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Attitudes and misconceptions surrounding epilepsy and first aid of seizures in the Eastern Mediterranean Region: a systematic review and meta-analysis.

Sally Shaaban, Lobna Ahmed Mohamed, Mohamed Saad Rakab, Mennatallah Nader Daawa, Eslam Radwan, Deena Abdullah Aldossary, Ahmad Hasan Aleissi, Maha Khadher Almatrafi, Zainab S Alalawi, Shorouk Mohsen

BMC Public Health · 2026-04-17 · Meta-analysis

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Abstract

PURPOSE: Misconceptions and knowledge gaps regarding epilepsy in the Eastern Mediterranean region (EMR) Arabic-speaking countries are common and may endanger people with epilepsy (PWE). This systematic review and meta-analysis aimed to quantify public knowledge, misconceptions, and attitudes and synthesize pooled evidence to guide public health and educational interventions. METHODS: This is a systematic review and meta-analysis of misconceptions and attitudes within Arabic-speaking countries regarding epilepsy. A comprehensive literature search of the following databases: PubMed, Scopus, and Web of Science were conducted following PRISMA guidelines. Studies were included if they were cross-sectional studies assessing epilepsy awareness and/or attitudes and conducted in Arabic-speaking countries. The Appraisal Tool for Cross-Sectional Studies (AXIS) and the Joanna Briggs Institute (JBI) critical appraisal tool were used for quality assessment. Heterogeneity between studies was evaluated using the I² statistic. Results were reported as pooled proportions with a 95% confidence interval (CI). Sensitivity and subgroup analyses assessed how individual studies affected the pooled results. The analysis was performed by Open Meta Analyst. RESULTS: As of January 2024, 75 of 5,646 studies satisfied the inclusion criteria with a total sample size of 61,681. The pooled prevalence of good knowledge and positive attitude were 47.2% and 50.5%, respectively. The most common myth about seizure first aid was that placing objects in the mouth will decrease tongue biting with a pooled prevalence of 38.6%. Beliefs attributing the disorder to spirit possession and the evil eye had a pooled prevalence of 14.1% and 17.3%, respectively. Approximately 45% and 62% of participants were uncomfortable with their children playing with or marrying PWE. Contagion beliefs were common in the Levant (29.6%), while spirit possession was prevalent in North Africa (22.1%). Schoolteachers in the EMR had the lowest knowledge (42.2%) and least positive attitudes (33.9%). Pooled knowledge level showed minimal improvement over the past decade. CONCLUSION: There are still a lot of misunderstandings about epilepsy in the EMR, and these may vary depending on the demographic, study area, or historical period. Additionally, stigma around epilepsy remains a significant issue, highlighting the critical need for targeted awareness programs and legislative measures.

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Bystanders · Equity & disparities

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