Abstract Details

Title Knowledge, Attitudes, and Practices Surrounding Seizures in a Rural Tz’utujil Maya Community in Guatemala

Topic General Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-016

Objective To describe community-level knowledge, attitudes, and practices regarding seizures in a Tz'utujil Mayan population.

Background Epilepsy is the most reported neurological disorder worldwide[1], yet its prevalence in Guatemala is unknown. In Latin America, people with epilepsy face a higher mortality risk than the general population. To expand equitable access to care for patients with seizures, it is necessary to understand how they are perceived in underrepresented regions.

Design/Methods A pilot qualitative study of twenty-five interviews was conducted in Spanish with a Tz’utujil interpreter in the Atitlan region of Guatemala. Community members were identified through a snowball sampling method with the help of a trusted local hospital. Interviews modeled on the Kleinman explanatory model of illness assessed knowledge, beliefs, and attitudes surrounding seizures. Recorded interviews were transcribed and translated into English. Two reviewers analyzed and coded each interview using a consensus-based coding framework.

Results Almost 80% of participants were familiar with epilepsy or seizures. Most of the interviewees describe seizures as loss of consciousness and bilateral limb shaking. In Tz’utujil, this is called Rex kimik, which translates to muerte verde in Spanish, or green death in English. Some interviewees attribute seizures to the brain, while others to strong emotions. Many participants fear seizures but do not believe they are contagious and would not avoid people with seizures. Some consider natural remedies and prayer as treatment options, choosing to offer comfort when witnessing a seizure instead of seeking emergency services. Many participants stated that high cost and limited access are barriers to seeking medical care.

Conclusions The Tz’utujil community was found to have strong cultural-religious beliefs about seizure etiology and treatment despite some Western medical knowledge. More cross-cultural investigation is needed to better understand how people in rural Mayan communities approach seizures. This can enable community-hospital partnerships to improve knowledge about seizures and other neurologic disorders.

Authors/Disclosures
Bibiana Valhuerdi Porto, MD PRESENTER	Dr. Valhuerdi Porto has nothing to disclose.
Camelia Valhuerdi Porto, MD (Tufts Medical Center)	Dr. Valhuerdi Porto has nothing to disclose.
Jesse F. Martinez-Kratz, MPH	Mr. Martinez-Kratz has nothing to disclose.
Alana M. Fretes Burgos, MD (Tufts Medical Center)	Dr. Fretes Burgos has nothing to disclose.
Jasmine Bagnas	Miss Bagnas has nothing to disclose.
Maria J. Aleman, MD	Ms. Aleman has received personal compensation in the range of $0-$499 for serving as a Co-Director of Internal Operations with The Clinical Problem Solvers.
Anamika Shrimali	Miss Shrimali has nothing to disclose.
Aleksandra Yakhkind, MD (Tufts Medical Center)	Dr. Yakhkind has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LangAware. Dr. Yakhkind has received personal compensation in the range of $0-$499 for serving as a Consultant for AAN. Dr. Yakhkind has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Round Table Group. Dr. Yakhkind has received research support from Sara's Wish Foundation Global Health Grant. Dr. Yakhkind has received publishing royalties from a publication relating to health care. Dr. Yakhkind has a non-compensated relationship as a Faculty with Massachusetts General Hospital CME that is relevant to AAN interests or activities.

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