Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel
Journal cover image

Pluralistic and singular causal attributions for epilepsy in Uganda.

Publication ,  Journal Article
Smith, CE; Kajumba, M; Bobholz, S; Smith, PJ; Kaddumukasa, M; Kakooza-Mwesige, A; Chakraborty, P; Sinha, DD; Kaddumukasa, MN; Gualtieri, A ...
Published in: Epilepsy Behav
January 2021

OBJECTIVE: In Uganda, causal attributions for epilepsy reflect a variety of beliefs and impact care-seeking behavior, perpetuate stigma, and undermine the effectiveness of interventions to narrow the epilepsy treatment gap. The objective of this study was to characterize beliefs about seizure etiology to gain a better understanding of how epilepsy is conceptualized in the community in order to inform culturally appropriate educational policies and interventions. METHODS: In a community-based study, 15,383 participants were surveyed about beliefs related to 15 potential causes for epilepsy. Principal axis factor analysis (PFA) was performed to identify causative factors and then utilized to classify singular versus pluralistic belief systems related to epilepsy etiology. Analysis of variance (ANOVA) and Mann-Whitney U-tests were conducted to examine the differences in background characteristics across the etiology belief groups. RESULTS: Three main causative factors emerged from the PFA: biological, sociospiritual, and biospiritual. Among those endorsing at least one factor (n = 13,036), the biological factor was endorsed most frequently as a potential cause for epilepsy (88.0%), followed by the sociospiritual (63.4%), then biospiritual (47.6%). Review of the patterns of endorsement found that only 22.2% endorsed the biological factor alone, 6.7% the sociospiritual factor alone, and 2.8% the biospiritual factor alone (total 31.7%). The remainder endorsed a combination of two or all three factors as being potentially causal, and most (65.7%) endorsed a pluralistic combination inclusive of a biological etiology. Group comparisons showed that endorsing only the biological factor was associated with the highest levels of education (p < 0.01), the pluralistic group had the highest ratio of people in the household who needed assistance to those that could provide aid (p < 0.01), and there were significant differences in income across specific groups (p < 0.01). CONCLUSIONS: Pluralistic attributions for epilepsy are common in Uganda, with the majority of community members drawing from biomedical and traditional concepts to construct complex explanations for seizures that transcend discrete belief categories traditionally depicted in the literature. These findings emphasize the need to understand cultural beliefs about epilepsy in order to design contextually specific interventions and education programs, which respect the fundamental beliefs and values of the community. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

January 2021

Volume

114

Issue

Pt B

Start / End Page

107334

Location

United States

Related Subject Headings

  • Uganda
  • Social Stigma
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Causality
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Smith, C. E., Kajumba, M., Bobholz, S., Smith, P. J., Kaddumukasa, M., Kakooza-Mwesige, A., … Koltai, D. C. (2021). Pluralistic and singular causal attributions for epilepsy in Uganda. Epilepsy Behav, 114(Pt B), 107334. https://doi.org/10.1016/j.yebeh.2020.107334
Smith, Caleigh E., Mayanja Kajumba, Samuel Bobholz, Patrick J. Smith, Mark Kaddumukasa, Angelina Kakooza-Mwesige, Payal Chakraborty, et al. “Pluralistic and singular causal attributions for epilepsy in Uganda.Epilepsy Behav 114, no. Pt B (January 2021): 107334. https://doi.org/10.1016/j.yebeh.2020.107334.
Smith CE, Kajumba M, Bobholz S, Smith PJ, Kaddumukasa M, Kakooza-Mwesige A, et al. Pluralistic and singular causal attributions for epilepsy in Uganda. Epilepsy Behav. 2021 Jan;114(Pt B):107334.
Smith, Caleigh E., et al. “Pluralistic and singular causal attributions for epilepsy in Uganda.Epilepsy Behav, vol. 114, no. Pt B, Jan. 2021, p. 107334. Pubmed, doi:10.1016/j.yebeh.2020.107334.
Smith CE, Kajumba M, Bobholz S, Smith PJ, Kaddumukasa M, Kakooza-Mwesige A, Chakraborty P, Sinha DD, Kaddumukasa MN, Gualtieri A, Nakasujja N, Onuoha E, Nakku J, Muhumuza C, Sanchez N, Fuller AT, Haglund MM, Koltai DC. Pluralistic and singular causal attributions for epilepsy in Uganda. Epilepsy Behav. 2021 Jan;114(Pt B):107334.
Journal cover image

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

January 2021

Volume

114

Issue

Pt B

Start / End Page

107334

Location

United States

Related Subject Headings

  • Uganda
  • Social Stigma
  • Patient Acceptance of Health Care
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Causality
  • 1103 Clinical Sciences