Epidemiology of epilepsy in Wulu County, an onchocerciasis-endemic area in South Sudan.

Autor:	Siewe Fodjo JN; Global Health Institute, University of Antwerp, Antwerp, Belgium., Jada SR; Amref Health Africa, Juba, South Sudan., Taban A; Wulu County Neglected Tropical Diseases Unit, South Sudan., Bebe J; Amref Health Africa, Juba, South Sudan., Yak Bol Y; Neglected Tropical Diseases Unit, Ministry of Health, Juba, South Sudan., Carter JY; Amref Health Africa Headquarters, Nairobi, Kenya., Colebunders R; Global Health Institute, University of Antwerp, Antwerp, Belgium.; Department of Tropical Disease Biology, Liverpool School of Tropical Diseases, Liverpool, United Kingdom.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Sep 06; Vol. 10 (18), pp. e37537. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e37537
Abstrakt:	Background: We sought to investigate the epidemiology of epilepsy in Wulu County (Lakes State, South Sudan), and document the onchocerciasis transmission status in the study villages. Methods: In February 2024, a community-based epilepsy study was conducted Wulu County and participants were surveyed via a door-to-door approach in five villages, namely: Kombi, Makundi Center, Tonjo, War-Pac, and Woko. All village residents were asked about ivermectin intake during the 2023 round of community-directed treatment with ivermectin (CDTI). In addition, children aged 3-9 years were tested for Ov16 antibodies using a rapid diagnostic test. Epilepsy diagnosis in screened individuals was confirmed by a physician. Results: We surveyed 1355 persons in the five study sites. The overall CDTI coverage in 2023 was 67.4 %. Fifty-five persons with epilepsy (PWE) were identified (prevalence 4.1 %) and a history of nodding seizures was noted in 11/55 (20 %) PWE. The mean age of PWE was 21.5 ± 9.6 years, with 32 (58.2 %) being males. Epilepsy onset frequently occurred under 5 years of age (38.6 % of cases). In two PWE, seizure onset occurred during the past 12 months (annual incidence: 147.6 per 100,000 persons). Twenty-nine PWE (52.7 %) were taking anti-seizure medicines, but only five were taking them daily. Overall, Ov16 seroprevalence in children aged 3-9 years (n = 119) was 15.1 % and differed across villages, peaking at 30.9 % in Woko village where epilepsy prevalence was also highest (7.1 %). Of the 35 recorded deaths during the past two years, 9 (25.7 %) occurred in PWE. Annual estimates for epilepsy mortality and fatality rates were 323.7 per 100,000 persons and 7031.3 per 100,000 PWE, respectively. Conclusion: High epilepsy prevalence was found in Wulu, particularly in villages with persistent onchocerciasis transmission. Frequent epilepsy onset among under-fives suggests that perinatal/early childhood etiologies are common. Appropriate measures should be instituted to prevent and treat epilepsy in Wulu villages. Competing Interests: The authors declare no competing interests. (© 2024 The Authors.)
Databáze:	MEDLINE
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