High prevalence of epilepsy in an onchocerciasis endemic health zone in the Democratic Republic of the Congo, despite 14 years of community-directed treatment with ivermectin: A mixed-method assessment.
Adolescent
Adult
Animals
Antibodies, Helminth
/ blood
Case-Control Studies
Child
Child, Preschool
Democratic Republic of the Congo
/ epidemiology
Epilepsy
/ epidemiology
Female
Focus Groups
Humans
Immunoglobulin G
/ blood
Ivermectin
/ therapeutic use
Male
Onchocerca volvulus
/ isolation & purification
Onchocerciasis
/ drug therapy
Prevalence
Rural Population
Seizures
/ epidemiology
Young Adult
Case–control
Epilepsy
Focus group discussion
Incidence
Ivermectin
Onchocerciasis
Prevalence
Stigma
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
06
09
2018
revised:
14
10
2018
accepted:
26
10
2018
entrez:
4
2
2019
pubmed:
4
2
2019
medline:
30
4
2019
Statut:
ppublish
Résumé
To investigate the reasons for the high prevalence of epilepsy (>6%) discovered in 2015 in the Aketi health zone in the north of the Democratic Republic of the Congo. Persons with epilepsy (PWE) diagnosed in a door-to-door survey in 2015 were traced and re-examined in 2017 by a neurologist. Confirmed PWE were paired with matched controls. For onchocerciasis assessment, children 7-10 years old were tested for IgG4 Onchocerca volvulus (OV16) antibodies, a rapid epidemiological mapping of onchocerciasis (REMO) study was performed, and ivermectin coverage was investigated. Forty-three (61.4%) previously diagnosed PWE were traced; the neurologist confirmed the epilepsy diagnosis in all of them. The overall OV16 positivity rate was 64.5%. Poor ivermectin coverage (55.9%) and a high prevalence of onchocercal nodules (>70%) were observed. The prevalence of epilepsy was 5.7% in Aketi rural town, with nine PWE (13.8%) experiencing head nodding seizures. A case-control study showed that PWE had lower body weight and higher ivermectin coverage in 2017 than healthy controls. The high prevalence of epilepsy in the Aketi health zone, despite 14 years of community-directed treatment with ivermectin (CDTI), was found to be associated with high onchocerciasis transmission and low ivermectin use. An awareness programme to increase ivermectin coverage and the introduction of a bi-annual CDTI programme should be considered.
Identifiants
pubmed: 30711145
pii: S1201-9712(18)34569-7
doi: 10.1016/j.ijid.2018.10.021
pmc: PMC6353816
pii:
doi:
Substances chimiques
Antibodies, Helminth
0
Immunoglobulin G
0
Ivermectin
70288-86-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
187-194Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
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