High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo

Autor: Michel Komba, Bethany Levick, Dadi Falay, Michel Mandro, Robert Colebunders, Caroline Bonareri Osoro, Patrick Suykerbuyk, Alliance Tagoto, Anne Laudisoit, Jean Marie Kashama, Floribert Tepage, Michael Begon, Chellafe Ensoy-Musoro
Přispěvatelé: Fleury, A
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Veterinary medicine
Endemic Diseases
Marine and Aquatic Sciences
Logistic regression
Onchocerciasis
Pathology and Laboratory Medicine
Geographical Locations
Epilepsy
0302 clinical medicine
Ivermectin
Risk Factors
Prevalence
Medicine and Health Sciences
030212 general & internal medicine
Prospective Studies
Age of Onset
Child
2. Zero hunger
Aged
80 and over
Mammals
Family Characteristics
High prevalence
Antiparasitic Agents
lcsh:Public aspects of medicine
Middle Aged
3. Good health
Infectious Diseases
Neurology
Helminth Infections
Child
Preschool
Vertebrates
Lower prevalence
Democratic Republic of the Congo
Female
medicine.drug
Research Article
Neglected Tropical Diseases
Freshwater Environments
Adult
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
030231 tropical medicine
03 medical and health sciences
Young Adult
Age Distribution
Signs and Symptoms
Rivers
Diagnostic Medicine
medicine
Parasitic Diseases
Humans
Animals
Aged
Demography
Leopards
business.industry
Ecology and Environmental Sciences
Public Health
Environmental and Occupational Health
Infant
Newborn
Organisms
Infant
Biology and Life Sciences
Aquatic Environments
lcsh:RA1-1270
Bodies of Water
medicine.disease
Tropical Diseases
Intervention studies
Logistic Models
Age Groups
Case-Control Studies
Multivariate Analysis
Amniotes
People and Places
Africa
Case control analysis
Lesions
Cats
Earth Sciences
Population Groupings
Human medicine
business
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005732 (2017)
PLoS neglected tropical diseases
PLOS Neglected Tropical Diseases
ISSN: 1935-2727
Popis: Background An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. The objective of this study was to determine the prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin was associated with a lower prevalence of epilepsy. Methodology/Principle findings Between July 2014 and February 2016, house-to-house epilepsy prevalence surveys were carried out in areas with a high level of onchocerciasis endemicity: 3 localities in the Bas-Uele, 24 in the Tshopo and 21 in the Ituri province. Ivermectin uptake was recorded for every household member. This database allowed a matched case-control pair subset to be created that enabled putative risk factors for epilepsy to be tested using univariate logistic regression models. Risk factors relating to onchocerciasis were tested using a multivariate random effects model. To identify presence of clusters of epilepsy cases, the Kulldorff's scan statistic was used. Of 12, 408 people examined in the different health areas 407 (3.3%) were found to have a history of epilepsy. A high prevalence of epilepsy was observed in health areas in the 3 provinces: 6.8–8.5% in Bas-Uele, 0.8–7.4% in Tshopo and 3.6–6.2% in Ituri. Median age of epilepsy onset was 9 years, and the modal age 12 years. The case control analysis demonstrated that before the appearance of epilepsy, compared to the same life period in controls, persons with epilepsy were around two times less likely (OR: 0.52; 95%CI: (0.28, 0.98)) to have taken Ivermectin than controls. After the appearance of epilepsy, there was no difference of Ivermectin intake between cases and controls. Only in Ituri, a significant cluster (p-value = 0.0001) was identified located around the Draju sample site area. Conclusions The prevalence of epilepsy in health areas in onchocerciasis endemic regions in the DRC was 2–10 times higher than in non-onchocerciasis endemic regions in Africa. Our data suggests that Ivermectin protects against epilepsy in an onchocerciasis endemic region. However, a prospective population based intervention study is needed to confirm this.
Author summary An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. Between July 2014 and February 2016, house-to-house epilepsy prevalence surveys were carried out in the Bas-Uele, Tshopo and Ituri province of the Democratic Republic of the Congo, in areas with a high level of onchocerciasis endemicity. Of 12, 408 people examined in the different health areas 407 (3.3%) were found to have a history of epilepsy. A nested case control analysis demonstrated that before the appearance of epilepsy, compared to the same life period in controls, persons with epilepsy were around two times less likely to have taken Ivermectin than controls. Our data suggests that Ivermectin protects against epilepsy in an onchocerciasis endemic region. However, a prospective population based intervention study is needed to confirm this.
Databáze: OpenAIRE
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