P2B214: Improving Epilepsy Education in LMIC Schools: A Study to Improve and Measure Epilepsy Awareness in Pakistan and India

Background: Epilepsy contributes to 1% of the burden of global diseases. Nearly 1/6th and 1/10th of the global burden lies in India and Pakistan, respectively. Widespread misconceptions and a lack of awareness regarding epilepsy contribute to social discrimination and poorer health outcomes. Improving general awareness may improve the quality of life in children with epilepsy and increase adherence to treatment.

Methods: We held an in-person educational session by volunteers in 5 schools (2 private and 3 public) in Gujranwala and Dera Ghazi Khan, Pakistan (n = 540; ages 10–15 yrs) and 5 private schools in Bangalore, Ahmedabad and Guntur, India (n=459; ages 10-15 yrs). We also distributed two types of fliers, one with a seizure action plan and another with a factsheet on epilepsy, both in English and a local language. To measure educational outcomes, we conducted pre- and post-surveys with 6-7 open-ended and multiple-choice questions regarding baseline knowledge, stigma around epilepsy, first aid and treatment for epilepsy. We performed McNemar’s and chi-squared tests to validate the results.

Results: For pre- and post- questions: Responses suggesting supernatural causes decreased from 51.9% to 10.9% in India and from 47.2% to 17.5% in Pakistan; belief that epilepsy was contagious reduced from 46.1% to 5.6% in India and from 30.2% to 7.5% in Pakistan. Knowledge on proper seizure first-aid increased from 46.2% to 94.7% in India and from 62.1% to 87.2% in Pakistan; and knowledge on the long-term management of epilepsy increased from 36.9% to 84.9% in India and from 23.3% to 75.0% in Pakistan. McNemar’s tests comparing pre- and post- results were significant (p < 0.001) for Indian respondents, while chi-squared tests for Pakistani respondents were also significant (p < 0.05).

Conclusion: Significant reduction in misconceptions regarding epilepsy in both Indian and Pakistani schools were observed following the interventional sessions. Findings highlight the value of targeted early-intervention school programs to address knowledge gaps and stigmas. As a future exercise, we suggest conducting refresher sessions in schools to promote knowledge retention and to reduce long-term negative effects of epilepsy stigmas, including social isolation, hindered psychosocial growth, and school drop-out rates.