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High prevalence of epilepsy in two rural onchocerciasis endemic villages in the Mahenge area,Tanzania,after 20 years of community directed treatment with ivermectin

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Infectious Diseases of Poverty 2018年第1期7卷 622-634页

作者： Bruno P.Mmbando Patrick Suykerbuyk mohamed mnacho Advocatus Kakorozya William Matuja Adam Hendy Helena Greter Williams H.Makunde Robert Colebunders 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

Background:Epilepsy is a neurological disorder with a multitude of underlying causes,which may include infection with Onchocerca volvulus,the parasitic worm that causes human onchocerciasis.A survey carried out in 1989 revealed a high prevalence of epilepsy(1.02%overall,ranging from 0.51 to 3.71%in ten villages)in the Mahenge area of Ulanga district,an onchocerciasis endemic region in south eastern *** study aimed to determine the prevalence and incidence of epilepsy following 20 years of onchocerciasis control through annual community directed treatment with ivermectin(CDTI).Methods:The study was conducted in January 2017 in two suburban and two rural villages in the Mahenge ***-todoor household visits were carried out by trained community health workers and data assistants to screen for persons suspected of having epilepsy,using a standardised *** with suspected epilepsy were then interviewed and examined by a neurologist for case *** associated epilepsy was defined as epilepsy without an obvious cause,with an onset of seizures between the ages of 3-18 years in previously healthy *** each village,fifty males aged≥20 years were tested for onchocerciasis antibodies using an OV16 rapid test and were examined for presence of onchocerciasis *** aged 6-10 years were also tested using OV16 ***:5117 individuals(median age 18.5 years,53.2%female)from 1168 households were screened.244(4.8%)were suspected of having epilepsy and invited for neurological *** of epilepsy was 2.5%,with the rural villages having the highest rate(3.5%vs 1.5%),P<*** incidence of epilepsy was 111 cases(95%CI:73-161)per 100000 person-years,while that of onchocerciasis associated epilepsy was 131(95%CI:70-223).Prevalence of OV16 antibodies in adult males and among children 6-10 years old was higher in rural villages than in suburban villages(76.5%vs 50.6,and 42.6%vs 4.7%respectively),(P

关键词： Epilepsy Onchocerciasis Mahenge Tanzania

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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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