High school students’ knowledge, attitude, and practice with respect to epilepsy in Kerala, southern India Jeyaraj D. Pandian, Deetha Santosh, T. Santosh Kumar, P. Sankara Sarma, Kurupath Radhakrishnan * R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India Received 8 June 2006; revised 19 July 2006; accepted 20 July 2006 Available online 12 September 2006 Abstract Very little information is available on knowledge, attitude, and practice (KAP) with respect to epilepsy among schoolchildren from developing countries. We quantified KAP with respect to epilepsy among 1213 tenth-grade students of Kerala, southern India. Ninety- eight percent of them had heard or read about epilepsy. However, nearly 60% of students thought that epilepsy was a form of insanity. Allopathic treatment was preferred by more than half of the respondents; however, many had faith in exorcism and visiting religious places as ways to cure epilepsy. Half of the students considered epilepsy a hindrance to education, employment, and marriage. Thirteen percent would be unwilling to sit adjacent to or play with a child with epilepsy. We conclude that although familiarity with epilepsy was high among high school students in Kerala, misconceptions and negative attitudes were alarmingly high. Persistent and effective infor- mation campaigns, therefore, are necessary to change their attitudes toward fellow students with epilepsy. Ó 2006 Elsevier Inc. All rights reserved. Keywords: Awareness; Knowledge, attitude, and practice; Epilepsy; School students; India; Stigma 1. Introduction Social stigma and discrimination often cause more suf- fering for persons with epilepsy than the seizures them- selves [1]. Although the etiology of stigma is complex, lack of knowledge about epilepsy has been found to be an important determinant of negative attitudes toward people with this condition [2]. Understanding knowledge, attitude, and practice (KAP) with respect to epilepsy in a community is an essential initial step in evolving strategies aimed at dispelling the myths and misconceptions associ- ated with this condition. The progressive emergence of positive public attitudes toward persons with epilepsy has been demonstrated in recently conducted KAP sur- veys in developed countries [3–5]. Unfortunately, howev- er, around 40 million of the 50 million people with epilepsy in the world reside in the developing world [6], where epilepsy continues to be a highly stigmatizing con- dition [7–9]. Epilepsy is one of the most common neurological syn- dromes of childhood. Negative public attitudes and bias toward children with epilepsy are still widely prevalent, and their prevalence may be greater in developing [9,10] as compared with developed [11,12] regions of the world. Chil- dren with epilepsy cope with the discrimination by peers that often follows seizures at school [13]. They often report feeling different from their peers and are fearful of having seizures in front of their friends, resulting in adjustment problems including poor self-esteem [14,15]. Educating children about epilepsy is an important step in alleviating the stigma faced by children with epilepsy at school. Furthermore, students are the future workforce of the country and have the poten- tial to become role models for society. KAP surveys have demonstrated significant differences in knowledge of and attitude toward children with epilepsy 1525-5050/$ - see front matter Ó 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2006.07.009 * Corresponding author. Present address: Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, Kerala, India. Fax: +91 471 2446433. E-mail addresses: krk@md3.vsnl.net.in, krk@sctimst.ac.in (K. Radhakrishnan). www.elsevier.com/locate/yebeh Epilepsy & Behavior 9 (2006) 492–497