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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