Meta-analysis of epilepsy prevalence in West Africa and its relationship with onchocerciasis endemicity and control.
West Africa
epilepsy
ivermectin
onchocerciasis
prevalence
vector control
Journal
International health
ISSN: 1876-3405
Titre abrégé: Int Health
Pays: England
ID NLM: 101517095
Informations de publication
Date de publication:
01 05 2020
01 05 2020
Historique:
received:
29
10
2019
revised:
04
02
2020
accepted:
19
02
2020
pubmed:
7
3
2020
medline:
25
11
2020
entrez:
7
3
2020
Statut:
ppublish
Résumé
A high prevalence and incidence of epilepsy has been reported in onchocerciasis-endemic regions in Central and East Africa. There is compelling epidemiological evidence suggesting that this high burden is caused by onchocerciasis-associated epilepsy (OAE). We hypothesized that OAE had also occured in West African onchocerciasis foci. We searched PubMed, the African Journals Online platform and grey literature for population-based epilepsy studies in West African countries. Epilepsy and onchocerciasis prevalence data were extracted. The pre-control onchocerciasis endemicity in the study sites was estimated from historical data of onchocerciasis control programmes. The prevalence of epilepsy in different sites was analysed, taking into account onchocerciasis endemicity and the duration of control. The pooled prevalence of epilepsy in the West African study sites was 13.14 per 1000 (95% confidence interval 11.28-15.00). Higher pre-control endemicity and a shorter duration of onchocerciasis control were both associated with increased epilepsy prevalence (p<0.001). Two studies in Ivory Coast that provided detailed descriptions of persons with epilepsy in onchocerciasis-endemic settings revealed that most of them had features of OAE (73.7% and 83.3%, respectively). Our findings suggest that before and during the early years of implementing onchocerciasis control in West Africa, high onchocerciasis endemicity resulted in a high prevalence of OAE and that subsequent control efforts significantly reduced the prevalence of OAE.
Sections du résumé
BACKGROUND
A high prevalence and incidence of epilepsy has been reported in onchocerciasis-endemic regions in Central and East Africa. There is compelling epidemiological evidence suggesting that this high burden is caused by onchocerciasis-associated epilepsy (OAE). We hypothesized that OAE had also occured in West African onchocerciasis foci.
METHODS
We searched PubMed, the African Journals Online platform and grey literature for population-based epilepsy studies in West African countries. Epilepsy and onchocerciasis prevalence data were extracted. The pre-control onchocerciasis endemicity in the study sites was estimated from historical data of onchocerciasis control programmes. The prevalence of epilepsy in different sites was analysed, taking into account onchocerciasis endemicity and the duration of control.
RESULTS
The pooled prevalence of epilepsy in the West African study sites was 13.14 per 1000 (95% confidence interval 11.28-15.00). Higher pre-control endemicity and a shorter duration of onchocerciasis control were both associated with increased epilepsy prevalence (p<0.001). Two studies in Ivory Coast that provided detailed descriptions of persons with epilepsy in onchocerciasis-endemic settings revealed that most of them had features of OAE (73.7% and 83.3%, respectively).
CONCLUSIONS
Our findings suggest that before and during the early years of implementing onchocerciasis control in West Africa, high onchocerciasis endemicity resulted in a high prevalence of OAE and that subsequent control efforts significantly reduced the prevalence of OAE.
Identifiants
pubmed: 32141502
pii: 5788427
doi: 10.1093/inthealth/ihaa012
pmc: PMC7320426
doi:
Substances chimiques
Ivermectin
70288-86-7
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
192-202Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
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