02048nas a2200277   4500000000100000008004100001260001200042653003900054653001400093653001500107653001400122653001500136653001500151100001400166700001300180700001300193700001200206700001800218700001600236245012100252856005900373300000900432490000700441520130800448022001401756       2024                            d  c07/202410aOnchocerciasis-associated epilepsy10aModelling10aIvermectin10aTreatment10aPrevalence10aIncidence.1 aStapley J1 aHamley J1 aWalker M1 aDixon M1 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>  a2041-1723