Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin
Abstract 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 Kelleng. We sought to determine the prevalence of epilepsy in these two villages following more than 13 years of commu...
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doaj-675e89da77f24bfd8746d82aa47d92d92020-11-25T02:44:09ZengBMCInfectious Diseases of Poverty2049-99572018-12-017111110.1186/s40249-018-0497-1Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectinJoseph Nelson Siewe Fodjo0Godwin Tatah1Earnest Njih Tabah2Leonard Ngarka3Leonard Njamnshi Nfor4Samuel Eric Chokote5Michel K. Mengnjo6Fidèle Dema7Aurélien Tele Sitouok8Grace Nkoro9Félicien E. Ntone10Anne-Cécile Zoung-Kanyi Bissek11Cédric B. Chesnais12Michel Boussinesq13Robert Colebunders14Alfred K. Njamnshi15Global Health Institute, University of AntwerpNeurology Department, Yaoundé Central HospitalNeurology Department, Yaoundé Central HospitalNeurology Department, Yaoundé Central HospitalNeuroscience Laboratory, FMBS, The University of Yaoundé INeurology Department, Yaoundé Central HospitalNeurology Department, Yaoundé Central HospitalNeurology Department, Yaoundé Central HospitalNeurology Department, Yaoundé Central HospitalNeuroscience Laboratory, FMBS, The University of Yaoundé INeuroscience Laboratory, FMBS, The University of Yaoundé INeuroscience Laboratory, FMBS, The University of Yaoundé IUMI 233, Institut de Recherche pour le Développement (IRD)UMI 233, Institut de Recherche pour le Développement (IRD)Global Health Institute, University of AntwerpNeurology Department, Yaoundé Central HospitalAbstract 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 Kelleng. We 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 2018. Epilepsy was diagnosed using a 2-step approach: administration of a standardized 5-item questionnaire followed by confirmation by a neurologist. Previously published diagnostic criteria for onchocerciasis-associated epilepsy (OAE) were used. Ov16 serology was done for children aged 7–10 years to assess onchocerciasis transmission. Findings were compared with previous data from these two villages. Results A total of 1525 individuals (1321 in Bilomo and 204 in Kelleng) in 233 households were surveyed in both villages. The 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 seizures. The 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 antibodies. Conclusions There is a decrease in epilepsy prevalence after 13 years and more of CDTI in both villages. The age-shift observed in PWE suggests that ivermectin may prevent OAE in younger residents. Ov16 seropositivity in children indicates ongoing onchocerciasis transmission possibly due to suboptimal control measures. Our findings support the existence of OAE in Cameroon and highlight the need to strengthen onchocerciasis elimination programs.http://link.springer.com/article/10.1186/s40249-018-0497-1OnchocerciasisEpilepsyNodding syndromeOv16 rapid diagnostic testIvermectinCameroon |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Joseph Nelson Siewe Fodjo Godwin Tatah Earnest Njih Tabah Leonard Ngarka Leonard Njamnshi Nfor Samuel Eric Chokote Michel K. Mengnjo Fidèle Dema Aurélien Tele Sitouok Grace Nkoro Félicien E. Ntone Anne-Cécile Zoung-Kanyi Bissek Cédric B. Chesnais Michel Boussinesq Robert Colebunders Alfred K. Njamnshi |
spellingShingle |
Joseph Nelson Siewe Fodjo Godwin Tatah Earnest Njih Tabah Leonard Ngarka Leonard Njamnshi Nfor Samuel Eric Chokote Michel K. Mengnjo Fidèle Dema Aurélien Tele Sitouok Grace Nkoro Félicien E. Ntone Anne-Cécile Zoung-Kanyi Bissek Cédric B. Chesnais Michel Boussinesq Robert Colebunders Alfred K. Njamnshi Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin Infectious Diseases of Poverty Onchocerciasis Epilepsy Nodding syndrome Ov16 rapid diagnostic test Ivermectin Cameroon |
author_facet |
Joseph Nelson Siewe Fodjo Godwin Tatah Earnest Njih Tabah Leonard Ngarka Leonard Njamnshi Nfor Samuel Eric Chokote Michel K. Mengnjo Fidèle Dema Aurélien Tele Sitouok Grace Nkoro Félicien E. Ntone Anne-Cécile Zoung-Kanyi Bissek Cédric B. Chesnais Michel Boussinesq Robert Colebunders Alfred K. Njamnshi |
author_sort |
Joseph Nelson Siewe Fodjo |
title |
Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin |
title_short |
Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin |
title_full |
Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin |
title_fullStr |
Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin |
title_full_unstemmed |
Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: impact of more than 13 years of ivermectin |
title_sort |
epidemiology of onchocerciasis-associated epilepsy in the mbam and sanaga river valleys of cameroon: impact of more than 13 years of ivermectin |
publisher |
BMC |
series |
Infectious Diseases of Poverty |
issn |
2049-9957 |
publishDate |
2018-12-01 |
description |
Abstract 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 Kelleng. We 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 2018. Epilepsy was diagnosed using a 2-step approach: administration of a standardized 5-item questionnaire followed by confirmation by a neurologist. Previously published diagnostic criteria for onchocerciasis-associated epilepsy (OAE) were used. Ov16 serology was done for children aged 7–10 years to assess onchocerciasis transmission. Findings were compared with previous data from these two villages. Results A total of 1525 individuals (1321 in Bilomo and 204 in Kelleng) in 233 households were surveyed in both villages. The 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 seizures. The 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 antibodies. Conclusions There is a decrease in epilepsy prevalence after 13 years and more of CDTI in both villages. The age-shift observed in PWE suggests that ivermectin may prevent OAE in younger residents. Ov16 seropositivity in children indicates ongoing onchocerciasis transmission possibly due to suboptimal control measures. Our findings support the existence of OAE in Cameroon and highlight the need to strengthen onchocerciasis elimination programs. |
topic |
Onchocerciasis Epilepsy Nodding syndrome Ov16 rapid diagnostic test Ivermectin Cameroon |
url |
http://link.springer.com/article/10.1186/s40249-018-0497-1 |
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