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Table 4 Research on epilepsy and stigma in LMIC, 2008–2017

From: A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

Study (First author, year [ref.])

Location

Sampling characteristics

Sample size

Study design

Type of stigma assessed

Description of stigma association (strength, significance)

Significant mediators/moderators

Alkhamees, 2013 [195]

Saudi Arabia

Not specified

110

Cross-sectional

Not specified

Stigma associated with overall QoL

None

Aydemir, 2011 [117]

Turkey

People with epilepsy for the past 4 years, compared to people with migraines and people with no symptoms (controls)

172

Case–control

Internalized

Stigma associated with decreased disclosure

None

Bhalla, 2012 [196]

Cambodia

People with epilepsy with controls matched on age, sex, and village

288

Case–control

Internalized

Stigma associated with worse QoL, limitations in work due to epilepsy, and social limitations due to epilepsy

None

Doganavsargil-Baysal, 2017 [112]

Turkey

Adults with epilepsy obtaining care at one outpatient clinic

89

Cross-sectional

Internalized

Stigma associated with lower scores on HQoL and greater psychiatric symptomatology

None

Elafros, 2013 [119]

Zambia

Caregivers of children aged < 8 years with epilepsy obtaining care at local clinics

100

Cross-sectional

Internalized

Maternal stigma associated with psychiatric morbidity and need for psychiatric support; actively limiting child activities

None

Espinola-Nadurielle, 2014 [114]

Mexico

Patients with epilepsy treated at one outpatient clinic and their caregivers

10

Qualitative

Not specified

Stigma associated with social withdrawal

None

Fawale, 2014 [115]

Nigeria

Adult patients with epilepsy treated at an outpatient clinic with age- and sex-matched controls

93

Case–control

Internalized

Stigma associated with worse QoL and worse social function

None

Getnet, 2016 [120]

Ethiopia

Adults with epilepsy on AEDs for at least 3 months obtaining care at outpatient clinics

450

Cross-sectional

Internalized

Perceived stigma associated with worse AED adherence

None

Hamid, 2013 [197]

Jordan

Adult patients with epilepsy obtaining care at an outpatient clinic

45

Cross-sectional

Not specified

Severity of stigma associated with worse mental health QoL

None

Hirfanoglu, 2009 [109]

Turkey

Children with epilepsy (aged 8–17 years) and their parents

533

Cross-sectional

Not specified

Child stigmatization associated with greater negativity about epilepsy, greater perceived lack of support, low self-esteem

None

Iqbal, 2013 [118]

Pakistan

Married women obtaining care at a tertiary center

381

Cross-sectional

Not specified

Stigma associated with concealment of epilepsy from future husbands

None

Komolafe, 2011 [198]

Nigeria

Women with epilepsy obtaining care from local clinics

6 groups of 8–15 women with epilepsy

Qualitative

Not specified

 

None

Kumari, 2009 [199]

India

People with epilepsy obtaining care at an outpatient clinic, selected randomly

45

Cross-sectional

Internalized, anticipated, enacted

Stigma associated with decreased HQoL

None

Lopez, 2009 [200]

Mexico

Children aged 6–18 years with epilepsy

~200

Cross-sectional

Not specified

Perceived stigma influences QoL

None

Luna, 2017 [116]

Ecuador

Adults with epilepsy or parents of children (aged < 15 years) with epilepsy

143

Cross-sectional

Internalized

Stigma associated with decreased disclosure of epilepsy

None

Nagarathnam, 2017 [201]

India

Adults with epilepsy on an AED for a year

170

Cross-sectional

Not specified

Stigma associated with worse QoL

None

Nehra, 2014 [202]

India

Adults with active epilepsy obtaining care from a clinic

208

Cross-sectional

Experienced, anticipated, internalized

Stigma correlated with worse overall function

None

Saadi, 2016 [203]

Bhutan

Patients with epilepsy obtaining care at a tertiary referral center

172

Cross-sectional

Not specified

Increased stigma associated with lower QoL

None

Tegegne, 2015 [204]

Ethiopia

Adults with epilepsy obtaining care from a hospital-based outpatient clinic

415

Cross-sectional

Internalized

Perceived stigma is associated with increased depression

None

Tsegabrhan, 2014 [205]

Ethiopia

Adults with epilepsy obtaining treatment from one hospital

300

Cross-sectional

Internalized

Stigma associated with increased depression

None

Turki, 2016 [110]

Tunisia

Patients with epilepsy followed by one clinic

20

Cross-sectional

Not specified

Absence of stigma associated with better self-esteem

None

Viteva, 2012 [206]

Bulgaria

‘Representative selection’ of patients with epilepsy at a neurology clinic

164

Cross-sectional

Internalized

Stigmatization frequency and severity correlated with depression

None

Viteva, 2013 [207]

Bulgaria

Consecutive patients with refractory and pharmaco-sensitive epilepsy

246

Cross-sectional

Internalized

Stigma associated with all subscales of QoL except change in health and sexual relations

None

Viteva, 2016 [121]

Bulgaria

Adults with epilepsy obtaining care from one hospital-based clinic

153

Cross-sectional

Internalized

Greater stigma associated with increased reporting of medication side effects

None

Yeni, 2016 [111]

Turkey

Outpatients with epilepsy obtaining care at one university

70

Cross-sectional

Internalized

Stigma associated with increased anxiety, depression, increased effects of disease on life, decreased role functioning, and worse disease-associated attitudes

None

  1. AED anti-epileptic drug, HQoL health-related quality of life, QoL quality of life