title: The importance of people compliance (social desirability bias) in the assessment of epilepsy prevalence in rural areas of developing countries. Results of the Atahualpa Project.
abstract: Epilepsy is a major health issue in rural areas of developing countries. However, heterogeneity of epilepsy prevalence in different studies precludes assessment of the magnitude of the problem. Using similar protocols, two population-based surveys were conducted 12 years apart (2003 and 2015) in a rural Ecuadorian village (Atahualpa). The only difference was a higher people compliance with interviewers during the second survey. Epilepsy prevalence in the 2003 survey was 13.5 per 1,000 (18/1,332) in villagers aged ≥20 years. This rate increased to 26.8 per 1,000 (41/1,530) in the 2015 survey. Thirty-three persons with epilepsy detected during the second survey lived in the village in 2003; six of them had seizures starting after 2003. Of the remaining 27 cases, 13 (48%) denied their problem during the first survey. Further interview revealed that denial was related to lack of confidence with unacquainted field personnel. Social Desirability Scale-17 scores were lower in those who admitted having epilepsy than in those who denied their condition (p = 0.048). Lack of confidence with interviewers and a social desirability bias account for a sizable proportion of epilepsy denial in the study population, and may explain heterogeneity of epilepsy prevalence reported in studies conducted in poor rural settings.
authors: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador.
authors: Oscar H
authors: OH
authors: Del Brutto
authors: Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
authors: Robertino M
authors: RM
authors: Mera
mesh_terms: D000328:Adult; D018672:Community Health Planning; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004484:Ecuador / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D012424:Rural Population; D012928:Social Desirability; D055815:Young Adult
keywords: Developing countries; Ecuador; Epilepsy prevalence; Population study; Social desirability bias