Global Health Institute, University of Antwerp, Campus Drie Eiken, Doornstraat 331, 2610 Wilrijk, Antwerp, Belgium.
Imo State University, Owerri, Nigeria.
Infect Dis Poverty. 2019 Jan 23;8(1):8. doi: 10.1186/s40249-019-0517-9.
High epilepsy prevalence and incidence have been reported in areas with high onchocerciasis transmission. Recent findings suggest that proper community-directed treatment with ivermectin (CDTI) is potentially able to prevent onchocerciasis-associated epilepsy (OAE). We assessed the epilepsy prevalence and onchocerciasis transmission in two Nigerian villages following more than 20 years of CDTI.
A cross-sectional door-to-door survey was performed in two villages in the Imo River Basin reported to be mesoendomic for onchocerciasis (Umuoparaodu and Umuezeala). Individuals were screened for epilepsy using a validated 5-item questionnaire. Persons suspected to have epilepsy were examined by a neurologist or a physician with training in epilepsy for confirmation. Onchocerciasis was investigated via skin snip microscopy and rapid diagnostic tests for Ov16 antibodies. Results were compared with previous findings from the Imo river basin.
A total of 843 individuals from 257 households in the two villages were encountered. We detected four persons with epilepsy (PWE) giving a crude epilepsy prevalence of 0.5%. This finding differs from observations reported 14 years ago which showed an epilepsy prevalence of 2.8% in the neighbouring village of Umulolo (P = 0.0001), and 1.2% from 13 villages in the Imo river basin (P = 0.07). The seroprevalence of Ov16 antibodies was found to be 0%. Only 4.6% of skin snips were positive compared to 26.8% in previous surveys (P < 0.0001). Ivermectin mass distribution coverage in the study sites in 2017 was 79.7%.
A low epilepsy and onchocerciasis prevalence was observed following more than 20 years of CDTI in the Imo River Basin. Absence of Ov16 antibodies indicates minimal transmission of onchocerciasis. These results contrast with observations from areas of high onchocerciasis transmission, where epilepsy prevalence and incidence remain high. Findings from this study suggest that sustained efforts could eventually achieve elimination of onchocerciasis in these villages.
在传播性高的盘尾丝虫病地区，癫痫的发病率和患病率均较高。最近的研究结果表明，适当的社区定向治疗（CDTI）有可能预防盘尾丝虫病相关癫痫（OAE）。我们评估了在两个尼日利亚村庄进行超过 20 年的 CDTI 后，癫痫的患病率和盘尾丝虫病的传播情况。
在伊莫河流域报告为盘尾丝虫病中间地带的两个村庄（Umuoparaodu 和 Umuezeala）进行了一项横断面门到门调查。使用经过验证的 5 项问卷对癫痫进行筛查。疑似癫痫的人由神经科医生或有癫痫培训的医生进行检查以确诊。通过皮肤划痕显微镜和 Ov16 抗体快速诊断检测来检查盘尾丝虫病。结果与伊莫河流域以前的发现进行了比较。
在两个村庄的 257 户家庭中，共遇到了 843 人。我们发现有 4 人患有癫痫（PWE），粗患病率为 0.5%。这一发现与 14 年前在邻近的 Umulolo 村观察到的 2.8%的癫痫患病率不同（P = 0.0001），也与伊莫河流域 13 个村庄的 1.2%的患病率不同（P = 0.07）。发现 Ov16 抗体的血清阳性率为 0%。与以前的调查相比（P < 0.0001），仅 4.6%的皮肤划痕阳性，而 26.8%阳性。2017 年在研究地点进行的伊维菌素大规模分发覆盖率为 79.7%。
在伊莫河流域进行超过 20 年的 CDTI 后，癫痫和盘尾丝虫病的患病率较低。没有 Ov16 抗体表明盘尾丝虫病的传播很少。这些结果与高传播性的盘尾丝虫病地区的观察结果形成对比，在这些地区，癫痫的患病率和发病率仍然很高。本研究的结果表明，持续努力最终可能实现这些村庄的盘尾丝虫病消除。
