03144nas a2200265 4500000000100000008004100001260001600042653002800058653002500086653001400111100001300125700001900138700001600157700001600173700002500189700001200214700001500226700001600241245012900257856015300386300000800539490000800547520230900555022001402864 2023 d bElsevier BV10aBehavioral Neuroscience10aNeurology (clinical)10aNeurology1 aNgarka L1 aSiewe Fodjo JN1 aAmbomatei C1 aNjamnshi WY1 aTaryunyu Njamnshi JN1 aNfor LN1 aMengnjo MK1 aNjamnshi AK00aEpidemiology of epilepsy and relationship with onchocerciasis prevalence in villages of the Ntui Health District of Cameroon uhttps://www.sciencedirect.com/science/article/pii/S1525505023001038/pdfft?md5=1f9f7a11f2ac720317609483235c9d51&pid=1-s2.0-S1525505023001038-main.pdf a1-70 v1423 a

Background: A strong association between epilepsy and onchocerciasis endemicity has been reported. We sought to document the epidemiology of epilepsy in onchocerciasis-endemic villages of the Ntui Health District in Cameroon and investigate how this relates to the prevalence of onchocerciasis.

Methods: In March 2022, door-to-door epilepsy surveys were conducted in four villages (Essougli, Nachtigal, Ndjame, and Ndowe). Ivermectin intake during the 2021 session of community-directed treatment with ivermectin (CDTI) was investigated in all participating village residents. Persons with epilepsy (PWE) were identified through a two-step approach: administration of a 5-item epilepsy screening questionnaire followed by clinical confirmation by a neurologist. Epilepsy findings were analyzed together with onchocerciasis epidemiological data previously obtained in the study villages.

Results: We surveyed 1663 persons in the four study villages. The 2021 CDTI coverage for all study sites was 50.9%. Overall, 67 PWE were identified (prevalence of 4.0% (IQR: 3.2–5.1) with one new-onset case during the past 12 months (annual incidence of 60.1 per 100,000 persons). The median age of PWE was 32 years (IQR: 25–40), with 41 (61.2%) being females. The majority (78.3%) of PWE met the previously published criteria for onchocerciasis-associated epilepsy (OAE). Persons with a history of nodding seizures were found in all villages and represented 19.4% of the 67 PWE. Epilepsy prevalence was positively correlated with onchocerciasis prevalence (Spearman Rho = 0.949, p = 0.051). Meanwhile, an inverse relationship was observed between distance from the Sanaga river (blackfly breeding site) and the prevalence of both epilepsy and onchocerciasis.

Conclusion: The high epilepsy prevalence in Ntui appears to be driven by onchocerciasis. It is likely that decades of CDTI have likely contributed to a gradual decrease in epilepsy incidence, as only one new case occurred in the past year. Therefore, more effective elimination measures are urgently needed in such endemic areas to curb the OAE burden.

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