02040nas a2200253   4500000000100000008004100001260004400042653003900086653001400125653001500139653001700154100001500171700001500186700001300201700001300214700001800227700001600245245012000261856005900381300000900440490000700449520131600456022001401772       2024                            d  bSpringer Science and Business Media LLC10aonchocerciasis-associated epilepsy10aModelling10aIvermectin10aEpidemiology1 aStapley JN1 aHamley JID1 aWalker M1 aDixon MA1 aColebunders R1 aBasáñez M00aModelling onchocerciasis-associated epilepsy and the impact of ivermectin treatment on its prevalence and incidence  uhttps://www.nature.com/articles/s41467-024-50582-9.pdf  a1-110 v153 a<p>Retrospective cohort studies in Cameroon found an association between Onchocerca volvulus microfilarial load in childhood (measured in 1991–1993) and risk of developing epilepsy later in life (measured in 2017). We parameterised and integrated this relationship (across children aged 3–15 years) into the previously published, stochastic transmission model, EPIONCHO-IBM, for Simulium damnosum sensu lato-transmitted onchocerciasis. We simulated 19 years (1998–2017) of annual ivermectin mass drug administration (MDA) reflecting coverage in the study area, and modelled epilepsy prevalence and incidence. Scenario-based simulations of 25 years of (annual and biannual) MDA in hyper- and holoendemic settings, with 65% and 80% therapeutic coverage, were also conducted. EPIONCHO-IBM predicted 7.6% epilepsy prevalence (compared to 8.2% in the Cameroon study) and incidence of 317 cases/100,000 person-years (compared to 350). In hyperendemic areas, 25 years of biannual MDA (80% coverage) eliminated onchocerciasis-associated epilepsy (OAE) and protected untreated under-fives from its development. Strengthening onchocerciasis programmes, implementing alternative strategies, and evaluating treatment for under-fives and school-age children are crucial to prevent OAE in highly-endemic settings.</p>
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