Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin

Infectious Diseases of Poverty

Short Report

Raji Abdul Sakibu¹  María-Gloria Basáñez²  Daniel Antwi-Berko³  Emmanuel Sam Donkoh³  Fredrick Obeng Ofori-Appiah³  Fiona Amoabil Avarikame³  Henk D. F. H. Schallig⁴  Joseph Nelson Siewe Fodjo⁵  Robert Colebunders⁵  Joseph Ameyaw⁶  Prince-Charles Kudzordzi⁷  Theophilus Nti Babae⁷  Blessing Ankrah⁷  Kenneth Bentum Otabil⁸  Emmanuel John Bart-Plange⁹  Vera Achiaa Darko^1,10  Joseph Gyekye Bamfo^1,11 

[1] Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis (MRC GIDA), and London Centre for Neglected Tropical Disease Research, School of Public Health, Imperial College London, London, UK;Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands;Global Health Institute, University of Antwerp, Antwerp, Belgium;Happy Family Hospital, Bono East Region, Nkoranza, Ghana;NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;Global Health Institute, University of Antwerp, Antwerp, Belgium;NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana;STU Clinic, Sunyani Technical University, Bono Region, Sunyani, Ghana;Tain District Hospital, Bono East Region, Nsawkaw, Ghana;

关键词: Onchocerca volvulus;    Microfilaria;    Onchocerciasis-associated epilepsy;    Seizure;    Ivermectin;    Mass drug administration;    Coverage;   

DOI  :  10.1186/s40249-023-01117-9

 received in 2023-02-28, accepted in 2023-06-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission, a high prevalence of epilepsy has been reported. This study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration (MDA).MethodsBetween October 2020 and August 2021, cross-sectional surveys were conducted in nine communities in the Tain District and Wenchi Municipality of the Bono Region of Ghana. In the first stage, a random door-to-door approach was used to screen the population for epilepsy using a pre-tested questionnaire. Persons suspected of having epilepsy were invited for a second-stage neurological examination for case verification. Community O. volvulus microfilarial infection status and Ov16 seropositivity were also determined. Ninety-five confidence intervals (95% CI) for prevalence values were calculated using the Wilson Score Interval.ResultsOf the 971 participants, 500 (51.5%) were females, and the median age (interquartile range) was 26 (15‒43) years. Fourteen participants (1.4%, 95% CI: 1.0‒2.0) were diagnosed as having epilepsy with generalized seizures being the most frequent seizure type (85.7%, 12/14). The overall microfilarial prevalence of O. volvulus was 10.3% (November 2020) and 9.9% (August 2021); the Ov16 seroprevalence was 22.2% (June 2021). Only 63.2% took ivermectin in the last round of MDA distribution in March 2021.ConclusionsThe 1.4% prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan Africa. However, the persistent microfilarial prevalence and low ivermectin study coverage call for the Ghana Onchocerciasis Elimination Programme to step up its efforts to ensure that the gains achieved are consolidated and improved to achieve the elimination of onchocerciasis by 2030.Graphical Abstract

【 授权许可】

CC BY   
© National Institute of Parasitic Diseases 2023

【 图 表 】

Fig. 2

Fig. 1

13570_2023_282_Article_IEq21.gif