Knowledge, attitude and practice among adult Lebanese patients with epilepsy and impact on seizure control: a cross sectional descriptive study

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Religious and sociocultural beliefs influence the nature of treatment and care received by epileptic patients. According to the World Health Organization (WHO), almost 94% of epileptic patients in developing nations are not taking the appropriate therapy to control their seizure leading to a higher incidence of lifelong active epilepsies in these regions. With no related data in Lebanon, this study sought to assess the knowledge, the attitude, and the practice towards epilepsy among adult Lebanese epileptic patients and the associated factors Methods: This was a cross-sectional descriptive study approved by the ethical committee at the Lebanese international university. The sample was drawn randomly from community pharmacies based on stratified cluster sampling and the strata were the six districts of Lebanon. Sixty community pharmacies constituted the primary sampling units, and ten pharmacies were randomly selected from the districts using the Research Randomizer computer program. Patients aged eighteen years and above with at least two years of diagnosis with epilepsy, who came for normal medications or para-pharmaceuticals were enrolled in the study. The enrolled participants were directly interviewed by the clinical pharmacists after providing their oral informed consent. The data collection sheet was established based on validated and standardized questionnaires including The Epilepsy Patient Knowledge Profile (EPQK) and The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS). Data were analysed using the Statistical Package of the Social Sciences software (SPSS, version 21). Results: A Total of 134 epileptic patients (53% females, 47% males) with a mean age of 36.53 ± 13.15 years were included in this study. Most respondents had attained a minimum of secondary school education (91.3%). The most-reported seizure type was generalized seizure (26%). Approximately 64% of the studied patients had good seizure control. Most of the patients had good knowledge (82%) and a positive attitude (98%) toward their disease with almost two-thirds having a good practice (63%) as well. There were no statistically significant associations between the level of knowledge, attitude, or practice with seizure control (p= 0.14, p=1 and p=0.25, respectively). However, a statistically significant association was identified between the knowledge and educational level (p<0.001), Knowledge and Occupation, and between Practice and the educational levels of patients (P=0.015). The Epilepsy Patient Knowledge Profile (EPQK) Epilepsy Beliefs and Attitudes tool (KEBAS) Neuropsychological assessment Figures Figure 1 Figure 2 Figure 3 1. INTRODUCTION Epilepsy is a neurological “brain” disorder during which the brain function becomes abnormal giving rise to bizarre behaviour, perception, and in some cases loss of consciousness. Epilepsy and seizure are different. A formal definition of seizure and epilepsy) was released in 2005 by the International League of Epilepsy Association (ILAE). Seizure is the event and epilepsy is the disorder of recurrent seizure episodes ( 1 , 2 ) Globally, epilepsy is the fourth most prevalent neurological disorder. More than 50 million people worldwide have epilepsy. Approximately, 80% of epileptic patients live in low- and middle-income countries ( 3 ). The average incidence of epilepsy each year in the United States is estimated at 150,000 or 48 for every 100,000 people ( 4 ). An estimated 724500 people with epilepsy live in the Arab world. The prevalence in the Arab world varies between 0.9 per 1000 in Sudan and 6.5 per 1000 in Saudi Arabia, with a median of 2.3 per 1000 ( 5 ). In developing countries like Lebanon, up to 94% of epileptic patients are not taking the appropriate therapy to control their seizure according to the World Health Organization (WHO), leading to a higher incidence of lifelong active epilepsies in these regions ( 8 ). Serious medical, psychological, social and economic consequences are the results of uncontrolled seizures where it accounts for 0.6% of the global burden of diseases and the risk of premature death is 3 times higher in epileptic patients compared to the normal population in the low and middle-income countries ( 6 , 9 , 10 ). The term “epilepsy” in such regions is replaced by “Supernatural Power”, “traditional healer”, and “stigma”. These false misconceptions, in addition to inadequate treatments and lack of medical infrastructures, may limit the implementation of individual or collective strategies to improve the quality of life for patients suffering from epilepsy ( 11 ). 2. OBJECTIVE The misconception, poor attitude, and practice toward epilepsy will contribute to the further deterioration of epilepsy control and subsequent physical, cognitive, psychological, and social burdens ( 7 ). Because previous studies have shown that people with epilepsy know only a little about their condition in the developing countries, and because of all the listed factors in these areas, it is important to evaluate the level of awareness among these populations. Due to the lack of data in Lebanon about the prominent concerns, we conducted this study to assess the knowledge, the attitude, and the practice towards seizure among adult Lebanese patients with epilepsy. This study will raise awareness on how the Lebanese epileptic patients 3. METHODS 3.1. Study Design This research is a cross-sectional, descriptive study. A questionnaire ( appendix C) was formulated based on the combination of existing international and local tools that can be simulated to evaluate knowledge, attitude, and practice among epileptic patients towards their illness in different socio-cultural backgrounds. A pilot study was conducted before relying on the used questionnaire. The study protocol was approved by the ethical committee at the Lebanese International University (LIU). 3.2. Study Location The sample was drawn randomly from community pharmacies based on stratified cluster sampling and the strata were the six districts of Lebanon (Beirut, Bekaa, North, South, and Mount Lebanon). Sixty community pharmacies constituted the primary sampling units and ten pharmacies were randomly selected from the districts using the Research Randomizer computer program. The study is based on the data collected from the answered questionnaires by patients with epilepsy. 3.3. Study Population Patients aged eighteen years and above with at least two years of diagnosis with epilepsy, who came for normal medications or para-pharmaceuticals were enrolled in the study. Those not meeting the inclusion criteria or have mental illnesses were excluded. Mental illnesses are described as any mental disease that leads to mild to severe perturbation in thoughts and/or behaviours, causing an incapacity to deal with normal life demands. Examples include mental retardation and psychiatric disorders. 3.4. Sample Size Calculation To calculate the size of our sample, we used epiinfo™. There is no data regarding the actual prevalence of epilepsy in Lebanon. The Lebanese population (> 15 years) is 4,953,754 (July 2016) and our study is a descriptive study, for CI 95% the sample size should be 384 patients with epilepsy. However, because our study included only patients that are 18 years old and older with an old diagnosis (2 years and more), and because similar studies were done in other countries larger than Lebanon that included a maximum of 220 patients, so the sample size could be adjusted to approximately 160 to 180 patients. 3.5. Sampling and Recruitment Data was collected by distributing the questionnaires for 5 months between December 2018 and April 2019. Patients attending pharmacies and clinics were informed about the study and invited to participate in it. Finally, patients who fulfilled the inclusion criteria and have accepted to be enrolled by oral formal consent were recruited in the study. 3.6. Study Procedure The enrolled participants were directly interviewed by the clinical pharmacists after providing their oral informed consent. The questionnaire was filled by the patients themselves without any assistance. The questionnaires included all questions that assessed the socio-demographic and clinical information such as employment status, level of education, the onset of seizure, the type of seizure, frequency of the seizure, last seizure, prescribed medication, and validated questions to assess knowledge, attitudes, and practices of patients living with epilepsy from local and international tools. The data collection sheet was established based on validated and standardized questionnaires including The Epilepsy Patient Knowledge Profile (EPQK) ( Appendix A) and The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS) ( Appendix B). Scores were generated using these questionnaires to classify knowledge (poor, moderate, or good), attitude (positive or negative), and practice (poor or good) ( Appendix D) The Epilepsy Patient Knowledge Profile (EPQK) which carries true/ false items (medical knowledge items and social knowledge items) chosen by a chain of specialists in the field of epilepsy and is reputed to be objective, sensitive, and unambiguous in its evaluation of medical knowledge levels in accordance to epilepsy ( Appendix A). The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS) was formulated to assess quantitatively the attitudes and beliefs of patients suffering from epilepsy ( Appendix B). The questionnaire was translated into Arabic and was back translated into English by trained, independent linguists. This facilitated the use of the questionnaire by the population under study. 3.7. Study Outcomes 3.7.1. Primary outcomes The results of this study are expected to shed the light on the knowledge, attitude, and practice of people living with epilepsy in Lebanon in terms of the causes, diagnosis, and treatment modalities and determining the relationship between KAP and seizure control. 3.7.2. Secondary outcomes : As secondary outcomes, we expect to identify the factors that may affect KAP and the inadequacy of seizure control. These outcomes may improve health outcomes by raising the awareness of the importance of seizure knowledge, good attitudes, and practices that lead to good seizure control. 3.8. Statistical Analysis Data were analysed using the Statistical Package of the Social Sciences (SPSS), version 21. Discrete variables (as socio-demographic and clinical characteristics) were summarized by using frequencies and percentages. Continuous variables were presented by mean, median, and standard deviation. Univariate associations were assessed for statistically significant differences using the Chi-square test or Fisher’s exact test for categorical variables, as appropriate. All reported p-values are two-sided, with alpha set at a significance level of 0.05 percentages. Continuous variables were presented by mean, median, and standard deviation. Univariate associations were assessed for statistically significant differences using the Chi-square test or Fisher’s exact test for categorical variables, as appropriate. All reported p-values are two-sided, with alpha set at a significance level of 0.05. 4. RESULTS 4.1. Patients Screening During the 12 weeks, a total of 165 were consecutively screened of the outpatient’s neurology clinics and pharmacies; 25 in total were excluded; 8 suffering from severe mental retardation, 12 were below 18 years old and 5 were recently diagnosed with epilepsy. 140 patients met the inclusion criteria, 6 declined consents, and were further excluded. Thus, 134 (81.21 % of total screened) were recruited. Fig1 represents the flow diagram for patient enrolment. 4.2. Demographic information and Epidemiological Characteristics The mean age of the study patients was 36.53 (SD±13.513) with a range of (17; 61). Of the 134 patients recruited, 71 (53%) were female and 63 (47%) were male with a female-male ratio of 1.12:1, and 75 (56%) of the study subjects were married. The mean age of the first attack is 19.87% (SD=13.145), with a range of (2; 65). Whereas the mean disease duration is 16.17 (SD=8.796) with a range of (3; 47). Most respondents (65.7%) had attained a minimum of secondary school education with 22.4 % are currently university students and around 63 (47%) have low income. The majority of participants (84.3%) did not identify the type of their epilepsy, and the most common epilepsy type of the others was the generalized tonic-clonic (61.9% of responders). The demographic distribution is also shown in Table 1. Around half of the patients, 66 (49.3%) are on monotherapy and the other half 68(50.7%) are on polytherapy, knowing that Valproic acid and carbamazepine are the most common type of medication used with (39.7%) and (34.9%) respectively. Table 2 represents the epidemiological/disease characteristics. Most of the study subjects, 123 (91.8%), were aware of the importance of taking their medications regularly, but only 80 patients (59.7%) do take them on this regular basic, mainly because of forgetting (50%). The majority of the study population 114 (85.1%) do agree with their medications and only a small sample, around 34 (25.4%) do believe in traditional healers as alternatives . Table3 shows the compliance of respondents. Table 1 . Demographic distribution of respondents Characteristic Frequency (%) Region North 34 (25.4%) Beirut 31 (23.1%) South 28 (20.9%) Mount Lebanon 21 (15.7%) Bekaa 20 (14.9%) Age 18-36 76 (56.7%) 37-55 44 (32.8%) 56-60 14 (10.4%) Gender Male 63 (47.0%) Female 71 (53.0%) Marital status Single 44 (32.8%) Married 75 (56.0%) Divorced 9 (6.7%) Widowed 6 (4.5%) Occupation Unemployed 20 (14.9%) Employed 58 (43.3%) Student 20 (14.9%) Housewife 28 (21.6%) Retired 4 (3%) Others 3 (2.2%) Education No formal 13 (9.7%) Primary 33 (24.6%) Secondary 41 (30.6%) University 30 (22.4%) Postgraduate 17 (12.7%) Income Low 63 (47.0%) Moderate 66 (49.3%) High 5 (3.7%) Table 2. Disease characteristics of the respondents Disease characteristics Mean ± SD Age 36.53 ± 13.513 Age at first seizure 19.67 ± 13.162 Disease duration 16.36 ± 8.539 N (%) Seizure type Partial simple 10 (17.2%) Partial complex 6 (10.3%) Generalized 36 (62.1%) Unidentified 6 (10.3%) Medication regimen Monotherapy 66 (49.3%) Polytherapy 68 (50.7%) Type of drug Carbamazepine 22 (34.9%) Valproic acid 25 (39.7%) Phenytoin 4 (6.3%) Levetiracetam 7 (11.1%) Pregabalin 4 (6.3%) Others 1 (1.6%) Table 3. Compliance characteristics of the respondents Compliance characteristics Frequency (%) Regularly missed medication Yes 80 (59.7%) No 54 (40.3%) Reasons for missing medication Financial 13 (23.2%) Inaccessible 4 (7.1%) Side effects 10 (17.9%) Forgetting 28 (50%) Others 1 (1.8%) 4.3. knowledge, attitude, and practice scores 35.1% of the study population knew that epilepsy is caused by brain neuron disturbances and most of them (94.8%) denied that epilepsy is contagious. Around 79.9% thought that epilepsy is curable, and the majority also (85.1%) believed in modern medications as treatment. Only 25.4% of respondents mentioned that they do believe in alternative traditional healers and a large group (67.25%) answered that epilepsy is diagnosed based on EEG. A positive attitude was observed with respect to working (96.3%), studying (87.3%), and having children (93.3%). However, around 34.6% stated that they are discriminated against by others. Among the practice behaviours, going to the hospital in case of seizure attacks, was the first choice for the majority of the study sample (33.8%). Table 4 shows the knowledge, attitude, and practice among 134 respondents with epilepsy. Table 4. Knowledge, attitude, and practice answers of the respondents Variables Frequency (%) Knowledge of causes What is the cause of epilepsy? I don’t know 15 (11.2%) Supernatural power 9 (6.7%) Hunger 1 (0.73%) Infection 2 (1.47%) Depression and anger 14 (10.4%) Psychological disorder 10 (7.3%) Mental illness 15 (10.95%) Genetic 21 (15.7%) Brain neuron disturbances 47 (35.1%) Can epilepsy be contagious? Yes 7 (5.2%) No 127 (94.8%) Knowledge of treatment Can epilepsy be treated? Yes 107 (79.9%) No 27 (20.1%) Can epilepsy be treated with medication? Yes 114 (85.1%) No 20 (14.9%) Do you believe in traditional healers? Yes 34 (25.4%) NO 100 (74.6%) Knowledge of diagnosis How is epilepsy diagnosed? Can’t be diagnosed 2 (1.5 %) I don’t know 10 (7.5%) Blood test 11 (8.2%) Based on signs and symptoms 21 (15.7%) Based on EEG 90 (67.25%) Knowledge of the cause of the relapse Relapse may be due I don’t know 14 (10.5%) Infection and Inflammation 14 (10.5%) Disease progression 33 (24.8%) Medication overdose 1 (0.8%) Medication side effects 13 (9.8) Medication failure 23 (17.3%) Medication noncompliance 35 (26.3%) Attitude Can epileptic patient work? Yes 129 (96.3%) No 5 (3.7%) Can epileptic patient study? Yes 117 (87.3%) No 17 (12.7%) Can epileptic patient have children? Yes 125 (93.3%) No 9 (6.7%) Are you discriminated by others? Yes 46 (34.6%) No 87 (65.4%) Practice What do you do in new seizure attack? Nothing 19 (14.3%) Smell a shoe 1 (0.8%) Put a metal in your hand 3 (2.3 %) Put a spoon in your mouth 3 (2.3%) Pray 22 (16.5%) Keep you away from danger places 15 (11.3%) Positioning 25 (18.8%) Go to the hospital 45 (33.8%) Patients answered multiple choices questions to assess their knowledge of epilepsy ranging from causes, causes of relapses, diagnosis, and treatment modalities to their attitude and practices. The majority of patients 110(82.7%) had good knowledge, scoring in the 80th percentile, 85(63.9%) had good practice towards their disease, scoring in the 60th percentile. These results are shown in detail in the following bar chart in figure 2, where most of the studied patients had good knowledge toward their disease cause (75.7%), diagnosis (90%), cause of relapse (78.9%), and treatment (84.3%). Most respondents were revealed to have a positive attitude, scoring in the 90th percentile (97.7%) of the 3 patients with negative attitudes, their responses were found to be around the theme of they are rejected and discriminated against by their families and community. In response to the impact of epilepsy on their daily living, the studied patients were aware and did not feel that the disease should limit living a normal life in terms of employment, studying, and making families. The knowledge, attitude, and practice distributions of respondents are depicted below in Table 5. Table 5. Distribution of respondents by knowledge, attitude, and practice Scores Frequency (%) Knowledge score Poor Knowledge 23 (17.3) Good Knowledge 110 (82.7) Practice score Poor Practice 48 (36.1) Good Practice 85 (63.9) Attitude score Negative attitude 3 (2.3) Positive attitude 130 (97.7) 4.4. Seizure Control Poor seizure control was defined as more than 1 episode of epilepsy in the previous six months. As mentioned in figure 3, approximately 86 (64.2%) of studied patients had good seizure control, while 48(35.8 %) had poor seizure control. Poor seizure control was higher in patients (70%) who were unemployed. 61.5% of patients who had only primary education were found to have poor seizure control. And 60.4% of poor seizure control patients were reported to regularly failing to take their medication, with 46.75% citing as forgetting difficulties as the reason. Though using bivariate analysis there was statistical significance (P < 0.001) between failure of regular treatment and adequacy of seizure control. 4.5. relationship between baseline characteristics, KAP, and seizure control Male and female patients scored equally in knowledge (82.3% vs 81.1%), attitude score (62.9% vs 64.8%) while in practice score, Male respondents are mentioned with a more positive attitude than female respondents (100% vs 95.8%). Furthermore, 9(75%) of non-formally educated patients were to have poor knowledge of their illness but subsequently scored well on attitude and practice scores. The majority of primary educating patients (20:60.66%) were found to have poor practice. Employed studied patients scored 87.9% on knowledge score compared to 57.9% for unemployed patients, while they were approximately scored equally in attitude (98.9% vs 95%) and practice scores (64.9% vs 70%). For patients who had epilepsy more than 30 years were found to be more knowledgeable (87.5% vs 82.4%), had a positive attitude (100% vs 97.6%), and good practice (87.5 % vs 62.4%) than patients that lived less than 30 years with epilepsy. The statistical significance was observed between education and knowledge scores(P-value<0.001), education and practice score(P-value=0.015), and occupation and knowledge score (P-value=0.002). Overall patients who were female, primary educated, and had disease less than 30 years were less likely to have the knowledge, a positive attitude, and good practice but I was not statistically significant. All these results are discussed extensively in table 6 below. Table 6. Relationships between baseline characteristics and knowledge, attitude, and practice Knowledge Attitude Practice Good N (%) Poor N (%) P-value Positive N (%) Negative N (%) P-value Good N (%) Poor N (%) P-value Gender Male 51 (82.3%) 11 (17.7%) 1 62 (100%) 0 (0 %) 0.248 39 (62.9%) 23 (37.1%) 0.858 Female 59 (81.1%) 12 (16.9%) 130 (95.8%) 3 (4.2%) 46 (64.8%) 25 (35.2%) Education No formal education 3 (25%) 9 (75%) <0.001 13 (100% 0 (0%) 0.71 10 (76.9%) 3 (23.1%) 0.015 Primary 23 (69.7%) 10 (30.3%) 31 (93.9%) 2 (6.1%) 13 (39.4%) 20 (60.6%) Secondary 37 (90.2%) 4 (9.8%) 39 (97.5%) 1 (2.5%) 27 (67.5%) 13 (32.5%) University 30 (100%) 0 (0%) 30 (100%) 0 (0%) 22 (73.3%) 8 (26.7%) Postgraduate 17 (100%) 0 (0%) 17 (100%) 0 (0%) 13 (76.5%) 4 (23.5%) Occupation Unemployed 11 (57.9%) 8 (42.1%) 0.002 19 (95%) 1 (5%) 0.879 14 (70%) 6 (30%) 0.419 Employed 51 (87.9%) 7 (12.1%) 56 (98.2%) 1 (1.8%) 37 (64.9%) 20 (35.1%) Student 20 (100%) 0 (0%) 20 (100%) 0 (0%) 15 (75%) 5 (25%) Housewife 24 (82.8%) 5 (17.2%) 28 (96.6%) 1 (3.4%) 16 (55.2%) 13 (44.8%) Retired 3 (75%) 1 (25%) 4 (100%) 0 (0%) 1 (25%) 3 (75%) Others 1 (33.3%) 2 (66.7%) 3 (100%) 0 (0%) 2 (66.7%) 1 (33.3%) Disease Duration ≤ 30years 103 (82.4%) 22 (17.6%) 1 122 (97.6%) 3 (2.4%) 1 78 (62.4 %) 47 (37.6%) 0.258 >30 years 7 (87.5%) 1 (12.5%) 8 (100%) 0 (0%) 7 (87.5%) 1 (12.5%) 4.6. Relationship between Seizure control and Knowledge, attitude, and practice As represented in table 7, Out of 110 patients with good knowledge about their disease, 75(68.2%) had good seizure control. And of 130 who had scored with a positive attitude, 83 (63.8%) were found to have good seizure control. Meanwhile, most patients with good practice (63.5%) had also good seizure control. In otherwise, nearly half the patients with poor knowledge (52.2%) were stated as having poor seizure control. In contrast, the majority of patients with a negative attitude (100%) and poor practice (66.7%) were found to have good seizure control. But there was no statistically significant difference between knowledge, attitude and practice, and seizure control. Table 7. Relationship between knowledge, attitude and practice and seizure control Seizure control P-value Good N (%) Poor N (%) Knowledge score Good Knowledge 75 (68.2%) 35 (31.8%) 0.258 Poor Knowledge 11 (47.8%) 12 (52.2 %) Attitude score Positive attitude 83 (63.8%) 47 (36.2%) 0.552 Negative attitude 3 (100%) 0 (0%) Practice score Good practice 54 (63.5%) 31 (36.5%) 0.85 Poor practice 32 (66.7%) 16 (33.3%) 5. DISCUSSION 5.1. Results Discussion Our study was conducted to evaluate the knowledge, attitude, and practice of epileptic adult patients attending pharmacies, and neurological clinics in Lebanon using validated collecting data tools and finally to determine the relevance of seizure control and analyse its relationship with knowledge, attitude, and practice. There are no similar studies conducted neither in Lebanon nor in other Arab countries to compare results with ours. Meanwhile, several studies worldwide have shown that knowledge, attitude, and practice are key factors to deal with epilepsy. Our patients had chronic epilepsy and the majority of them were young adults (36.53±13.513), approximately equally distributed between Lebanese governorates, the majority of them were female, employed, with a moderate level of income and higher literacy rate. A demographic characteristics summary of previous similar studies is shown in Table 8 to compare results with the current study. Table 8. Demographic characteristics summary of previous similar studies Author(s) Region year Udaya Seneviratne et al Sri Lanka 2002 MGouri-Devi et al India 2010 Yousuf RM et al Malaysia 2017 Sample size 207 120 132 Gender Males 55% 60% 51.5% Females 45% 40% 48.5% Age 10-30: 59.9% 31-50: 30.9% 51-70: 8.2% >70: 1% <30: 69.2% 31-45: 27.5% 46-60: 3.3% 60: 4.5% Education 89.4%< grade 10 Illiterate:24.2% School 64.2% Graduate and above: 5% No formal Education: 8.3% Primary:15.2% Secondary: 61.4% University:15.2% Occupation Unemployed 54.1% 43.3% 37.1% Employed 32.4% 25.2% 43.3% Students 13.5% 30.8% 17.$% Income Low:90.8% Middle:9.2% Marital status Married: 50.8% Unmarried: 49.2% Married:37.1% Single:62.1% Widowed: 0.8% We found that most of the respondents are knowledgeable (82.5%), have a good practice (63.9%), positive attitude (79.7%), and good seizure control (68.2%) irrespective of their age, gender, and disease duration (p-value were not significant). The possible reason behind these convenient results could be the high educational level of our sample, where up to 65.7% have achieved a minimum of secondary education. This is proved by the positive association found between the educational level of our patients and their knowledge toward their disease on one hand (p < 0.001), and their practice in another hand (p=0.015). Realizing the importance of education opens doors to gain knowledge, which helps in guiding a better sense of right from wrong. A KAP assessment study, M Gourie-Devie et al (13), found to have relatively comparable results in terms of knowledge, where we can see that the most common answer in the two samples was brain neuron disturbances when asked about the cause of epilepsy (35.1% vs 55% for Indian sample), and also similar percentage (10.95% % in our study sample and 14.2% in the other study sample) answered that epilepsy is a mental disorder. On the other hand, regarding also the epilepsy definition, only 6.7 % in our study sample believed that epilepsy is caused by supernatural power versus 16.7 % in the Indian study sample and only a small group in the two samples doe believe in traditional faith healers (only 25.4% in our study sample versus 19.2% in the comparable study). And when asked about epilepsy transmitting, only 1 patient (0.8%) in the other study thought that epilepsy is contagious whereas 7 patients (5.2 %) do have these thoughts. About treatment, a good percentage in both studies believe that their disease is treatable with modern drugs (85.1% vs 91.7%). Similar attitude results are also seen between the two studies, where most of the two samples believe that epileptic patients can have children (93.3% vs 92.5 %), can study (87.3% vs 80.8%), and can effectively work (96.3% vs 90.8%). Moving to the practice field, some percentages make difference in the two groups, for example, only 1 patient (0.8%) in our study population rely on smelling a shoe during seizure attack versus 15 patients (12.5%) in the other study. But despite this small gap, going to the hospital, remain the first to do after seizure attacks (33.8 vs 96%). In summary, M Gourie-Devie et al had found similar results to our study in the Indian population (good knowledge, good attitude, good practice), knowing that the sample study had similar demographic characteristics to ours; beginning with the age, where around 83 (69.2%) of this study population is below 30, versus 76(56.7%) of our sample is between 18-36, so the majority of the two sample populations are known to be young adults, moving to the socioeconomic status, where the population is classified to have low to moderate-income, which is close to the Indian sample where the majority is found to get a low income (90.8%) and finally, regarding the education, the two studies show also very comparable results, so we can find that around 74 % of our population and around 77% of the other study sample have attained a base of primary education. The only two differences in the demographic characteristics are the occupation and the gender, where our sample is found to be almost half female half male, whereas most of the second study patients (62%) are males, and the majority of our patients are employed (58%) versus 28% in the Indian sample. Our positive knowledge results were not seen in the Yousef RM et al study (14), where 90.9% were unaware about their disease cause, regardless of age, educational background, or disease duration. On the other hand, results were comparable for attitude and practice questions. Table 9 below is a review comparing the results with previous studies. Table 9. Comparison of results between studies Author(year) Sample size Region Cause of Disease Epilepsy is curable Epilepsy can be treated by medication Believing in Faith healers Take regular treatment Regular follow up Cause of Relapse Practice in case of attacks Current study 35.5 % Brain disorder 79.9% 85.1% 25.4% 91.8% 87.3% 26.3% due to non-compliance 33.8 % go the hospital Yousef RM et al (2017) 132 Malaysia 90.9% don’t know 97.9% 93.9% 22.7% 97.7% 90.9% 76% due to non -compliance 0.8% Go to the hospital Udaya Seneviratne et al (2002) 207 Sri Lanka 41.5% Brain disorder 71% 41.5% Gizat Kassie et al (2014) 180 Ethiopia 32.2% Don’t know 36.6% 60% 53.33% Positioning Udaya Seneviratne ET al (12) found that the majority of Sri Lanka patients are male 55%, ranging between 10 to 30 years old (59.9%), Their education level was low, up to 89% in contrast to Lebanese epileptic patients that this current study showed a high level of education (up to 65% were educated). A large part of them was unemployed (54.1%). In contrast, in this study, most epileptic Lebanese patients (58.2 %) were employed. In Contra wise to our results, the majority here were on monotherapy (75.4% vs 49.3%) with carbamazepine the major drug choice (48.3% vs 34. 9%). Most of their respondents had also a positive attitude as in the Lebanese sample (75.8 vs 97.7%); where Lebanese patients had a remarkable high attitude; and good seizure control, whereas they appeared to have bad knowledge despite the similar level of literacy to our study sample. Also, in contrast to this study, a large group of their patients does believe in spiritual healers. In Gizat Kassie et al study (15), like our study sample, most of the patients (58%) are young adults between 20 and 35 years old, with low income (74%). Regarding occupation status, both samples are employed in the majority, but the noticeable in the Ethiopian sample is that the majority employed specifically farmers (28.28%). Two demographic differences exist between the two samples, where our sample is almost half male (47%), half female (53.0%), whereas most are male in the other study (40%), and most of our study is married (56%) whereas most of the second study is single (32.2%). The two samples are also comparable in terms of education where our sample as already discussed (30.6%) have achieved a minimum of secondary education, and in the other study, 22.22% of the Ethiopian sample had achieved a level between grad1 – grad8. A big difference is also in the disease duration recordings, where our patients tend to have a mean of 16.36 years of epilepsy duration, much longer than the Ethiopian sample when the majority suffer from epilepsy for only 1-5 years. As a result of knowledge scoring, the two samples tend to know, in the majority, that epilepsy is a disease of the brain (53.1% vs 74.44%). On the other hand, for practice results, the highest percentages are seen for positioning where most of our study tend to go to the hospital, and what was remarkable is that none of the patients rely on praying in this situation, while a small percentage in our study (16.5%) do believe in praying. Overall, like our sample, the Ethiopian sample has an acceptable treatment knowledge (60%), a positive attitude (70%), and good practice (53.3%). Also, the association analysis done separately between knowledge and attitude with the demographic characteristics had shown not only that the knowledge is positively associated with educational level in our study, but also with age, income, and duration of the disease. In contrast to this study, the attitude was found to be associated with several variables (age, gender, literacy, mental status, and income). The studies mentioned above could demonstrate that education is not the only variable affecting knowledge, which could be affected by many other factors, such as the social cultures, religious background, technological facilities that facilitate internet access, and the research about the disease process. 5.2. Cofactors of KAP When managing an individual living with epilepsies there are unmodifiable factors such as the age of onset, etiology of the disease, and its pattern. Besides, despite adequate medication, it has been found that seizures will persist. It is necessary therefore to identify other modifiable factors that could improve seizure control in our patient population. Knowledge can be defined as awareness or understanding of facts which is acquired through experience and education perceiving. Many factors may influence the knowledge of patients toward their illness: their socioeconomic status, education, and interaction with health care providers. When reinforcing these factors, we will strengthen respectively their knowledge. As a knowledge, additional factors affect also the attitude and practice of patients; mainly highlighted in low and middle-income countries; as the stigma, religious beliefs, lack of psychosocial support, Health care assistance, and health awareness clubs. Because of these precipitating factors, epileptic patients may become victims due to their misconceptions about the disease. 5.3. Recommendations: We recommend the development of a standardized comprehensive association to raise awareness about epilepsy and educate patients about their disease cause, treatment, the necessity of taking treatment on daily basis, how to deal with epilepsy attacks and their rights to be incorporated into society. And we recommend further studies on other factors that may contribute to knowledge, attitude, practice, and seizure controls. 5.4. Strengths and Limitations This study is the first to record the knowledge, attitude, and practice of adult epileptic patients in Lebanon. The results of our study can aid the regulatory and consultative agencies in helping epileptic patients to deal with their conditions. Our study has several limitations. First, our sample size is less than the number calculated as discussed in the methods part. The pharmacies and neurologic clinics for recruitment are chosen by convenience, which can be considered as a second limitation. Additionally, because it is time-consuming, and because of some critical questions (information Bias), we couldn’t use the structured questionnaire, and new assumptions were made to overcome this barrier. 6. CONCLUSION The Lebanese patients suffering from epilepsy had basic good knowledge, attitude, and practice towards their disease with good seizure control. Meanwhile, the seizure control was not associated with the knowledge, attitude, and practice of the patient toward their disease, whereas a remarkable association was found between the education level of patients and their knowledge and their practice. Abbreviations KAP: knowledge, attitude, and practice ILAE: International league of epilepsy association CBZ: Carbamazepine PA: Valproic acid LEV: Levetiracetam Declarations Ethics Approval and Consent to Participate This study was approved by the Ethical Committee of the Lebanese International University. Oral consent was obtained from all patients participating in the study. Given the nature of the study, the Ethics Committee waived the requirement for written consent. Consent for Publication Not applicable. Competing Interests The authors declare that they have no competing interests. Funding This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors' Contributions Nada Kassem, Soumaya Houssein and Iqbal Fahs conceived and designed the study. Iqbal Fahs and Marwan Akel assisted with data collection, reviewed and revised the manuscript. Nada Kassem and Soumaya Houssein Were responsible for the data collection, entry organization, assisted with data analysis, data curation and contributed to manuscript writing. Nada Kassem performed statistical analysis, interpreted results, writing and revised the final draft of the manuscript. Nathalie Lahoud provided critical insights on study design and methodology. All authors reviewed and approved the final manuscript and agreed to be accountable for all aspects of work. References Definition of Epilepsy 2014 // International League Against Epilepsy [Internet]. [cited 2019 May 19]. Available from: https://www.ilae.org/guidelines/definition-and-classification/definition-of-epilepsy-2014 Presentation Illustrating the 2014 Definition of Epilepsy.pdf [Internet]. [cited 2019 May 19]. Available from: https://www.epilepsy.com/sites/core/files/atoms/files/Presentation%20Illustrating%20the%202014%20Definition%20of%20Epilepsy.pdf Epilepsy [Internet]. [cited 2019 May 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsy Epilepsy Statistics | Epilepsy Foundation [Internet]. [cited 2019 May 19]. Available from: https://www.epilepsy.com/learn/about-epilepsy-basics/epilepsy-statistics World Health Organization, editor. Epilepsy in the WHO Eastern Mediterranean region: bridging the gap. Cairo, Egypt: World Health Organization, Regional Office for the Eastern Mediterranean; 2010. 30 p. Introduction | Epilepsy Across the Spectrum: Promoting Health and Understanding | The National Academies Press [Internet]. [cited 2019 May 19]. Available from: https://www.nap.edu/read/13379/chapter/3#25 About SUDEP: A Deadly Result of Uncontrolled Seizures [Internet]. Epilepsy Foundation. [cited 2019 May 19]. Available from: https://www.epilepsy.com/aimforzero/about-sudep Global Campaign against Epilepsy, International Bureau of Epilepsy, International League against Epilepsy, editors. Atlas: epilepsy care in the world. Geneva: Programme for Neurological Diseases and Neuroscience, Department of Mental Health and Substance Abuse, World Health Organization; 2005. 91 p. The global burden and stigma of epilepsy - ScienceDirect [Internet]. [cited 2019 May 19]. Available from: https://www.sciencedirect.com/science/article/pii/S1525505007004878 The Treatment Gap in Epilepsy: The Current Situation and Ways Forward - Meinardi - 2001 - Epilepsia - Wiley Online Library [Internet]. [cited 2019 May 19]. Available from: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2001.32800.x McLin WM, Boer HM de. Public Perceptions About Epilepsy. Epilepsia. 1995 Oct 1;36(10):957–9. Seneviratne U, Rajapakse P, Pathirana R, Seetha T. Knowledge, attitude, and practice of epilepsy in rural Sri Lanka. Seizure. 2002 Jan;11(1):40–3. Gourie-Devi M, Singh V, Bala K. Knowledge, attitude and practices among patients of epilepsy attending tertiary hospital in Delhi, India and a review of Indian studies. Neurology Asia. 2010;8. Rathor D, Shahar MA, Omar A, SM Shah A, Hasmoni M, Draman C, et al. Assessment of Knowledge, attitude and practices of Epilepsy Patients’ towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia. Bangladesh Journal of Medical Science. 2017 Aug 19;16:545. Kassie, G. M., Kebede, T. M., & Duguma, B. K. (2014). Knowledge, Attitude, and Practice of Epileptic Patients Towards Their Illness and Treatment in Jimma University Specialized Hospital, Southwest Ethiopia. North American Journal of Medical Sciences , 6 (8), 383–390. https://doi.org/10.4103/1947-2714.139288 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4979174","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":358106209,"identity":"26ad58e7-a3db-43c3-8219-6fa28fb85337","order_by":0,"name":"Nada Kassem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYHACAwaGAxDWAYkKIMnM3EC0FsYDFmdAWhiJ18J8oLINrBW/FnP2wxs/MJyxs5dv7044cHNebTR/O1DLj4ptOLVY9qQVSzDcSE7ccObshoMztx3PnXGYsYGx58xt3K46kGMgwfCBOcFAInfDYcltx3IbgFqYGdvwaDn/xvgHw4d6e/n5bzcc/jvnWO58glpu5JgBHQZUdoN3wwHJhhqgXQS1PCuzSDhzHOiX3A0HJI4dyN0I1HIQr1/OJ2++8eFYNTDEzm7+IFFTlzvv/OGDD35U4NYCBgkI5mEweQC/elRQR4riUTAKRsEoGCEAAIbfZ5QtmOU6AAAAAElFTkSuQmCC","orcid":"","institution":"Lebanese International University","correspondingAuthor":true,"prefix":"","firstName":"Nada","middleName":"","lastName":"Kassem","suffix":""},{"id":358106210,"identity":"c001ad8e-2e4f-4150-9c11-46a68fe203ce","order_by":1,"name":"Soumaya Houssein","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Soumaya","middleName":"","lastName":"Houssein","suffix":""},{"id":358106211,"identity":"b0cad86a-508c-4528-9297-4d403bf991dc","order_by":2,"name":"Iqbal Fahs","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Iqbal","middleName":"","lastName":"Fahs","suffix":""},{"id":358106212,"identity":"ff8344bc-5a63-4898-9426-1777d674c8c4","order_by":3,"name":"Nathalie Lahoud","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Nathalie","middleName":"","lastName":"Lahoud","suffix":""},{"id":358106213,"identity":"1077511a-07fa-44ed-9589-75e0d6cc11ad","order_by":4,"name":"Marwan Akel","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Marwan","middleName":"","lastName":"Akel","suffix":""}],"badges":[],"createdAt":"2024-08-26 15:52:41","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4979174/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4979174/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":66869330,"identity":"6c41f398-e44e-40f5-baf8-afa86a066c8c","added_by":"auto","created_at":"2024-10-17 09:33:09","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":28061,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram for patient’s enrolment\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4979174/v1/e6e5f23b68295926a4a0dd14.png"},{"id":66868687,"identity":"95097a8c-714c-48f8-92aa-9f65b3fa3785","added_by":"auto","created_at":"2024-10-17 09:25:09","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":20599,"visible":true,"origin":"","legend":"\u003cp\u003eChart showing knowledge and practice as per categories\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4979174/v1/19a934c209029fe4e0f66ad7.png"},{"id":66868691,"identity":"a80f58f9-f069-4a1e-92e4-cd9865638529","added_by":"auto","created_at":"2024-10-17 09:25:12","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":35307,"visible":true,"origin":"","legend":"\u003cp\u003eSeizure control frequencies among respondents\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4979174/v1/d1016e9192b8e391c2cf71e6.png"},{"id":103345253,"identity":"8a75ab0d-369b-46aa-b8ad-118a6d81cab8","added_by":"auto","created_at":"2026-02-24 16:11:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2199240,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4979174/v1/977811f9-68b6-4119-8eec-2542ebc89673.pdf"},{"id":66868689,"identity":"783b3af8-efc9-4cad-87d9-91fecd7f90c4","added_by":"auto","created_at":"2024-10-17 09:25:10","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":672392,"visible":true,"origin":"","legend":"","description":"","filename":"Supplemantarymaterials.docx","url":"https://assets-eu.researchsquare.com/files/rs-4979174/v1/d4781422007f120b77785d07.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, attitude and practice among adult Lebanese patients with epilepsy and impact on seizure control: a cross sectional descriptive study","fulltext":[{"header":"1. INTRODUCTION ","content":"\u003cp\u003eEpilepsy is a neurological \u0026ldquo;brain\u0026rdquo; disorder during which the brain function becomes abnormal giving rise to bizarre behaviour, perception, and in some cases loss of consciousness. Epilepsy and seizure are different. A formal definition of seizure and epilepsy) was released in 2005 by the International League of Epilepsy Association (ILAE). Seizure is the event and epilepsy is the disorder of recurrent seizure episodes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Globally, epilepsy is the fourth most prevalent neurological disorder. More than 50\u0026nbsp;million people worldwide have epilepsy. Approximately, 80% of epileptic patients live in low- and middle-income countries (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The average incidence of epilepsy each year in the United States is estimated at 150,000 or 48 for every 100,000 people (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). An estimated 724500 people with epilepsy live in the Arab world. The prevalence in the Arab world varies between 0.9 per 1000 in Sudan and 6.5 per 1000 in Saudi Arabia, with a median of 2.3 per 1000 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In developing countries like Lebanon, up to 94% of epileptic patients are not taking the appropriate therapy to control their seizure according to the World Health Organization (WHO), leading to a higher incidence of lifelong active epilepsies in these regions (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSerious medical, psychological, social and economic consequences are the results of uncontrolled seizures where it accounts for 0.6% of the global burden of diseases and the risk of premature death is 3 times higher in epileptic patients compared to the normal population in the low and middle-income countries (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe term \u0026ldquo;epilepsy\u0026rdquo; in such regions is replaced by \u0026ldquo;Supernatural Power\u0026rdquo;, \u0026ldquo;traditional healer\u0026rdquo;, and \u0026ldquo;stigma\u0026rdquo;. These false misconceptions, in addition to inadequate treatments and lack of medical infrastructures, may limit the implementation of individual or collective strategies to improve the quality of life for patients suffering from epilepsy (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e"},{"header":"2. OBJECTIVE","content":"\u003cp\u003eThe misconception, poor attitude, and practice toward epilepsy will contribute to the further deterioration of epilepsy control and subsequent physical, cognitive, psychological, and social burdens (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Because previous studies have shown that people with epilepsy know only a little about their condition in the developing countries, and because of all the listed factors in these areas, it is important to evaluate the level of awareness among these populations.\u003c/p\u003e \u003cp\u003eDue to the lack of data in Lebanon about the prominent concerns, we conducted this study to assess the knowledge, the attitude, and the practice towards seizure among adult Lebanese patients with epilepsy. This study will raise awareness on how the Lebanese epileptic patients\u003c/p\u003e"},{"header":"3. METHODS","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.1. Study Design\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThis research is a cross-sectional, descriptive study. A questionnaire (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eappendix\u003c/span\u003e C) was formulated based on the combination of existing international and local tools that can be simulated to evaluate knowledge, attitude, and practice among epileptic patients towards their illness in different socio-cultural backgrounds. A pilot study was conducted before relying on the used questionnaire. The study protocol was approved by the ethical committee at the Lebanese International University (LIU).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.2. Study Location\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThe sample was drawn randomly from community pharmacies based on stratified cluster sampling and the strata were the six districts of Lebanon (Beirut, Bekaa, North, South, and Mount Lebanon). Sixty community pharmacies constituted the primary sampling units and ten pharmacies were randomly selected from the districts using the Research Randomizer computer program. The study is based on the data collected from the answered questionnaires by patients with epilepsy.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.3. Study Population\u003c/span\u003e\u003c/h2\u003e \u003cp\u003ePatients aged eighteen years and above with at least two years of diagnosis with epilepsy, who came for normal medications or para-pharmaceuticals were enrolled in the study. Those not meeting the inclusion criteria or have mental illnesses were excluded.\u003c/p\u003e \u003cp\u003eMental illnesses are described as any mental disease that leads to mild to severe perturbation in thoughts and/or behaviours, causing an incapacity to deal with normal life demands. Examples include mental retardation and psychiatric disorders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.4. Sample Size Calculation\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eTo calculate the size of our sample, we used epiinfo\u0026trade;. There is no data regarding the actual prevalence of epilepsy in Lebanon. The Lebanese population (\u0026gt;\u0026thinsp;15 years) is 4,953,754 (July 2016) and our study is a descriptive study, for CI 95% the sample size should be 384 patients with epilepsy.\u003c/p\u003e \u003cp\u003eHowever, because our study included only patients that are 18 years old and older with an old diagnosis (2 years and more), and because similar studies were done in other countries larger than Lebanon that included a maximum of 220 patients, so the sample size could be adjusted to approximately 160 to 180 patients.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.5. Sampling and Recruitment\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eData was collected by distributing the questionnaires for 5 months between December 2018 and April 2019.\u003c/p\u003e \u003cp\u003ePatients attending pharmacies and clinics were informed about the study and invited to participate in it. Finally, patients who fulfilled the inclusion criteria and have accepted to be enrolled by oral formal consent were recruited in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.6. Study Procedure\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThe enrolled participants were directly interviewed by the clinical pharmacists after providing their oral informed consent. The questionnaire was filled by the patients themselves without any assistance.\u003c/p\u003e \u003cp\u003eThe questionnaires included all questions that assessed the socio-demographic and clinical information such as employment status, level of education, the onset of seizure, the type of seizure, frequency of the seizure, last seizure, prescribed medication, and validated questions to assess knowledge, attitudes, and practices of patients living with epilepsy from local and international tools. The data collection sheet was established based on validated and standardized questionnaires including The Epilepsy Patient Knowledge Profile (EPQK) (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eAppendix\u003c/span\u003e A) and The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS) (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eAppendix\u003c/span\u003e B). Scores were generated using these questionnaires to classify knowledge (poor, moderate, or good), attitude (positive or negative), and practice (poor or good) (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eAppendix\u003c/span\u003e D)\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe Epilepsy Patient Knowledge Profile (EPQK) which carries true/ false items (medical knowledge items and social knowledge items) chosen by a chain of specialists in the field of epilepsy and is reputed to be objective, sensitive, and unambiguous in its evaluation of medical knowledge levels in accordance to epilepsy (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eAppendix\u003c/span\u003e A).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS) was formulated to assess quantitatively the attitudes and beliefs of patients suffering from epilepsy (\u003cspan refid=\"Sec27\" class=\"InternalRef\"\u003eAppendix\u003c/span\u003e B).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe questionnaire was translated into Arabic and was back translated into English by trained, independent linguists. This facilitated the use of the questionnaire by the population under study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.7. Study Outcomes\u003c/span\u003e\u003c/h2\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.7.1. Primary outcomes\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThe results of this study are expected to shed the light on the knowledge, attitude, and practice of people living with epilepsy in Lebanon in terms of the causes, diagnosis, and treatment modalities and determining the relationship between KAP and seizure control.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.7.2. Secondary outcomes\u003c/span\u003e:\u003c/h2\u003e \u003cp\u003eAs secondary outcomes, we expect to identify the factors that may affect KAP and the inadequacy of seizure control. These outcomes may improve health outcomes by raising the awareness of the importance of seizure knowledge, good attitudes, and practices that lead to good seizure control.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003e3.8. Statistical Analysis\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eData were analysed using the Statistical Package of the Social Sciences (SPSS), version 21. Discrete variables (as socio-demographic and clinical characteristics) were summarized by using frequencies and percentages. Continuous variables were presented by mean, median, and standard deviation. Univariate associations were assessed for statistically significant differences using the Chi-square test or Fisher\u0026rsquo;s exact test for categorical variables, as appropriate. All reported p-values are two-sided, with alpha set at a significance level of 0.05 percentages. Continuous variables were presented by mean, median, and standard deviation. Univariate associations were assessed for statistically significant differences using the Chi-square test or Fisher\u0026rsquo;s exact test for categorical variables, as appropriate. All reported p-values are two-sided, with alpha set at a significance level of 0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. RESULTS ","content":"\u003cp\u003e4.1. Patients Screening\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDuring the 12 weeks, a total of 165 were consecutively screened of the outpatient\u0026rsquo;s neurology clinics and pharmacies; 25 in total were excluded; 8 suffering from severe mental retardation, 12 were below 18 years old and 5 were recently diagnosed with epilepsy. 140 patients met the inclusion criteria, 6 declined consents, and were further excluded. Thus, 134 (81.21 % of total screened) were recruited. Fig1 represents the flow diagram for patient enrolment.\u003c/p\u003e\n\u003cp\u003e4.2. Demographic information and Epidemiological Characteristics\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe mean age of the study patients was 36.53 (SD\u0026plusmn;13.513) with a range of (17; 61). Of the 134 patients recruited, 71 (53%) were female and 63 (47%) were male with a female-male ratio of 1.12:1, and 75 (56%) of the study subjects were married. The mean age of the first attack is 19.87% (SD=13.145), with a range of (2; 65). Whereas the mean disease duration is 16.17 (SD=8.796) with a range of (3; 47).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost respondents (65.7%) had attained a minimum of secondary school education with 22.4 % are currently university students and around 63 (47%) have low income.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe majority of participants (84.3%) did not identify the type of their epilepsy, and the most common epilepsy type of the others was the generalized tonic-clonic (61.9% of responders). The demographic distribution is also shown in Table 1.\u003c/p\u003e\n\u003cp\u003eAround half of the patients, 66 (49.3%) are on monotherapy and the other half 68(50.7%) are on polytherapy, knowing that Valproic acid and carbamazepine are the most common type of medication used with (39.7%) and (34.9%) respectively. Table 2 represents the epidemiological/disease characteristics. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost of the study subjects, 123 (91.8%), were aware of the importance of taking their medications regularly, but only 80 patients (59.7%) do take them on this regular basic, mainly because of forgetting (50%). The majority of the study population 114 (85.1%) do agree with their medications and only a small sample, around 34 (25.4%) do believe in traditional healers as alternatives\u003cstrong\u003e.\u003c/strong\u003e Table3 shows the compliance of respondents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1\u003cem\u003e.\u003c/em\u003e Demographic distribution of respondents\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"571\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCharacteristic\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eFrequency (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Region\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNorth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e34 (25.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBeirut\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e31 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSouth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e28 (20.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMount Lebanon\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e21 (15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBekaa\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e20 (14.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e18-36\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e76 (56.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e37-55\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e44 (32.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e56-60\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e14 (10.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Gender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e63 (47.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e71 (53.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Marital status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e44 (32.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e75 (56.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDivorced\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e9 (6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWidowed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e6 (4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Occupation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnemployed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e20 (14.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e58 (43.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e20 (14.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousewife\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e28 (21.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRetired\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 4 (3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 3 (2.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Education\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo formal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e13 (9.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e33 (24.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e41 (30.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUniversity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e30 (22.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostgraduate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e17 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Income\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e63 (47.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e66 (49.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 231px;\"\u003e\n \u003cp\u003e5 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2. Disease characteristics of the respondents\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 309px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDisease characteristics\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMean \u0026plusmn; SD\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 309px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e36.53 \u0026plusmn; 13.513\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 309px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at first seizure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e19.67 \u0026plusmn; 13.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 309px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e16.36 \u0026plusmn; 8.539\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 309px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eN (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeizure type\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePartial simple\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e10 (17.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePartial complex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e6 (10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eGeneralized\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e36 (62.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eUnidentified\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e6 (10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedication regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eMonotherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e66 (49.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePolytherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e68 (50.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of drug\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eCarbamazepine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e22 (34.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eValproic acid\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e25 (39.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePhenytoin\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e4 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eLevetiracetam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e7 (11.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePregabalin\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e4 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e1 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3. Compliance characteristics of the respondents\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"576\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompliance characteristics\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eFrequency (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRegularly missed\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003emedication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e80 (59.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e54 (40.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Reasons for missing medication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eFinancial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e13 (23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eInaccessible\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e4 (7.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eSide effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e10 (17.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eForgetting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e28 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e1 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e4.3. knowledge, attitude, and practice scores\u003c/p\u003e\n\u003cp\u003e35.1% of the study population knew that epilepsy is caused by brain neuron disturbances and most of them (94.8%) denied that epilepsy is contagious. Around 79.9% thought that epilepsy is curable, and the majority also (85.1%) believed in modern medications as treatment. Only 25.4% of respondents mentioned that they do believe in alternative traditional healers and a large group (67.25%) answered that epilepsy is diagnosed based on EEG.\u003c/p\u003e\n\u003cp\u003eA positive attitude was observed with respect to working (96.3%), studying (87.3%), and having children (93.3%). However, around 34.6% stated that they are discriminated against by others. Among the practice behaviours, going to the hospital in case of seizure attacks, was the first choice for the majority of the study sample (33.8%). Table 4 shows the knowledge, attitude, and practice among 134 respondents with epilepsy.\u003c/p\u003e\n\u003cp\u003eTable 4. Knowledge, attitude, and practice answers of the respondents\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"613\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 444px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eVariables\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; Frequency (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 613px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge of causes\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"9\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eWhat is the cause of epilepsy?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e15 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eSupernatural power\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e9 (6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eHunger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e1 (0.73%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e2 (1.47%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eDepression and anger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e14 (10.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003ePsychological disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e10 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eMental illness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e15 (10.95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eGenetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e21 (15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eBrain neuron disturbances\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e47 (35.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan epilepsy be contagious?\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e7 (5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e127 (94.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 613px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge of treatment\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCan epilepsy be treated?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e107 (79.9%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e27 (20.1%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan epilepsy be treated with medication?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e114 (85.1%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e20 (14.9%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you believe in traditional healers?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e34 (25.4%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6011%;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\u003cbr\u003e100 (74.6%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 82.5568%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge of diagnosis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHow is epilepsy diagnosed?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eCan\u0026rsquo;t be diagnosed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e2 (1.5 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e10 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eBlood test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e11 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eBased on signs and symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e21 (15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eBased on EEG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e90 (67.25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 82.5568%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge of the cause of the relapse\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRelapse may be due\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e14 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eInfection and Inflammation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e14 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eDisease progression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e33 (24.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eMedication overdose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eMedication side effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e13 (9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eMedication failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e23 (17.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eMedication noncompliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e35 (26.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 82.5568%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAttitude\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan epileptic patient work?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e129 (96.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e5 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan epileptic patient study?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e117 (87.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e17 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan epileptic patient have children?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e125 (93.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e9 (6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre you discriminated by others?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e46 (34.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e87 (65.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 82.5568%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePractice\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" valign=\"top\" style=\"width: 24.1465%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat do you do in new seizure attack?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eNothing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e19 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eSmell a shoe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003ePut a metal in your hand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e3 (2.3 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003ePut a spoon in your mouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e3 (2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003ePray\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e22 (16.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eKeep you away from danger places\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e15 (11.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003ePositioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e25 (18.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 35.4778%;\"\u003e\n \u003cp\u003eGo to the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.9324%;\"\u003e\n \u003cp\u003e45 (33.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePatients answered multiple choices questions to assess their knowledge of epilepsy ranging from causes, causes of relapses, diagnosis, and treatment modalities to their attitude and practices. The majority of patients 110(82.7%) had good knowledge, scoring in the 80th percentile, 85(63.9%) had good practice towards their disease, scoring in the 60th percentile. These results are shown in detail in the following bar chart in figure 2, where most of the studied patients had good knowledge toward their disease cause (75.7%), diagnosis (90%), cause of relapse (78.9%), and treatment (84.3%).\u003c/p\u003e\n\u003cp\u003eMost respondents were revealed to have a positive attitude, scoring in the 90th percentile (97.7%) of the 3 patients with negative attitudes, their responses were found to be around the theme of they are rejected and discriminated against by their families and community. In response to the impact of epilepsy on their daily living, the studied patients were aware and did not feel that the disease should limit living a normal life in terms of employment, studying, and making families.\u003c/p\u003e\n\u003cp\u003eThe knowledge, attitude, and practice distributions of respondents are depicted below in Table 5.\u003c/p\u003e\n\u003cp\u003eTable 5. Distribution of respondents by knowledge, attitude, and practice\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"581\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eScores\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Frequency (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Poor Knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e23 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Good Knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e110 (82.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePractice score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Poor Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e48 (36.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Good Practice\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e85 (63.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAttitude score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Negative attitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e3 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8072%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Positive attitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48.1928%;\"\u003e\n \u003cp\u003e130 (97.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e4.4. Seizure Control\u003c/p\u003e\n\u003cp\u003ePoor seizure control was defined as more than 1 episode of epilepsy in the previous six months. As mentioned in figure 3, approximately 86 (64.2%) of studied patients had good seizure control, while 48(35.8 %) had poor seizure control. Poor seizure control was higher in patients (70%) who were unemployed. 61.5% of patients who had only primary education were found to have poor seizure control. And 60.4% of poor seizure control patients were reported to regularly failing to take their medication, with 46.75% citing as forgetting difficulties as the reason. Though using bivariate analysis there was statistical significance (P \u0026lt; 0.001) between failure of regular treatment and adequacy of seizure control.\u003c/p\u003e\n\u003cp\u003e4.5.\u0026nbsp;relationship between baseline characteristics, KAP, and seizure control\u003c/p\u003e\n\u003cp\u003eMale and female patients scored equally in knowledge (82.3% vs 81.1%), attitude score (62.9% vs 64.8%) while in practice score, Male respondents are mentioned with a more positive attitude than female respondents (100% vs 95.8%). Furthermore, 9(75%) of non-formally educated patients were to have poor knowledge of their illness but subsequently scored well on attitude and practice scores. The majority of primary educating patients (20:60.66%) were found to have poor practice. Employed studied patients scored 87.9% on knowledge score compared to 57.9% for unemployed patients, while they were approximately scored equally in attitude (98.9% vs 95%) and practice scores (64.9% vs 70%). For patients who had epilepsy more than 30 years were found to be more knowledgeable (87.5% vs 82.4%), had a positive attitude (100% vs 97.6%), and good practice (87.5 % vs 62.4%) than patients that lived less than 30 years with epilepsy. The statistical significance was observed between education and knowledge scores(P-value\u0026lt;0.001), education and practice score(P-value=0.015), and occupation and knowledge score (P-value=0.002). Overall patients who were female, primary educated, and had disease less than 30 years were less likely to have the knowledge, a positive attitude, and good practice but I was not statistically significant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll these results are discussed extensively in table 6 below.\u003c/p\u003e\n\u003cp\u003eTable 6. Relationships between baseline characteristics and knowledge, attitude, and practice\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 203px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKnowledge\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAttitude\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePractice\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cem\u003eGood\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cem\u003ePoor\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ePositive\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cem\u003eNegative N\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cem\u003eGood\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cem\u003ePoor\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(%)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 51\u003c/p\u003e\n \u003cp\u003e(82.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 11\u003c/p\u003e\n \u003cp\u003e(17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.248\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e(62.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e(37.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.858\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003cp\u003e(81.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e(16.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003cp\u003e(95.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e(64.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e(35.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo formal education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e(75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e(76.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e(69.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e(30.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e(93.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(39.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e20 (60.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e(90.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e(9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e(97.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e(67.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(32.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUniversity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003cp\u003e(73.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e(26.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostgraduate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(76.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e(23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnemployed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e(57.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e(42.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e(95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e(70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e(30%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.419\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployed\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e(87.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(12.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003cp\u003e(98.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e(64.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(35.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e(75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousewife\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(82.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(17.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e(96.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(55.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(44.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRetired\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDisease Duration\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le; 30years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e103 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e22 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e122 (97.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(62.4 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e47 (37.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;30 years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e4.6.\u0026nbsp;Relationship between Seizure control and Knowledge, attitude, and practice\u003c/p\u003e\n\u003cp\u003eAs represented in table 7, Out of 110 patients with good knowledge about their disease, 75(68.2%) had good seizure control. And of 130 who had scored with a positive attitude, 83 (63.8%) were found to have good seizure control. Meanwhile, most patients with good practice (63.5%) had also good seizure control. In otherwise, nearly half the patients with poor knowledge (52.2%) were stated as having poor seizure control. In contrast, the majority of patients with a negative attitude (100%) and poor practice (66.7%) were found to have good seizure control. But there was no statistically significant difference between knowledge, attitude and practice, and seizure control.\u003c/p\u003e\n\u003cp\u003eTable 7. Relationship between knowledge, attitude and practice and seizure control\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSeizure control\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGood\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eN (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePoor\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eN (%)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;Knowledge score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGood Knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(68.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e(31.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePoor Knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e(47.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e(52.2 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; Attitude score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePositive attitude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003cp\u003e(63.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e(36.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.552\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNegative attitude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp;Practice score\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGood practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003cp\u003e(63.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e(36.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePoor practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e(66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"5. DISCUSSION","content":"\u003cp\u003e5.1. Results Discussion\u003c/p\u003e\n\u003cp\u003eOur study was conducted to evaluate the knowledge, attitude, and practice of epileptic adult patients attending pharmacies, and neurological clinics in Lebanon using validated collecting data tools and finally to determine the relevance of seizure control and analyse its relationship with knowledge, attitude, and practice. There are no similar studies conducted neither in Lebanon nor in other Arab countries to compare results with ours. Meanwhile, several studies worldwide have shown that knowledge, attitude, and practice are key factors to deal with epilepsy. Our patients had chronic epilepsy and the majority of them were young adults (36.53\u0026plusmn;13.513), approximately equally distributed between Lebanese governorates, the majority of them were female, employed, with a moderate level of income and higher literacy rate. A demographic characteristics summary of previous similar studies is shown in Table 8\u0026nbsp;to compare results with the current study.\u003c/p\u003e\n\u003cp\u003eTable 8. Demographic characteristics summary of previous similar studies\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"599\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor(s)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eRegion\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eyear\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUdaya Seneviratne et al\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSri Lanka\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2002\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMGouri-Devi et al\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eIndia\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2010\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eYousuf RM et al\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMalaysia\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2017\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e55%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e51.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e45%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e48.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e10-30: 59.9%\u003c/p\u003e\n \u003cp\u003e31-50: 30.9%\u003c/p\u003e\n \u003cp\u003e51-70: 8.2%\u003c/p\u003e\n \u003cp\u003e\u0026gt;70: 1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026lt;30: 69.2%\u003c/p\u003e\n \u003cp\u003e31-45: 27.5%\u003c/p\u003e\n \u003cp\u003e46-60: 3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026lt;20:18.9%\u003c/p\u003e\n \u003cp\u003e20-40: 59.09%\u003c/p\u003e\n \u003cp\u003e41-60: 17.42\u003c/p\u003e\n \u003cp\u003e\u0026gt;60: 4.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e89.4%\u0026lt; grade 10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eIlliterate:24.2%\u003c/p\u003e\n \u003cp\u003eSchool 64.2%\u003c/p\u003e\n \u003cp\u003eGraduate and above: 5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNo formal Education: 8.3%\u003c/p\u003e\n \u003cp\u003ePrimary:15.2%\u003c/p\u003e\n \u003cp\u003eSecondary: 61.4%\u003c/p\u003e\n \u003cp\u003eUniversity:15.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e54.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e43.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e37.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e32.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e43.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003eStudents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e13.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e30.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e17.$%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eIncome\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eLow:90.8%\u003c/p\u003e\n \u003cp\u003eMiddle:9.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMarital status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eMarried: 50.8%\u003c/p\u003e\n \u003cp\u003eUnmarried: 49.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eMarried:37.1%\u003c/p\u003e\n \u003cp\u003eSingle:62.1%\u003c/p\u003e\n \u003cp\u003eWidowed: 0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWe found that most of the respondents are knowledgeable (82.5%), have a good practice (63.9%), positive attitude (79.7%), and good seizure control (68.2%) irrespective of their age, gender, and disease duration (p-value were not significant). \u0026nbsp; The possible reason behind these convenient results could be the high educational level of our sample, where up to 65.7% have achieved a minimum of secondary education. This is proved by the positive association found between the educational level of our patients and their knowledge toward their disease on one hand (p \u0026lt; 0.001), and their practice in another hand (p=0.015). Realizing the importance of education opens doors to gain knowledge, which helps in guiding a better sense of right from wrong.\u003c/p\u003e\n\u003cp\u003eA KAP assessment study, M Gourie-Devie et al (13), found to have relatively comparable results in terms of knowledge, where we can see that the most common answer in the two samples was brain neuron disturbances when asked about the cause of epilepsy (35.1% vs 55% for Indian sample), and also similar percentage (10.95% % in our study sample and 14.2% in the other study sample) answered that epilepsy is a mental disorder. On the other hand, regarding also the epilepsy definition, only 6.7 % in our study sample believed that epilepsy is caused by supernatural power versus 16.7 % in the Indian study sample and only a small group in the two samples doe believe in traditional faith healers (only 25.4% in our study sample versus 19.2% in the comparable study). And when asked about epilepsy transmitting, only 1 patient (0.8%) in the other study thought that epilepsy is contagious whereas 7 patients (5.2 %) do have these thoughts. \u0026nbsp;About treatment, a good percentage in both studies believe that their disease is treatable with modern drugs (85.1% vs 91.7%). Similar attitude results are also seen between the two studies, where most of the two samples believe that epileptic patients can have children (93.3% vs 92.5 %), can study (87.3% vs 80.8%), and can effectively work (96.3% vs 90.8%). Moving to the practice field, some percentages make difference in the two groups, for example, only 1 patient (0.8%) in our study population rely on smelling a shoe during seizure attack versus 15 patients (12.5%) in the other study. But despite this small gap, going to the hospital, remain the first to do after seizure attacks (33.8 vs 96%). In summary, M Gourie-Devie et al had found similar results to our study in the Indian population (good knowledge, good attitude, good practice), knowing that the sample study had similar demographic characteristics to ours; beginning with the age, where around 83 (69.2%) of this study population is below 30, versus 76(56.7%) of our sample is between 18-36, so the majority of the two sample populations are known to be young adults, moving to the socioeconomic status, where the population is classified to have low to moderate-income, which is close to the Indian sample where the majority is found to get a low income (90.8%) and finally, regarding the education, \u0026nbsp;the two studies show also very comparable results, so we can find that around 74 % of our population and around 77% of the other study sample have attained a base of primary education. The only two differences in the demographic characteristics are the occupation and the gender, where our sample is found to be almost half female half male, whereas most of the second study patients (62%) are males, and the majority of our patients are employed (58%) versus 28% in the Indian sample.\u003c/p\u003e\n\u003cp\u003eOur positive knowledge results were not seen in the Yousef RM et al study (14), where 90.9% were unaware about their disease cause, regardless of age, educational background, or disease duration. \u0026nbsp;On the other hand, results were comparable for attitude and practice questions.\u003c/p\u003e\n\u003cp\u003eTable 9 below is a review comparing the results with previous studies.\u003c/p\u003e\n\u003cp\u003eTable 9. Comparison of results between studies\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"611\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2623%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor(year)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSample size\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eRegion\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.18033%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCause of Disease\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.83607%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEpilepsy is curable\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEpilepsy can be treated by medication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4918%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBelieving in Faith healers\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9836%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTake regular treatment\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.34426%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eRegular follow up\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.9672%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCause of Relapse\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8033%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePractice in case of attacks\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2623%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCurrent study\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.18033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.5 % Brain disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.83607%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e79.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e85.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4918%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e25.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9836%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e91.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.34426%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e87.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.9672%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e26.3% due to non-compliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33.8 % go the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2623%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eYousef RM et al (2017)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e132 Malaysia\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.18033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e90.9% don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.83607%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e97.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e93.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4918%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e22.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9836%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e97.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.34426%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e90.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.9672%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e76% due to non -compliance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.8% Go to the hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2623%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUdaya Seneviratne et al (2002)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e207\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSri Lanka\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.18033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41.5% Brain disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.83607%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e71%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4918%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9836%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.34426%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.9672%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2623%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eGizat Kassie et al (2014)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e180\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthiopia\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.18033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32.2%\u003c/p\u003e\n \u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.83607%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 36.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4918%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9836%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.34426%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.9672%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8033%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e53.33% Positioning\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eUdaya Seneviratne ET al\u0026nbsp;(12)\u0026nbsp;found that the majority of Sri Lanka patients are male 55%, ranging between 10 to 30 years old (59.9%), Their education level was low, up to 89% in contrast to Lebanese epileptic patients that this current study showed a high level of education (up to 65% were educated). A large part of them was unemployed (54.1%). In contrast, in this study, most epileptic Lebanese patients (58.2 %) were employed. In Contra wise to our results, the majority here were on monotherapy (75.4% vs 49.3%) with carbamazepine the major drug choice (48.3% vs 34. 9%). Most of their respondents had also a positive attitude as in the Lebanese sample (75.8 vs 97.7%); where Lebanese patients had a remarkable high attitude; and good seizure control, whereas they appeared to have bad knowledge despite the similar level of literacy to our study sample. Also, in contrast to this study, a large group of their patients does believe in spiritual healers.\u003c/p\u003e\n\u003cp\u003eIn Gizat Kassie et al study (15), like our study sample, most of the patients (58%) are young adults between 20 and 35 years old, with low income (74%). \u0026nbsp;Regarding occupation status, both samples are employed in the majority, but the noticeable in the Ethiopian sample is that the majority employed specifically farmers (28.28%). \u0026nbsp;Two demographic differences exist between the two samples, where our sample is almost half male (47%), half female (53.0%), whereas most are male in the other study (40%), and most of our study is married (56%) whereas most of the second study is single (32.2%). The two samples are also comparable in terms of education where our sample as already discussed (30.6%) have achieved a minimum of secondary education, and in the other study, 22.22% of the Ethiopian sample had achieved a level between grad1 \u0026ndash; grad8. A big difference is also in the disease duration recordings, where our patients tend to have a mean of 16.36 years of epilepsy duration, much longer than the Ethiopian sample when the majority suffer from epilepsy for only 1-5 years. \u0026nbsp;As a result of knowledge scoring, the two samples tend to know, in the majority, that epilepsy is a disease of the brain (53.1% vs 74.44%). On the other hand, for practice results, the highest percentages are seen for positioning where most of our study tend to go to the hospital, and what was remarkable is that none of the patients rely on praying in this situation, while a small percentage in our study (16.5%) do believe in praying. \u0026nbsp;Overall, like our sample, the Ethiopian sample has an acceptable treatment knowledge (60%), a positive attitude (70%), and good practice (53.3%). Also, the association analysis done separately between knowledge and attitude with the demographic characteristics had shown not only that the knowledge is positively associated with educational level in our study, but also with age, income, and duration of the disease. In contrast to this study, the attitude was found to be associated with several variables (age, gender, literacy, mental status, and income).\u003c/p\u003e\n\u003cp\u003eThe studies mentioned above could demonstrate that education is not the only variable affecting knowledge, which could be affected by many other factors, such as the social cultures, religious background, technological facilities that facilitate internet access, and the research about the disease process.\u003c/p\u003e\n\u003cp\u003e5.2. Cofactors of KAP\u003c/p\u003e\n\u003cp\u003eWhen managing an individual living with epilepsies there are unmodifiable factors such as the age of onset, etiology of the disease, and its pattern. Besides, despite adequate medication, it has been found that seizures will persist. It is necessary therefore to identify other modifiable factors that could improve seizure control in our patient population.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKnowledge can be defined as awareness or understanding of facts which is acquired through experience and education perceiving. Many factors may influence the knowledge of patients toward their illness: their socioeconomic status, education, and interaction with health care providers. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhen reinforcing these factors, we will strengthen respectively their knowledge. \u0026nbsp; As a knowledge, additional factors affect also the attitude and practice of patients; mainly highlighted in low and middle-income countries; as the stigma, religious beliefs, lack of psychosocial support, Health care assistance, and health awareness clubs. Because of these precipitating factors, epileptic patients may become victims due to their misconceptions about the disease.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e5.3. Recommendations:\u003c/p\u003e\n\u003cp\u003eWe recommend the development of a standardized comprehensive association to raise awareness about epilepsy and educate patients about their disease cause, treatment, the necessity of taking treatment on daily basis, how to deal with epilepsy attacks and their rights to be incorporated into society. And we recommend further studies on other factors that may contribute to knowledge, attitude, practice, and seizure controls.\u003c/p\u003e\n\u003cp\u003e5.4. Strengths and Limitations\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study is the first to record the knowledge, attitude, and practice of adult epileptic patients in Lebanon. The results of our study can aid the regulatory and consultative agencies in helping epileptic patients to deal with their conditions.\u003c/p\u003e\n\u003cp\u003eOur study has several limitations. First, our sample size is less than the number calculated as discussed in the methods part. The pharmacies and neurologic clinics for recruitment are chosen by convenience, which can be considered as a second limitation. Additionally, because it is time-consuming, and because of some critical questions (information Bias), we couldn\u0026rsquo;t use the structured questionnaire, and new assumptions were made to overcome this barrier.\u003c/p\u003e"},{"header":"6. CONCLUSION","content":"\u003cp\u003eThe Lebanese patients suffering from epilepsy had basic good knowledge, attitude, and practice towards their disease with good seizure control. Meanwhile, the seizure control was not associated with the knowledge, attitude, and practice of the patient toward their disease, whereas a remarkable association was found between the education level of patients and their knowledge and their practice.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eKAP: knowledge, attitude, and practice\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eILAE: International league of epilepsy association\u003c/p\u003e\n\u003cp\u003eCBZ: Carbamazepine\u003c/p\u003e\n\u003cp\u003ePA: Valproic acid\u003c/p\u003e\n\u003cp\u003eLEV: Levetiracetam\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethical Committee of the Lebanese International University. Oral consent was obtained from all patients participating in the study. Given the nature of the study, the Ethics Committee waived the requirement for written consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNada Kassem, Soumaya Houssein and Iqbal Fahs conceived and designed the study.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIqbal Fahs and Marwan Akel assisted with data collection, reviewed and revised the manuscript.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNada Kassem and Soumaya Houssein Were responsible for the data collection, entry organization, assisted with data analysis, data curation and contributed to manuscript writing.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNada Kassem performed statistical analysis, interpreted results, writing and revised the final draft of the manuscript.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNathalie Lahoud provided critical insights on study design and methodology.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors reviewed and approved the final manuscript and agreed to be accountable for all aspects of work.\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDefinition of Epilepsy 2014 // International League Against Epilepsy [Internet]. [cited 2019 May 19]. Available from: https://www.ilae.org/guidelines/definition-and-classification/definition-of-epilepsy-2014\u003c/li\u003e\n\u003cli\u003ePresentation Illustrating the 2014 Definition of Epilepsy.pdf [Internet]. [cited 2019 May 19]. Available from: https://www.epilepsy.com/sites/core/files/atoms/files/Presentation%20Illustrating%20the%202014%20Definition%20of%20Epilepsy.pdf\u003c/li\u003e\n\u003cli\u003eEpilepsy [Internet]. [cited 2019 May 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsy\u003c/li\u003e\n\u003cli\u003eEpilepsy Statistics | Epilepsy Foundation [Internet]. [cited 2019 May 19]. Available from: https://www.epilepsy.com/learn/about-epilepsy-basics/epilepsy-statistics\u003c/li\u003e\n\u003cli\u003eWorld Health Organization, editor. Epilepsy in the WHO Eastern Mediterranean region: bridging the gap. Cairo, Egypt: World Health Organization, Regional Office for the Eastern Mediterranean; 2010. 30 p. \u003c/li\u003e\n\u003cli\u003eIntroduction | Epilepsy Across the Spectrum: Promoting Health and Understanding | The National Academies Press [Internet]. [cited 2019 May 19]. Available from: https://www.nap.edu/read/13379/chapter/3#25\u003c/li\u003e\n\u003cli\u003eAbout SUDEP: A Deadly Result of Uncontrolled Seizures [Internet]. Epilepsy Foundation. [cited 2019 May 19]. Available from: https://www.epilepsy.com/aimforzero/about-sudep\u003c/li\u003e\n\u003cli\u003eGlobal Campaign against Epilepsy, International Bureau of Epilepsy, International League against Epilepsy, editors. Atlas: epilepsy care in the world. Geneva: Programme for Neurological Diseases and Neuroscience, Department of Mental Health and Substance Abuse, World Health Organization; 2005. 91 p. \u003c/li\u003e\n\u003cli\u003eThe global burden and stigma of epilepsy - ScienceDirect [Internet]. [cited 2019 May 19]. Available from: https://www.sciencedirect.com/science/article/pii/S1525505007004878\u003c/li\u003e\n\u003cli\u003eThe Treatment Gap in Epilepsy: The Current Situation and Ways\u0026emsp;Forward - Meinardi - 2001 - Epilepsia - Wiley Online Library [Internet]. [cited 2019 May 19]. Available from: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2001.32800.x\u003c/li\u003e\n\u003cli\u003eMcLin WM, Boer HM de. Public Perceptions About Epilepsy. Epilepsia. 1995 Oct 1;36(10):957\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eSeneviratne U, Rajapakse P, Pathirana R, Seetha T. Knowledge, attitude, and practice of epilepsy in rural Sri Lanka. Seizure. 2002 Jan;11(1):40\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eGourie-Devi M, Singh V, Bala K. Knowledge, attitude and practices among patients of epilepsy attending tertiary hospital in Delhi, India and a review of Indian studies. Neurology Asia. 2010;8. \u003c/li\u003e\n\u003cli\u003eRathor D, Shahar MA, Omar A, SM Shah A, Hasmoni M, Draman C, et al. Assessment of Knowledge, attitude and practices of Epilepsy Patients\u0026rsquo; towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia. Bangladesh Journal of Medical Science. 2017 Aug 19;16:545. \u003c/li\u003e\n\u003cli\u003eKassie, G. M., Kebede, T. M., \u0026amp; Duguma, B. K. (2014). Knowledge, Attitude, and Practice of Epileptic Patients Towards Their Illness and Treatment in Jimma University Specialized Hospital, Southwest Ethiopia. \u003cem\u003eNorth American Journal of Medical Sciences\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(8), 383\u0026ndash;390. https://doi.org/10.4103/1947-2714.139288\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"The Epilepsy Patient Knowledge Profile (EPQK), Epilepsy Beliefs and Attitudes tool (KEBAS), Neuropsychological assessment","lastPublishedDoi":"10.21203/rs.3.rs-4979174/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4979174/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e Epilepsy is the fourth most prevalent neurological disorder accounting for more than 50 million cases worldwide. Religious and sociocultural beliefs influence the nature of treatment and care received by epileptic patients. According to the World Health Organization (WHO), almost 94% of epileptic patients in developing nations are not taking the appropriate therapy to control their seizure leading to a higher incidence of lifelong active epilepsies in these regions. With no related data in Lebanon, this study sought to assess the knowledge, the attitude, and the practice towards epilepsy among adult Lebanese epileptic patients and the associated factors\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eThis was a cross-sectional descriptive study approved by the ethical committee at the Lebanese international university. The sample was drawn randomly from community pharmacies based on stratified cluster sampling and the strata were the six districts of Lebanon. Sixty community pharmacies constituted the primary sampling units, and ten pharmacies were randomly selected from the districts using the Research Randomizer computer program. Patients aged eighteen years and above with at least two years of diagnosis with epilepsy, who came for normal medications or para-pharmaceuticals were enrolled in the study. The enrolled participants were directly interviewed by the clinical pharmacists after providing their oral informed consent. The data collection sheet was established based on validated and standardized questionnaires including The Epilepsy Patient Knowledge Profile (EPQK) and The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS). Data were analysed using the Statistical Package of the Social Sciences software (SPSS, version 21).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA Total of 134 epileptic patients (53% females, 47% males) with a mean age of 36.53 ± 13.15 years were included in this study. Most respondents had attained a minimum of secondary school education (91.3%). The most-reported seizure type was generalized seizure (26%). Approximately 64% of the studied patients had good seizure control. Most of the patients had good knowledge (82%) and a positive attitude (98%) toward their disease with almost two-thirds having a good practice (63%) as well. There were no statistically significant associations between the level of knowledge, attitude, or practice with seizure control (p= 0.14, p=1 and p=0.25, respectively). However, a statistically significant association was identified between the knowledge and educational level (p\u0026lt;0.001), Knowledge and Occupation, and between Practice and the educational levels of patients (P=0.015).\u003c/p\u003e","manuscriptTitle":"Knowledge, attitude and practice among adult Lebanese patients with epilepsy and impact on seizure control: a cross sectional descriptive study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-17 09:25:04","doi":"10.21203/rs.3.rs-4979174/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"20000a37-5738-4f6d-9ace-298f602ac1f5","owner":[],"postedDate":"October 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-24T16:10:38+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-17 09:25:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4979174","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4979174","identity":"rs-4979174","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}