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High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo.

Abstract An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. The objective of this study was to determine the prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin was associated with a lower prevalence of epilepsy.
PMID
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Authors

Mayor MeshTerms

Endemic Diseases

Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28708828
OWN - NLM
STAT- MEDLINE
DA  - 20170714
DCOM- 20170801
LR  - 20170801
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul
TI  - High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic
      Republic of the Congo.
PG  - e0005732
LID - 10.1371/journal.pntd.0005732 [doi]
AB  - BACKGROUND: An increased prevalence of epilepsy has been reported in many
      onchocerciasis endemic areas. The objective of this study was to determine the
      prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic
      of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin
      was associated with a lower prevalence of epilepsy. METHODOLOGY/PRINCIPLE
      FINDINGS: Between July 2014 and February 2016, house-to-house epilepsy prevalence
      surveys were carried out in areas with a high level of onchocerciasis endemicity:
      3 localities in the Bas-Uele, 24 in the Tshopo and 21 in the Ituri province.
      Ivermectin uptake was recorded for every household member. This database allowed 
      a matched case-control pair subset to be created that enabled putative risk
      factors for epilepsy to be tested using univariate logistic regression models.
      Risk factors relating to onchocerciasis were tested using a multivariate random
      effects model. To identify presence of clusters of epilepsy cases, the
      Kulldorff's scan statistic was used. Of 12, 408 people examined in the different 
      health areas 407 (3.3%) were found to have a history of epilepsy. A high
      prevalence of epilepsy was observed in health areas in the 3 provinces: 6.8-8.5% 
      in Bas-Uele, 0.8-7.4% in Tshopo and 3.6-6.2% in Ituri. Median age of epilepsy
      onset was 9 years, and the modal age 12 years. The case control analysis
      demonstrated that before the appearance of epilepsy, compared to the same life
      period in controls, persons with epilepsy were around two times less likely (OR: 
      0.52; 95%CI: (0.28, 0.98)) to have taken Ivermectin than controls. After the
      appearance of epilepsy, there was no difference of Ivermectin intake between
      cases and controls. Only in Ituri, a significant cluster (p-value = 0.0001) was
      identified located around the Draju sample site area. CONCLUSIONS: The prevalence
      of epilepsy in health areas in onchocerciasis endemic regions in the DRC was 2-10
      times higher than in non-onchocerciasis endemic regions in Africa. Our data
      suggests that Ivermectin protects against epilepsy in an onchocerciasis endemic
      region. However, a prospective population based intervention study is needed to
      confirm this.
FAU - Levick, Bethany
AU  - Levick B
AD  - Institute of Integrative Biology, School of Biological Sciences, University of
      Liverpool, Liverpool, United-Kingdom.
FAU - Laudisoit, Anne
AU  - Laudisoit A
AD  - Institute of Integrative Biology, School of Biological Sciences, University of
      Liverpool, Liverpool, United-Kingdom.
AD  - CIFOR, Jalan Cifor, Situ Gede, Sindang Barang, Bogor Bar, Jawa Barat, Indonesia.
AD  - Global Health Institute, University of Antwerp, Antwerp, Belgium.
FAU - Tepage, Floribert
AU  - Tepage F
AD  - National Onchocerciasis Control Program (PNLO), Ministry of Health, Buta,
      Democratic Republic of the Congo.
FAU - Ensoy-Musoro, Chellafe
AU  - Ensoy-Musoro C
AD  - Interuniversity Institute for Biostatistics and statistical Bioinformatics,
      University of Hasselt, Hasselt, Belgium.
FAU - Mandro, Michel
AU  - Mandro M
AD  - Ituri Provincial Health Division, Ministry of Health, Bunia, Democratic Republic 
      of the Congo.
FAU - Bonareri Osoro, Caroline
AU  - Bonareri Osoro C
AD  - Interuniversity Institute for Biostatistics and statistical Bioinformatics,
      University of Hasselt, Hasselt, Belgium.
AD  - Nanyuki Teaching and Referral Hospital, Nanyuki, Kenya.
FAU - Suykerbuyk, Patrick
AU  - Suykerbuyk P
AD  - Global Health Institute, University of Antwerp, Antwerp, Belgium.
FAU - Kashama, Jean Marie
AU  - Kashama JM
AD  - Neuropsychopathologic Centre of Mont Amba (CNPP), University of Kinshasa,
      Kinshasa, Democratic Republic of the Congo.
FAU - Komba, Michel
AU  - Komba M
AD  - Biodiversity Monitoring Centre, Faculty of Sciences, University of Kisangani,
      Kisangani, Democratic Republic of the Congo.
FAU - Tagoto, Alliance
AU  - Tagoto A
AD  - National HIV program, Ministry of Health, Kisangani, Democratic Republic of the
      Congo.
FAU - Falay, Dadi
AU  - Falay D
AD  - Department of Pediatrics, University of Kisangani, Kisangani, Democratic Republic
      of the Congo.
FAU - Begon, Michael
AU  - Begon M
AD  - Institute of Integrative Biology, School of Biological Sciences, University of
      Liverpool, Liverpool, United-Kingdom.
FAU - Colebunders, Robert
AU  - Colebunders R
AUID- ORCID: http://orcid.org/0000-0002-1919-1340
AD  - Global Health Institute, University of Antwerp, Antwerp, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20170714
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Antiparasitic Agents)
RN  - 70288-86-7 (Ivermectin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Age of Onset
MH  - Aged
MH  - Aged, 80 and over
MH  - Antiparasitic Agents/therapeutic use
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Democratic Republic of the Congo/epidemiology
MH  - Demography
MH  - *Endemic Diseases
MH  - Epilepsy/*epidemiology
MH  - Family Characteristics
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Ivermectin/therapeutic use
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Onchocerciasis/drug therapy/*epidemiology
MH  - Prevalence
MH  - Prospective Studies
MH  - Risk Factors
MH  - Young Adult
EDAT- 2017/07/15 06:00
MHDA- 2017/08/02 06:00
CRDT- 2017/07/15 06:00
PHST- 2017/03/16 [received]
PHST- 2017/06/20 [accepted]
PHST- 2017/07/26 [revised]
AID - 10.1371/journal.pntd.0005732 [doi]
AID - PNTD-D-17-00374 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jul 14;11(7):e0005732. doi:
      10.1371/journal.pntd.0005732. eCollection 2017 Jul.