{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:59:56Z","timestamp":1774364396005,"version":"3.50.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Eclampsia is among the primary causes of maternal and perinatal morbidity and mortality in Zanzibar. Many women and men are not aware of the signs, symptoms and causes of eclampsia and may have different explanatory models. Therefore, this study aimed to describe the community understanding of pre-eclampsia, as a key stage to improve maternal and perinatal health in Unguja Island, Zanzibar.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A qualitative study design of six focus group discussions (FDGs) was performed using a focus group interview guide; 51 male and female <jats:bold>r<\/jats:bold>espondents at three selected wards of Unguja Island, Zanzibar participated. Thematic analysis was applied using Qualitative data analysis (QDA Miner Lite software version 2.0.9).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall participants demonstrated a lack of understanding regarding eclampsia. The majority of participants perceived that there are certain things related to eclampsia: Mjusi or Mdudu (devil\/satanic), superstitious issues, tension\/stress from partners, food consumption, eating slaughtered meat like chicken, cow and goat during pregnancy, nice smelling lotion, soap and perfumes have been stated to be the causes of eclampsia. Spiritual and traditional remedies were mentioned as a treatment for eclampsia, including herbs, makombe (written verses of the Qur\u2019an) and steaming (smoked dry leaves). Local names of eclampsia used by the communities, in urban and rural areas are mjusi (lizard) or mdudu (bug), which means the devil enters a woman\u2019s body, especially during pregnancy or within 42 days post-delivery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Most participants had a lack of understanding of eclampsia and perceived that there are traditional and spiritual issues related to its causes, attributed risks and clinical presentation, which makes them rely more on traditional and spiritual treatments. Therefore, health educational programs in the community setting and at the antenatal clinics, aiming at improving knowledge and dismissing myths and misperceptions regarding eclampsia, are recommended in rural and urban areas of Unguja Zanzibar.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313536","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T18:32:58Z","timestamp":1736965978000},"page":"e0313536","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Knowledge of and perception towards eclampsia among women and men in Unguja Island, Zanzibar: A qualitative study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0148-3262","authenticated-orcid":true,"given":"Nassra Is-hak","family":"Yussuf","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-6620","authenticated-orcid":true,"given":"Jelle","family":"Stekelenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Johnson","family":"Mahande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel Nathaniel","family":"Manongi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"issue":"03","key":"pone.0313536.ref001","doi-asserted-by":"crossref","DOI":"10.26502\/aimr.0122","article-title":"Knowledge and Myths about Preeclampsia and Eclampsia and its Influence on Antenatal Service Utilization among Pregnant Women and their Male Partners in Mtwara Regional\u2014Tanzania: A Cross Sectional Analytical Study","volume":"05","author":"A S Machenje","year":"2022","journal-title":"Arch Intern Med Res"},{"issue":"March","key":"pone.0313536.ref002","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.preghy.2019.03.007","article-title":"Hypertensive disorder of pregnancy prevalence and associated factors among pregnant women attending ante natal care at Gondar town health Institutions, North West Ethiopia 2017","volume":"16","author":"TA Walle","year":"2019","journal-title":"Pregnancy Hypertens"},{"key":"pone.0313536.ref003","doi-asserted-by":"crossref","DOI":"10.3390\/jcdd5010003","article-title":"Pre-eclampsia and eclampsia: An update on the pharmacological treatment applied in Portugal","volume":"5","author":"GM Peres","year":"2018","journal-title":"Journal of Cardiovascular Development and Disease"},{"key":"pone.0313536.ref004","doi-asserted-by":"crossref","first-page":"242","DOI":"10.12688\/f1000research.12249.1","article-title":"Recent advances in the diagnosis and management of pre-eclampsia","volume":"7","author":"K Duhig","year":"2018","journal-title":"F1000Research"},{"issue":"1","key":"pone.0313536.ref005","first-page":"1","article-title":"Maternal mortality Evidence brief","author":"WHO","year":"2019","journal-title":"Matern Mortal"},{"issue":"August 2017","key":"pone.0313536.ref006","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.preghy.2017.11.006","article-title":"Prediction of adverse maternal outcomes from pre-eclampsia and other hypertensive disorders of pregnancy: A systematic review","volume":"11","author":"UV Ukah","year":"2018","journal-title":"Pregnancy Hypertens"},{"issue":"1","key":"pone.0313536.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40885-021-00178-y","article-title":"Prevalence and materno-fetal outcomes of preeclampsia\/eclampsia amongst pregnant women at a teaching hospital in north-central Nigeria: a retrospective cross-sectional study","volume":"27","author":"GO Akaba","year":"2021","journal-title":"Clin Hypertens"},{"key":"pone.0313536.ref008","first-page":"1","article-title":"Perceptions on preeclampsia and eclampsia among senior, older women, in rural Southwestern Uganda","volume":"5","author":"H Nabulo","year":"2021","journal-title":"J Glob Health Rep"},{"issue":"9","key":"pone.0313536.ref009","doi-asserted-by":"crossref","first-page":"3937","DOI":"10.18203\/2320-1770.ijrcog20174039","article-title":"Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre","volume":"6","author":"SS Pillai","year":"2017","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"issue":"1","key":"pone.0313536.ref010","article-title":"Community\u2019s perceptions of pre-eclampsia and eclampsia in Sindh Pakistan: A qualitative study","volume":"13","author":"AR Khowaja","year":"2016","journal-title":"Reprod Health"},{"issue":"1","key":"pone.0313536.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-018-1972-1","article-title":"Screening and management of pre-eclampsia and eclampsia in antenatal and labor and delivery services: Findings from cross-sectional observation studies in six sub-Saharan African countries","volume":"18","author":"B Rawlins","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"issue":"8 August","key":"pone.0313536.ref012","first-page":"1","article-title":"Perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia: A qualitative study","volume":"17","author":"M Mekie","year":"2022","journal-title":"PLoS ONE"},{"issue":"1","key":"pone.0313536.ref013","article-title":"Community perceptions of pre-eclampsia and eclampsia in Ogun State, Nigeria: A qualitative study","volume":"13","author":"DO Akeju","year":"2016","journal-title":"Reprod Health"},{"issue":"October","key":"pone.0313536.ref014","first-page":"1","article-title":"Maternal mortality in urban and rural Tanzania: Social determinants and health system efficiency","author":"J Shabani","year":"2018","journal-title":"Int Growth Cent"},{"issue":"2","key":"pone.0313536.ref015","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5897\/IJMMS2017.1343","article-title":"Determination, knowledge and prevalence of pregnancy-induced hypertension\/eclampsia among women of childbearing age at Same District Hospital in Tanzania","volume":"10","author":"DE Ejike","year":"2018","journal-title":"Int J Med Med Sci"},{"issue":"2","key":"pone.0313536.ref016","article-title":"Assessment of Maternal Mortality and its Associated Causes at Shinyanga Regional Hospital in Tanzania","volume":"4","author":"OE Mapunda","year":"2016","journal-title":"Womens Health Bull"},{"issue":"2","key":"pone.0313536.ref017","doi-asserted-by":"crossref","first-page":"412","DOI":"10.4314\/ahs.v16i2.9","article-title":"Knowledge of pre-eclampsia in women living in Makole Ward, Dodoma, Tanzania","volume":"16","author":"AR Savage","year":"2016","journal-title":"Afr Health Sci"},{"issue":"1","key":"pone.0313536.ref018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-09384-z","article-title":"Prevalence and risk factors associated with severe pre-eclampsia among postpartum women in Zanzibar: A cross-sectional study","volume":"20","author":"MM Machano","year":"2020","journal-title":"BMC Public Health"},{"key":"pone.0313536.ref019","author":"K Yeates","journal-title":"\u2018They say she is bewitched\u2019: A qualitative study of community and health provider perspectives regarding pre-eclampsia and eclampsia in rural Tanzania"},{"issue":"6","key":"pone.0313536.ref020","doi-asserted-by":"crossref","first-page":"e0234257","DOI":"10.1371\/journal.pone.0234257","article-title":"A qualitative study on knowledge, perception, and practice related to non-communicable diseases in relation to happiness among rural and urban residents in Bhutan","volume":"15","author":"H Kohori-Segawa","year":"2020","journal-title":"PLOS ONE"},{"issue":"1","key":"pone.0313536.ref021","article-title":"Community perceptions of pre-eclampsia in rural Karnataka State, India: A qualitative study","volume":"13","author":"M Vidler","year":"2016","journal-title":"Reprod Health"},{"issue":"1","key":"pone.0313536.ref022","article-title":"Community perceptions of pre-eclampsia and eclampsia in southern Mozambique","volume":"13","author":"H Boene","year":"2016","journal-title":"Reprod Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T18:33:09Z","timestamp":1736965989000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313536"}},"subtitle":[],"editor":[{"given":"Ghada Abdrabo Abdellatif","family":"Elshaarawy","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313536","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]}}}