Epilepsy-related stigma in Nigeria: A systematic review of manifestations, impacts, and socio-cultural drivers

Background: Stigma poses significant challenges to the overall quality of life of people living with epilepsy (PLWE) in Nigeria; yet, there remains a limited understanding of the stigmatisation of PLWE. Objectives: Guided by critical theory, the purpose of this systematic review is to synthesise evidence on the nature, impact, and socio-cultural drivers of epilepsy-related stigma in Nigeria. This review attempts to provide insights that could be useful for informing interventions to empower PLWE, reduce their burdens, improve their outcomes, and foster their inclusion in the Nigerian society. Method: Literature search was conducted using six electronic databases - APA PsycINFO, Google Scholar, JSTOR, MEDLINE, PubMed, and Scopus - to identify relevant studies published between 2011 and 2024. Qualitative and quantitative studies were included. A total of 10 studies met the inclusion criteria and were analysed using thematic and narrative syntheses. Results: The findings revealed that stigma is a multi-dimensional issue encompassing perceived, enacted, and internalised forms. Cultural misconceptions such as beliefs associating epilepsy with witchcraft, curses, and contagion were found to be the primary drivers of stigma. Economic barriers, gender-specific vulnerabilities, and social exclusion further perpetuate discrimination and healthcare disparities. Stigma is associated with social determinants of health, such as education, employment, and gender, to limit opportunities and quality of life for PLWE. Conclusion: This study highlights that stigma adversely affects PLWE, perpetuating marginalisation, social isolation, and healthcare inequalities. Contribution: Urgent action is required to implement culturally sensitive interventions, enhance healthcare policies, and increase awareness to address stigmatisation, ensuring equitable treatment and access.