As documented by many authors, the social position of epileptics in ma
ny small scale societies of Africa is marginal at best, and is often c
haracterized by rejection, discrimination, even ostracism. Such negati
ve and noxious attitudes toward persons suffering from epilepsy are ro
oted in traditional beliefs about causes and nature of convulsive diso
rders and these have parallels in European history. This article focus
es on the psychosociocultural aspects and indigenous concepts of epile
psy, on popular attitudes towards, and social status of, sufferers fro
m epilepsy in a Tanzanian tribal population. The authors present a com
parative analysis of focus group discussions conducted with epileptics
and with matched controls in two isolated communities. In one communi
ty (Mahenge) a clinic for epilepsy has been operating for over 36 year
s, with a public education component during the last four years, where
as in the other community (Ruaha) epileptics have only been sporadical
ly treated in a small mission dispensary and people have had little op
portunity to learn about the nature and modern treatment of convulsive
disorders. The responses obtained in focus group discussions reflect
the significant change in notions about the illness, in the attitude t
oward and in the social status of epileptics in Mahenge, while the peo
ple of Ruaha still regard epilepsy as a typical ''African'' affliction
fraught with supernatural danger and not effectively treatable by mod
ern medicine. (C) 1997 Elsevier Science Ltd.