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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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From river blindness control to elimination:bridge over troubled water

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Infectious Diseases of Poverty 2018年第1期7卷 215-229页

作者： Robert Colebunders Maria-Gloria Basanez Katja Siling Rory J.Post Anke Rotsaert Bruno Mmbando patrick suykerbuyk Adrian Hopkins Global Health Institute University of AntwerpAntwerpBelgium London Centre for Neglected Tropical Disease Research Imperial College LondonLondonUK Institute of Tropical Medicine AntwerpBelgium London School of Hygiene&Tropical Medicine LondonUK Liverpool John Moores University LiverpoolUK National Institute for Medical Research TangaTanzania Neglected and Disabling diseases of Poverty Consultant GravesendKentUK

Background:An estimated 25 million people are currently infected with onchocerciasis(a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors),and 99%of these are in sub-Saharan *** African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure,the Expanded Special Project for the Elimination of Neglected Tropical Diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa,including onchocerciasis ***:In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy,its implementation will present particular difficulties in *** aim to highlight these in an attempt to ensure that they are well understood and that effective plans can be laid to solve them by the countries concerned and their international ***:A specific concern is the burden of disease caused by onchocerciasis-associated epilepsy in hyperendemic zones situated in countries experiencing difficulties in strengthening their onchocerciasis control *** difficulties should be identified and programmes supported during the transition from morbidity control to interruption of transmission and elimination.

关键词： Onchocerciasis Control Elimination Monitoring&evaluation Community drug distributors Epilepsy Prevalence Incidence

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

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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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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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Inducing neuronal regeneration and differentiation via the BDNF/ TrkB signaling pathway: a key target against neurodegenerative diseases?

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Neural Regeneration Research 2024年第3期19卷 495-496页

作者： Mirjana Antonijevic patrick Dallemagne Christophe Rochais Normandie University UNICAENCERMNCaenFrance

Brain-derived neurotrophic factor(BDNF)is one of the neurotrophins,a specific polypeptide growth factor,which plays a crucial role in the proliferation,differentiation,survival,and death of neurons and non-neuronal *** is not only essential to maintain the balance between death on one side and survival of neurons on the other,but also it mediates additional higher-order activities such as learning,memory,and *** is initially synthesized as a precursor protein,proBDNF,that can be secreted as it is or it can be cleaved intracellularly by furin and proconvertases,or extracellularly by extracellular proteases such as matrix metalloprotease-9 and matrix metalloprotease-2,or plasmin to give mature BDNF.

关键词： death diseases degenerative

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Diffraction limit of light in curved space

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Photonics Research 2024年第2期12卷 235-243页

作者： JINGXUAN ZHANG CHENNI XU patrick SEBBAH LI-GANG WANG School of Physics Zhejiang UniversityHangzhou 310058China Department of Physics The Jack and Pearl Resnick Institute for Advanced TechnologyBar-Ilan UniversityRamat-Gan 5290002Israel

Overcoming the diffraction limit is crucial for obtaining high-resolution images and observing fine *** this conventional difficulty still puzzling us and the prosperous development of wave dynamics of light interacting with gravitational fields in recent years,how spatial curvature affects the diffraction limit is an attractive and important *** we investigate the issue of the diffraction limit and optical resolution on two-dimensional curved space—surfaces of revolution(SORs)with constant or variable spatial *** show that the diffraction limit decreases and the resolution is improved on SORs with positive Gaussian curvature,opening a new avenue to *** diffraction limit is also influenced by the propagation direction,as well as the propagation distance in curved space with variable spatial *** results provide a possible method to control the optical resolution in curved space or equivalent waveguides with varying refractive index distribution and may allow one to detect the presence of the nonuniform strong gravitational effect by probing locally the optical resolution.

关键词： limit curved curvature

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Trombe walls with porous medium insertion and their influence on thermal comfort in flats in Cusco,Peru

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Energy and Built Environment 2024年第2期5卷 194-210页

作者： patrick Facelli Sanchez Lisset Mercado Hancco Department of Civil Engineering Faculty of Architecture and Civil EngineeringUniversidad Nacional de San Antonio Abad del Cusco08003 CuscoPeru

The Trombe wall is a passive indirect heating system which should be used in Cusco,Peru to improve thermal conditions against the typical frosts and low temperatures during winter in the high Andean *** to this problem,the use of a modified Trombe wall with insertion of porous medium is proposed to improve thermal comfort in flat buildings in *** research aims to analyse and compare the performance of dwellings without Trombe wall,with traditional Trombe wall,and with Trombe wall with glass and plastic pellets insertion in thermal comfort ***■CFD was used to simulate and analyse the *** simulation was performed with three prototype flats(55 m^(2),75 m^(2) and 95 m^(2))for six months of the *** the results obtained,the level of thermal comfort in the traditional scenarios is low with an average PMV of-1.86,in the scenarios with Trombe wall is good and in the scenarios with Trombe wall with insertion of porous medium is slightly better than the previous one,reaching an average PMV of+0.10 and a temperature of 21.90℃.The study carried out is important because it represents an efficient eco-sustainable heating alternative that improves the thermal comfort sensation in houses during the coldest months of the year.

关键词： Trombe wall thermal comfort porous medium residential buildings computational fluid dynamics

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Multiple sclerosis drug repurposing for neuroregeneration

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Neural Regeneration Research 2024年第3期19卷 507-508页

作者： Peter Göttle Michael Dietrich patrick Küry Department of Neurology Medical FacultyHeinrich-Heine UniversityDüsseldorfGermany

Multiple sclerosis(MS)is an autoimmune disorder of the central nervous system(CNS)and is primarily characterized by immune cell infiltration leading to relapses followed by remission phases and a disease course turning progressive over time with neurodegenerative processes taking over(Amin and Hersh,2023).Of note,beyond relapse-associated worsening early in disease progression independent of relapse activity may arise independently of relapse activity and can occur in all ***-mediated damage of myelin sheaths and the subsequent loss of mature oligodendrocytes are resulting in impaired axonal integrity,neurodegeneration and accounts for irreversible neuronal damage(Kuhlmann et al.,2023).The current landscape of available disease-modifying therapies comprises mainly immunomodulatory drugs that effectively diminish relapses and slow down progression at the onset form of the disease,namely relapsing MS(RMS).In this regard,a number of drugs have been approved as disease-modifying therapies for MS by US Food and Drug Administration and European Medicines Agencies(Box 1).

关键词： drugs impaired irreversible

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