03365nas a2200457   4500000000100000008004100001260004400042653002400086653005700110653002100167653002400188653001700212653003900229653001300268653001500281653002900296653001300325100001400338700001300352700001900365700001400384700001700398700002000415700001300435700001600448700001300464700001300477700001300490700001400503700001800517700001400535700001600549700001800565700001800583245013800601856009300739300000900832490000700841520204500848022001402893       2023                            d  bSpringer Science and Business Media LLC10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aOnchocerca volvulus10aMicrofilaria10aOnchocerciasis-associated epilepsy10aSeizures10aIvermectin10aMass drug administration10aCoverage1 aOtabil KB1 aAnkrah B1 aBart-Plange EJ1 aDonkoh ES1 aAvarikame FA1 aOfori-Appiah FO1 aBabae TN1 aKudzordzi P1 aDarko VA1 aAmeyaw J1 aBamfo JG1 aSakibu RA1 aAntwi-Berko D1 aFodjo JNS1 aBasáñez M1 aSchallig HDFH1 aColebunders R00aPrevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin  uhttps://link.springer.com/content/pdf/10.1186/s40249-023-01117-9.pdf?pdf=button%20sticky  a1-140 v123 a<p><strong>Background:</strong> 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&nbsp;years of implementation of ivermectin mass drug administration (MDA).</p>

<p><strong>Methods:</strong> 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.</p>

<p><strong>Results:</strong> 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.</p>

<p><strong>Conclusions:</strong> 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. Graphical Abstract</p>
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