Knowledge and attitude towards epilepsy among students of economics in Herat, Afghanistan

Objective: We conducted a study on knowledge and attitude towards epilepsy in Afghanistan, where there is no previous report, where Islam coexist with shamanistic concepts derived from earlier beliefs and practices. Methods: A self-administered questionnaire consisting of 19 questions and 72 items, based on questions used in previous studies was distributed to students of economics at Herat University. Results: Of 515 returned questionnaires, 243 were analysed after exclusion of the insufficiently completed questionnaires. Fewer respondents in our survey than in others reported to ever heard or read of epilepsy. Spirit possession as a cause for epilepsy was held by less than 10% of our respondents. Students who marked at least one item that indicated that they viewed Islamic beliefs positively (i.e. Curse from God as a cause of epilepsy, would pray when witnessing a seizure, would recommend to see an imam to a relative with epilepsy) were reluctant to share their room with a person with epilepsy (54.3% vs. 35.4%; p < 0.001) or marry a person with epilepsy (61.2% vs. 37.0%; p < 0.001). They were more pessimistic concerning the effectiveness of treatment of epilepsy. Nevertheless they would more often recommend a relative with epilepsy to see a doctor (63.8% vs 38.6%; p < 0.001). Medical doctors, imams and traditional healers were recommended for the treatment of seizures and epilepsy by the same students, indicative of syncretic concepts and mixed attitude to epilepsy. Conclusion: This study shows that Afghan economic students have mixed modern scientific as well as shamanistic and Islamic concepts of epilepsy.