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High prevalence of epilepsy in onchocerciasis endemic health areas in Democratic Republic of the Congo

Infectious Diseases of Poverty 2018年第1期7卷 663-676页

作者： Evy Lenaerts Michel Mandro Deby Mukendi Patrick Suykerbuyk Housseini Dolo Deogratias Wonya’Rossi françoise ngave Chellafe Ensoy-Musoro Anne Laudisoit An Hotterbeekx Robert Colebunders Global Health Institute University of AntwerpAntwerpBelgium Provincial Health Division of Ituri Ministry of HealthBuniaDemocratic Republic of Congo Centre Neuro Psycho Pathologique Universitede Kinshasa(CNPP-UNIKIN)KinshasaDemocratic Republic of Congo International Center of Excellence in Research Faculty of Medicine and OdontostomatologyBamakoMali Neglected Tropical Diseases Control program Ministry of HealthBuniaDemocratic Republic of the Congo Centre de Recherche en Maladies Tropicales Hopital General de Reference de RethyRethyDemocratic Republic of Congo Interuniversity Institute for Biostatistics and statistical Bioinformatics University of HasseltHasseltBelgium EcoHealth Alliance New YorkUSA Global Health Institute Faculty of Medicine and Health SciencesGouverneur Kinsbergen CentrumDoornstraat 3312610 WilrijkBelgium

Background:A high prevalence of epilepsy has been observed in many onchocerciasis endemic *** study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural population in Ituri province,Democratic Republic of ***:In August 2016,a community-based cross-sectional study was conducted in an onchocerciasis endemic area in the rural health zone of Logo,Ituri *** within two neighbouring health areas were randomly *** identify persons with epilepsy,a three-stage approach was *** the first stage,all individuals of the selected households were screened for epilepsy by non-medical field workers using a validated 5-item *** the second and third stage,suspected cases of epilepsy were examined by non-specialist medical doctors,and by a neurologist,respectively.A case of epilepsy was defined according to the 2014 International League Against Epilepsy(ILAE)*** to *** was assessed by testing for IgG4 antibodies to an *** antigen(OV16 Rapid Test,)in individuals aged 3 years and ***:Out of 1389 participants included in the survey,64 were considered to have active epilepsy(prevalence 4.6%)(95%confidence interval[CI]:3.6-5.8).The highest age-specific epilepsy prevalence estimate was observed in those aged 20 to 29 years(8.2%).Median age of epilepsy onset was 10 years,with a peak incidence of epilepsy in the 10 to 15 year-old age ***16 test results were available for 912 participants,of whom 30.5%(95%CI,27.6-33.6)tested *** prevalence of OV16 positivity in a village ranged from 8.6 to 68.0%.After adjusting for age,gender and ivermectin use,a significant association between exposure to onchocerciasis and epilepsy was observed(adjusted odds ratio=3.19,95%CI:1.63-5.64)(P<0.001).Conclusions:A high prevalence of epilepsy and a significant association between epilepsy and exposure to *** were observed in the population in Ituri

关键词： Onchocerciasis epilepsy Prevalence Democratic Republic of Congo

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Community perceptions of epilepsy and its treatment in an onchocerciasis endemic region in Ituri,Democratic Republic of Congo

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Infectious Diseases of Poverty 2018年第1期7卷 1202-1210页

作者： Housseini Dolo Michel Mandro Deogratias Wonya’Rossi francoise ngave Jessica Fraeyman Joseph NSiewe Patrick Suykerbuyk Robert Colebunders Global Health Institute University of AntwerpAntwerpBelgium Provincial Ministry of Health BuniaIturiDemocratic Republic of the Congo International Center of Excellence in Research Faculty of Medicine and Odonto StomatologyBamakoMali Research Group Social Epidemiology and Health Policy University of AntwerpAntwerpBelgium Centre de Recherche en Maladies Tropicales de l’Ituri Hopital General de Reference de RethyRethyDemocratic Republic of Congo

Background:A recent study in the Logo and Rethy health zones in the Ituri Province in the Democratic Republic of Congo(DRC)reported that the majority of the persons with epilepsy(PWE)had not been treated with anti-epileptic medication(AEM)or had stopped *** to the implementation of an epilepsy treatment programme in these health zones,this study investigated the perceptions and experiences regarding epilepsy and its treatment amongst community leaders,PWE and/or their families,traditional healers and health ***:A total of 14 focus group discussions(FGD)and 39 semi-structured interviews(SSI)were conducted with PWE and/or their family members,community leaders,traditional healers,and health professionals in the Logo and Rethy health zones during February 2-19,***:In the two health zones,the clinical signs of convulsive epilepsy were recognized by community ***,a variety of misconceptions about epilepsy were identified including the beliefs that epilepsy is a family-related condition,a contagious disease,is transmitted by insects,saliva or by touching a person of the same sex during seizures,or is caused by evil spirits and *** role of traditional healers in spreading these beliefs was *** study also reported sexual abuse on PWE,stigmatisation of PWE and loss of productivity of PWE and their *** PWE had been using AEM and traditional treatment but were not convinced about the efficacy of these treatment *** lack of training of health providers about epilepsy care,financial barriers in obtaining AEM,and the shortage of AEM at primary health facilities were *** remedies,the community requested access to a decentralized center for epilepsy *** also proposed using churches and community health workers as communication channels for information about ***:Clinical signs of convulsive epilepsy were recognized by the community in the Logo and Rethy health

关键词： Epilepsy Onchocerciasis Community Perception Experiences Treatment Programme Qualitative study

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Onchocerca volvulus as a risk factor for developing epilepsy in onchocerciasis endemic regions in the Democratic Republic of Congo:a case control study

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Infectious Diseases of Poverty 2018年第1期7卷 781-786页

作者： Michel Mandro Patrick Suykerbuyk Floribert Tepage Degratias Rossy francoise ngave Mirza Nazmul Hasan An Hotterbeekx Germain Mambandu Jean Marie Kashama Anne Laudisoit Robert Colebunders Provincial Health Division of Ituri Ministry of HealthBuniaDemocratic Republic of Congo Global Health Institute University of AntwerpAntwerpBelgium Ministry of Health ButaDemocratic Republic of Congo Programme national de lutte contre l’onchocercose KisanganiDemocratic Republic of Congo Centre de Recherche en Maladies Tropicales de l’Ituri RethyDemocratic Republic of Congo University of Hasselt Campus DiepenbeekHasseltBelgium Office of the governor of Tshopo KisanganiDemocratic Republic of Congo Neuropsychopathologic Centre of Mont Amba(CNPP) University of KinshasaKinshasaDemocratic Republic of Congo EcoHealth Alliance New YorkUSA

Background:A high prevalence of epilepsy has been observed in onchocerciasis endemic areas in the Democratic Republic of Congo(DRC).With this study we aimed to investigate whether Onchocerca volvulus infection is a risk factor for developing epilepsy in onchocerciasis endemic regions in the ***:Between October and December 2015,a multi-centre case control study was performed in onchocerciasis endemic health zones(HZ)in the DRC:one study site was situated in Tshopo Province in the HZ of Wanierukula(village of Salambongo)where there had been 13 annual community distributions of treatment with ivermectin(CDTI),a second was situated in Ituri Province in the HZ of Logo(village of Draju)where ivermectin had never been distributed and in the HZ of Rethy(village of Rassia)where there had been THREE CDTI annual campaigns before the *** with unprovoked convulsive epilepsy of unknown etiology were enrolled as cases(n=175).Randomly selected healthy members of families without epilepsy cases from the same village and age-groups and were recruited as controls(n=170).Results:Onchocerciasis associated symptoms(e.g.,itching and abnormal skin)were more often present in cases compared to controls(respectively,OR=2.63,95%CI:1.63-4.23,P<0.0001 and OR=3.23,95%CI:1.48-7.09,P=0.0034).A higher number of cases was found to present with microfilariae in skin snips and with *** IgG4 antibodies in the blood compared to ***,the microfilariae load in skin snips was 3-10 times higher in cases than ***:This case control study confirms that *** is a risk factor for developing epilepsy in onchocerciasis endemic regions in the DRC.

关键词： Onchocerciasis Epilepsy Case control study Risk factors Democratic Republic of Congo

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