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Treatment and prevention of epilepsy in onchocerciasis-endemic areas is urgently needed

Infectious Diseases of Poverty 2024年第1期13卷 85-89页

作者： Robert Colebunders joseph nelson siewe fodjo Olivia Kamoen Luis-Jorge Amaral Amber Hadermann Chiara Trevisan Mark J.Taylor Julia Gauglitz Achim Hoerauf Yasuaki Sato Katja Polman Maria-Gloria Basanez Dan Bhwana Thomson Lakwo Gasim Abd-Elfarag Sebastien D.Pion Global Health Institute University of AntwerpAntwerpBelgium Department of Neurology Heilig Hart ZiekenhuisLierBelgium Department of Public Health Institute of Tropical MedicineAntwerpBelgium Liverpool School of Tropical Medicine LiverpoolUK Department of Computer Science University of AntwerpAntwerpBelgium Institute of Medical Microbiology Immunology and ParasitologyUniversity Hospital BonnBonnGermany German Center for Infection Research(DZIF) Partner Site Bonn-CologneBonnGermany School of Global Humanities and Social Sciences Nagasaki UniversityNagasakiJapan MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected TropicalDisease Research Department of Infectious Disease EpidemiologySchool of Public HealthImperial College LondonLondonUK National Institute for Medical Research TangaTanzania Vector Control Division Ministry of HealthKampalaUganda School of Public Health University of JubaJubaSouth Sudan Access for Humanity JubaSouth Sudan French National Research Institute for Sustainable Development MontpellierFrance

Background There is increasing epidemiological evidence supporting the association between onchocerciasis and seizures, reinforcing the concept of onchocerciasis-associated epilepsy (OAE). The aim of this paper is to provide an update on the new knowledge about OAE and to propose recommendations to the World Health Organization how to address this public health *** text During the 2nd International Workshop on OAE held on 19-21 September, 2023, in Antwerp, Belgium, participants recognised OAE as a substantial yet neglected public health problem, particularly in areas of sub-Saharan Africa where onchocerciasis remains hyperendemic. Evidence from prospective population-based studies suggest that strengthening onchocerciasis elimination efforts leads to a significant reduction of OAE incidence. There is a need to validate an OAE case definition to estimate the burden of disease and identify onchocerciasis-endemic areas requiring intensification of onchocerciasis elimination programmes and integration of epilepsy care. It is expected that raising awareness about OAE will boost the population uptake of ivermectin. The implementation of a community-based epilepsy treatment programme offering free anti-seizure medications (ASMs) has shown high effectiveness in reducing the frequency of seizures and improving the overall quality of life of people with *** To reduce OAE burden, enhanced collaboration between onchocerciasis and mental health programmes at community, national, and international levels is required. Urgent efforts are needed to ensure the uninterrupted provision of free ASMs in onchocerciasis-endemic areas. Furthermore, OAE should be included in the quantification of the onchocerciasis disease burden.

关键词： Onchocerciasis Morbidity Burden of disease Prevention Ivermectin Epilepsy Nodding syndrome Treatment Children Policy

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Would ivermectin for malaria control be beneficial in onchocerciasis-endemic regions?

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Infectious Diseases of Poverty 2019年第4期8卷 108-108页

作者： joseph nelson siewe fodjo Marina Kugler An Hotterbeekx Adam Hendy Jean-Pierre Van Geertruyden Robert Colebunders Global Health Institute University of AntwerpKinsbergen centrumDoornstraat 3312610 AntwerpBelgium 不详

Background:There is accumulating evidence supporting the use of ivermectin as a malaria control *** findings from the repeat ivermectin mass drug administrations for control of malaria trial demonstrated a reduced incidence of malaria in villages which received repeated ivermectin mass drug administration(MDA;six doses)compared to those who had only one round of *** other studies investigating the benefits of ivermectin for malaria purposes are ongoing/*** text:While ivermectin MDA offers promising perspectives in the fight against malaria,we highlight the added benefits and anticipated challenges of conducting future studies in onchocerciasis-endemic regions,which are confronted with a substantial disease burden including onchocerciasis-associated *** the frequency of ivermectin MDA in such places may reduce the burden of both malaria and onchocerciasis,and allow for more entomological investigations on both the Anopheles mosquitoes and the ***,acceptability and feasibility studies are needed to assess the endorsement by the local populations,as well as the programmatic feasibility of implementing ivermectin MDA several times a ***:Onchocerciasis-endemic sites would doubly benefit from ivermectin MDA interventions,as these will alleviate onchocerciasis-associated morbidity and mortality,while potentially curbing malaria *** onchocerciasis programs and other relevant stakeholders in the malaria/ivermectin research agenda would foster the implementation of pluri-annual MDA in target communities.

关键词： Malaria Ivermectin Onchocerciasis Mass drug administration Vector control

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Stigma and epilepsy in onchocerciasisendemic regions in Africa:a review and recommendations from the onchocerciasisassociated epilepsy working group

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Infectious Diseases of Poverty 2019年第3期8卷 21-31页

作者： Sarah O'Neill Julia Irani joseph nelson siewe fodjo Denis Nono Catherine Abbo Yasuaki Sato Augustine Mugarura Housseini Dolo Maya Ronse Alfred K.Njamnshi Robert Colebunders CRISS-School of Public Health Universite Libre de Bruxelles and LAMC Faculte de Philosophie et de Sciences Sociales Universite Libre de BruxellesBrusselsBelgium Department of Public health Institute o f Tropical MedicineAntwerpBelgium Global Health Institute University of AntwerpAntwerpBelgium Department of Mental Health Austrian Partnership Programme in Higher Education and Research for Developm ent(APPEAR)Project&AVSI FoundationGulu UniversityGuluUganda Department of Psychiatry Makerere UniversityKampalaUganda Department of Environmental Science and Technology Osaka Sangyo UniversityOsakaJapan Epilepsy Support Association of Uganda WakisoUganda Department of Neurology Yaounde Central Hospital/FMBSThe University of Yaounde IBrain Research Africa Initiative(BRAIN)YaoundeCameroon

Background:In onchocerciasis-endemic areas,particularly in those with a sub-optimal onchocerciasis control programme,a high prevalence of epilepsy is *** onchocerciasis and epilepsy are stigmatizing *** first international workshop on onchocerciasis-associated epilepsy(OAE)was held in Antwerp,Belgium(12-14 October 2017)and during this meeting,an OAE alliance was *** this paper,we review what is known about epilepsy-associated stigma in onchocerciasis-endemic regions,and present the recommendations of the OAE alliance working group on *** body:For this scoping review,literature searches were performed on the electronic databases PubMed,Scopus and Science Direct using the search terms"epilepsy AND onchocerciasis AND stigma".Hand searches were also undertaken using Google Scholar,and in total seven papers were identified that addressed epilepsy-related stigma in an onchocercisasis-endemic *** to the limited number of published research papers on epilepsyassociated stigma in onchocerciasis-endemic areas,other relevant literature that describes important aspects related to stigma is *** thematic presentation of this scoping review follows key insights on the barriers to alleviating the social consequences of stigma in highly affected onchocerciasis-endemic areas,which were established by experts during the working group on stigma and discrimination at the first international workshop on *** themes are:knowledge gaps,perceived disease aetiology,access to education,marriage restrictions,psycho-social well-being,burden on the care-giver and treatment seeking *** on the literature and expert discussions during the OAE working group on stigma,this paper describes important issues regarding epilepsy-related stigma in onchocerciasis-endemic regions and recommends interventions that are needed to reduce stigma and discrimination for the improvement of the psycho-social well-being of persons with ***

关键词： Epilepsy Onchocerciasis Stigma,Anti-epileptic treatment Nodding syndrome Discrimination Misconception,Africa

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Comprehensive management of epilepsy in onchocerciasis-endemic areas:lessons learnt from community-based surveys

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Infectious Diseases of Poverty 2019年第1期8卷 98-98页

作者： joseph nelson siewe fodjo Marieke C.J.Dekker Richard Idro Michel Ndahura Mandro Pierre-Marie Preux Alfred K.Njamnshi Robert Colebunders Global Health Institute University of AntwerpAntwerpBelgium Full list of author information is available at the end of the article 不详

Background:Onchocerciasis-endem ic regions are known to have a high epilepsy *** resources in these areas and poor access to healthcare by persons with epilepsy(PWE)result in a wide anti-epileptic treatment gap,poor seizure control and a high burden of seizure-related *** comm unity-based surveys highlight the need for epilepsy managem ent strategies suitable for remote onchocerciasis-endemic villages to ensure better health outcom es for *** this paper,we propose a feasible approach to manage PWE in such *** text:Improved management of PWE in onchocerciasis-endemic areas may be achieved by decentralizing epilepsy *** approaches for the diagnosis and treatment of epilepsy may be used by non-physicians,under the supervision of physicians or *** reduce the treatment gap,a regular supply of subsidized anti-epileptic drugs(AED)appropriate for different types of onchocerciasis-associated epilepsy should be *** up a communitybased epilepsy surveillance system will enable early diagnosis and treatment of PWE thereby preventing *** awareness programs on epilepsy must be implemented to reduce stigma and facilitate the social rehabilitation of ***,strengthening onchocerciasis elimination programs by optimizing community-directed treatment with iverm eain(CDTI)and considering alternative treatment strategies might reduce the incidence of ***:A community-based approach with task-shifting of epilepsy care from specialists to non-physician health workers will reduce epilepsy-associated *** advocacy and collaboration with various stakeholders is needed to establish a sustainable,cost-effective chronic care model for epilepsy that will significantly improve the quality of life of PWE in onchocerciasis-endemic regions.

关键词： Epilepsy Onchocerciasis Community-based approach Comprehensive management

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Prevalence and incidence of nodding syndrome and other forms of epilepsy in onchocerciasis-endemic areas in northern Uganda after the implementation of onchocerciasis control measures

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Infectious Diseases of Poverty 2020年第2期9卷 93-93页

作者： Nolbert Gumisiriza Frank Mubiru joseph nelson siewe fodjo Martin Mbonye Kayitale An Hotterbeekx Richard Idro Issa Makumbi Tom Lakwo Bernard Opar Joice Kaducu joseph Francis Wamala Robert Colebunders 不详 Global Health Institute University of AntwerpAntwerpBelgium Full list of author information is available at the end of the article

Background:Around 2007,a nodding syndrome(NS)epidemic appeared in onchocerciasis-endemic districts of northern Uganda,where ivermeain mass distribution had never been *** study evaluated the effect of community-directed treatment with ivermectin(CDTI)and ground larviciding of rivers initiated after 2009 and 2012 respectively,on the epidemiology of NS and other forms of epilepsy(OFE)in some districts of northern ***:In 2012,a population-based community survey of NS/epilepsy was carried out by the Ugandan Ministry of Health in Kitgum and Pader *** August 2017,we conducted a new survey in selected villages of these districts and compared our findings with the 2012 *** addition,two villages in Moyo distria(where CDTI was ongoing since 1993)served as comparative onchocerciasis-endemic sites in which larviciding had never been *** comparison between 2012 and 2017 prevalence and cumulative incidence were done using the Fisher's and Pearson's Chi-square tests at 95%level of ***:A total of 2138 individuals in 390 households were *** the seleaed villages of Kitgum and Pader,there was no significant decrease in prevalence of NS and OFE between 2012 and ***,the cumulative incidence of all forms of epilepsy decreased from 1165 to 130 per 100000 persons per year(P=0.002);that of NS decreased from 490 to 43 per 100000 persons per year(P=0.037);and for OFE from 675 to 87 per 100000 persons per year(P=0.024).The median age of affeaed persons(NS and OFE)shifted from 13.5(IQR:11.0-15.0)years in 2012 to 18.0(IQR:15.0-20.3)years in 2017;P<*** age-standardized prevalence of OFE in Moyo in 2017 was 4.6%,similar to 4.5%in Kitgum and ***:Our findings support the growing evidence of a relationship between infection by Onchocerca volvulus and some types of childhood epilepsy,and suggest that a combination of bi-annual mass distribution of ivermectin and ground larviciding of rivers is an

关键词： Nodding syndrome Epilepsy Onchocerciasis Prevalence Incidence Ivermeain Larviciding Uganda

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Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin

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Infectious Diseases of Poverty 2023年第4期12卷 106-106页

作者： Kenneth Bentum Otabil Blessing Ankrah Emmanuel John Bart-Plange Emmanuel Sam Donkoh Fiona Amoabil Avarikame Fredrick Obeng Ofori-Appiah Theophilus Nti Babae Prince-Charles Kudzordzi Vera Achiaa Darko joseph Ameyaw joseph Gyekye Bamfo Raji Abdul Sakibu Daniel Antwi-Berko joseph nelson siewe fodjo María-Gloria Basáñez Henk D.F.H.Schallig Robert Colebunders NeTroDis Research Group Centre for Research in Applied Biology School of Sciences University of Energy and Natural Resources Sunyani Ghana Department of Biological Science School of Sciences University of Energy and Natural Resources Sunyani Ghana Global Health Institute University of Antwerp Antwerp Belgium Department of Medical Laboratory Science School of Sciences University of Energy and Natural Resources Sunyani Ghana STU Clinic Sunyani Technical University Sunyani Ghana Happy Family Hospital Nkoranza Ghana Tain District Hospital Nsawkaw Ghana Department of Infectious Disease Epidemiology MRC Centre for Global Infectious Disease Analysis (MRC GIDA) and London Centre for Neglected Tropical Disease Research School of Public Health Imperial College London London UK Department of Medical Microbiology Experimental Parasitology Unit Amsterdam University Medical Centres Academic Medical Centre at the University of Amsterdam Amsterdam The Netherlands

BackgroundIn onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission,a high prevalence of epilepsy has been *** study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration(MDA).MethodsBetween 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 *** the first stage,a random door-to-door approach was used to screen the population for epilepsy using a pre-tested *** suspected of having epilepsy were invited for a second-stage neurological examination for case *** *** microfilarial infection status and Ov16 seropositivity were also ***-five confidence intervals(95%CI)for prevalence values were calculated using the Wilson Score *** the 971 participants,500(51.5%)were females,and the median age(interquartile range)was 26(15‒43)*** 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 *** 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 *** 1.4%prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan ***,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.

关键词： Onchocerca volvulus Microflaria Onchocerciasis-associated epilepsy Seizure Ivermectin Mass drug administration Coverage

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Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon:impact of more than 13 years of ivermectin

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Infectious Diseases of Poverty 2018年第1期7卷 1191-1201页

作者： joseph nelson siewe fodjo Godwin Tatah Earnest Njih Tabah Leonard Ngarka Leonard Njamnshi Nfor Samuel Eric Chokote Michel KMengnjo Fidele Dema Aurelien Tele Sitouok Grace Nkoro Felicien ENtone Anne-Cecile Zoung-Kanyi Bissek Cedric BChesnais Michel Boussinesq Robert Colebunders Alfred K.Njamnshi Global Health Institute University of AntwerpAntwerpBelgium Neurology Department YaoundeCentral HospitalYaoundeCameroon Neurology Department CH Saint-NazaireSaint-NazaireFrance Neuroscience Laboratory FMBSThe University of YaoundeIYaoundeCameroon Ministry of Public Health YaoundeCameroon Neurology Department CHU BrugmanBrusselsBelgium Yoko District Hospital YaoundeCameroon UMI 233 Institut de Recherche pour le Developpement(IRD)MontpellierFrance UniversiteMontpellier MontpellierFrance INSERM Unite1175 MontpellierFrance Brain Research Africa Initiative(BRAIN) YaoundeCameroon.

Background:A high epilepsy prevalence has been reported in several onchocerciasis-endemic villages along the Mbam and Sanaga river valleys in Cameroon,including Bilomo and *** sought to determine the prevalence of epilepsy in these two villages following more than 13 years of community-directed treatment with ivermectin(CDTI).Methods:Door-to-door surveys were performed on the entire resident population in the villages in August 2017 and January *** was diagnosed using a 2-step approach:administration of a standardized 5-item questionnaire followed by confirmation by a *** published diagnostic criteria for onchocerciasis-associated epilepsy(OAE)were ***16 serology was done for children aged 7-10 years to assess onchocerciasis *** were compared with previous data from these two ***:A total of 1525 individuals(1321 in Bilomo and 204 in Kelleng)in 233 households were surveyed in both *** crude prevalence of epilepsy was 4.6%in Bilomo(2017)and 7.8%in Kelleng(2018),including 12(15.6%of cases)persons with epilepsy(PWE)with nodding *** age and sex-standardized prevalence in Kelleng decreased from 13.5%in 2004 to 9.3%in 2018(P<0.001).The median age of PWE shifted from 17(IQR:12-22)years to 24(IQR:20-30)years in Bilomo(P<0.001);and slightly from 24(IQR:14-34)years to 28(IQR:21.25-36.75)years in Kelleng(P=0.112).Furthermore,47.6%of all tested children between 7 and 10 years had Ov16 ***:There is a decrease in epilepsy prevalence after 13 years and more of CDTI in both *** age-shift observed in PWE suggests that ivermectin may prevent OAE in younger ***16 seropositivity in children indicates ongoing onchocerciasis transmission possibly due to suboptimal control *** findings support the existence of OAE in Cameroon and highlight the need to strengthen onchocerciasis elimination programs.

关键词： Onchocerciasis Epilepsy Nodding syndrome Ov16 rapid diagnostic test Ivermectin Cameroon

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Onchocerciasis-associated epilepsy:another piece in the puzzle from the Mahenge mountains, southern Tanzania

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Infectious Diseases of Poverty 2019年第3期8卷 88-93页

作者： Christoph Kaiser Bruno P.Mmbando joseph N.siewe fodjo Patrick Suykerbuyk Mohamed Mnacho Advocatus Kakorozya William Matuja Adam Hendy Helena Greter Williams H.Makunde Robert Colebunders Pediatric Practice Balzenbergstrasse 7376530 Baden-BadenGermany National Institute for Medical Research Tanga Research CentreTangaTanzania Global Health Institute University of AntwerpAntwerpBelgium Muhimbili National Hospital Dar es SalaamTanzania Enhance Tanzania Foundation Dar es SalaamTanzania Muhimbili University of Health and allied Sciences Dar es SalaamTanzania University of Texas Medical Branch GalvestonTXUSA

In a study from the onchocerciasis-endemic area of Mahenge in southern Tanzania,Mmbando et al.[Inf Dis Poverty.2018,7:64]demonstrate that in four selected villages the overall epilepsy prevalence was high,and significantly more elevated in the two villages of higher onchocerciasis endemicity compared to those of lower *** is replicating earlier findings from many other areas of tropical *** authors are also providing data indicating that in the Mahenge focus,the prevalence of nodding syndrome may be related to that of onchocerciasis in the same way as epilepsy in *** application of a clinical case definition for onchocerciasis-associated epilepsy(OAE)as used in the study of Mmbando et al.[Inf Dis Poverty.2018;7:64]faces some difficulties;indeed,its precision in discerning cases of OAE from epilepsy due to other etiologies is not known,and it does not allow for a specific diagnosis in the individual *** an operational surveillance tool for assessing the number of patients in the population could mean substantial advance for better estimating the burden of OAE,the proposed definition should be tried in different settings and its performance reviewed in the process.

关键词： epilepsy mountains Poverty

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