it was an inherited disorder. 93% thought that PWE should be allowed to attend regular school but only 32.4% felt that driving was permissible. 83.8% indicated willingness to reveal that they had epilepsy if this was the case. Only 17.9% had heard of the 2 epilepsy organizations. Individuals with an elementary occupation were more likely to believe that epilepsy was inherited (x1.5), contagious (x2), a mental disorder (x3.5) or due to demonic possession (x4). All individuals who indicated demonic possession as the cause had been told this by their church and some had witnessed attempted exorcisms of PWE. Conclusions: This study suggests that KAPs in this mostly middle-income group largely differ from other developing countries. Perceived stigma was generally less than expected. There are, however, important differences related to level of education. Major issues include a widespread reluctance to allow PWE to drive. This is of great concern in view of current initiatives to change restrictive driving regulations and suggests an urgent need to educate the population on this issue. Religious organizations will need to be involved so that PWE can be offered appropriate information and care. Finally, after 6 years less than 20% of interviewed individuals knew of the existence of the JLAE/JEA, indicating a need for greater involvement of the wider population in the activities of the JEA.