02960nas a2200445   4500000000100000008004100001260004400042653001900086653002200105653001400127653001500141653001500156653002100171653001300192653001400205653001300219653001100232100001800243700001900261700001300280700001300293700001600306700001500322700001400337700001500351700001400366700001100380700001300391700001600404700001300420700001200433700001800445700001200463245009200475856006000567300000800627490000700635520185800642022001402500       2024                            d  bSpringer Science and Business Media LLC10aonchocerciasis10aBurden of Disease10aMorbidity10aPrevention10aIvermectin10aNodding syndrome10aEpilepsy10aTreatment10aChildren10aPolicy1 aColebunders R1 aSiewe Fodjo JN1 aKamoen O1 aAmaral L1 aHadermann A1 aTrevisan C1 aTaylor MJ1 aGauglitz J1 aHoerauf A1 aSato Y1 aPolman K1 aBasáñez M1 aBhwana D1 aLakwo T1 aAbd-Elfarag G1 aPion SD00aTreatment and prevention of epilepsy in onchocerciasis-endemic areas is urgently needed  uhttps://mednexus.org/doi/pdf/10.1186/s40249-024-01174-8  a1-50 v133 a<p><strong>Background: </strong>There is increasing epidemiological evidence supporting the association between onchocerciasis and seizures, reinforcing the concept of onchocerciasis-associated epilepsy (OAE). The aim of this paper is to provide an update on the new knowledge about OAE and to propose recommendations to the World Health Organization how to address this public health problem.</p>

<p><strong>Main text: </strong>During the 2nd International Workshop on OAE held on 19–21 September, 2023, in Antwerp, Belgium, participants recognised OAE as a substantial yet neglected public health problem, particularly in areas of sub-Saharan Africa where onchocerciasis remains hyperendemic. Evidence from prospective population-based studies suggest that strengthening onchocerciasis elimination efforts leads to a significant reduction of OAE incidence. There is a need to validate an OAE case definition to estimate the burden of disease and identify onchocerciasis-endemic areas requiring intensification of onchocerciasis elimination programmes and integration of epilepsy care. It is expected that raising awareness about OAE will boost the population uptake of ivermectin. The implementation of a community-based epilepsy treatment programme offering free anti-seizure medications (ASMs) has shown high effectiveness in reducing the frequency of seizures and improving the overall quality of life of people with epilepsy.</p>

<p><strong>Conclusions:</strong> To reduce OAE burden, enhanced collaboration between onchocerciasis and mental health programmes at community, national, and international levels is required. Urgent efforts are needed to ensure the uninterrupted provision of free ASMs in onchocerciasis-endemic areas. Furthermore, OAE should be included in the quantification of the onchocerciasis disease burden.&nbsp;</p>
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