Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin.

IF 8.1 1区医学

Infectious Diseases of Poverty Pub Date : 2023-08-17 DOI:10.1186/s40249-023-01117-9

Kenneth Bentum Otabil, Blessing Ankrah, Emmanuel John Bart-Plange, Emmanuel Sam Donkoh, Fiona Amoabil Avarikame, Fredrick Obeng Ofori-Appiah, Theophilus Nti Babae, Prince-Charles Kudzordzi, Vera Achiaa Darko, Joseph Ameyaw, Joseph Gyekye Bamfo, Raji Abdul Sakibu, Daniel Antwi-Berko, Joseph Nelson Siewe Fodjo, María-Gloria Basáñez, Henk D F H Schallig, Robert Colebunders

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Abstract

Background: In onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission, a high prevalence of epilepsy has been reported. This study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration (MDA).

Methods: Between October 2020 and August 2021, cross-sectional surveys were conducted in nine communities in the Tain District and Wenchi Municipality of the Bono Region of Ghana. In the first stage, a random door-to-door approach was used to screen the population for epilepsy using a pre-tested questionnaire. Persons suspected of having epilepsy were invited for a second-stage neurological examination for case verification. Community O. volvulus microfilarial infection status and Ov16 seropositivity were also determined. Ninety-five confidence intervals (95% CI) for prevalence values were calculated using the Wilson Score Interval.

Results: Of the 971 participants, 500 (51.5%) were females, and the median age (interquartile range) was 26 (15‒43) years. Fourteen participants (1.4%, 95% CI: 1.0‒2.0) were diagnosed as having epilepsy with generalized seizures being the most frequent seizure type (85.7%, 12/14). The overall microfilarial prevalence of O. volvulus was 10.3% (November 2020) and 9.9% (August 2021); the Ov16 seroprevalence was 22.2% (June 2021). Only 63.2% took ivermectin in the last round of MDA distribution in March 2021.

Conclusions: The 1.4% prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan Africa. However, the persistent microfilarial prevalence and low ivermectin study coverage call for the Ghana Onchocerciasis Elimination Programme to step up its efforts to ensure that the gains achieved are consolidated and improved to achieve the elimination of onchocerciasis by 2030.

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在大规模使用伊维菌素27年后，加纳盘尾丝虫病流行中部地区的癫痫患病率。

背景:在盘尾丝虫病流行地区，据报道盘尾丝虫病传播率高，癫痫发病率高。本研究旨在确定实施伊维菌素大规模给药(MDA) 27年后加纳波诺地区癫痫的患病率和临床特征。方法:在2020年10月至2021年8月期间，在加纳博诺地区坦恩区和温池市的9个社区进行了横断面调查。在第一阶段，采用随机挨家挨户的方法，通过预先测试的问卷对人群进行癫痫筛查。怀疑患有癫痫的人被邀请进行第二阶段神经学检查，以核实病例。同时测定社区涡旋微丝虫感染状况和Ov16血清阳性。使用Wilson评分区间计算患病率值的95个置信区间(95% CI)。结果:971名参与者中，500名(51.5%)为女性，年龄中位数(四分位数间距)为26岁(15-43岁)。14名参与者(1.4%，95% CI: 1.0-2.0)被诊断为癫痫，全面性发作是最常见的发作类型(85.7%，12/14)。总微丝虫患病率分别为10.3%(2020年11月)和9.9%(2021年8月);Ov16血清阳性率为22.2%(2021年6月)。在2021年3月的最后一轮丙二醛分发中，只有63.2%的人服用了伊维菌素。结论:波诺地区1.4%的癫痫患病率与撒哈拉以南非洲的中位数癫痫患病率相似。然而，微丝虫病的持续流行和伊维菌素研究的低覆盖率要求加纳消除盘尾丝虫病规划加紧努力，确保巩固和改进已取得的成果，到2030年实现消除盘尾丝虫病。

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来源期刊

Infectious Diseases of Poverty INFECTIOUS DISEASES-

自引率

1.20%

发文量

368

期刊介绍： Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.

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