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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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