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西非癫痫患病率的荟萃分析及其与盘尾丝虫病流行和控制的关系。

Meta-analysis of epilepsy prevalence in West Africa and its relationship with onchocerciasis endemicity and control.

机构信息

Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium.

120 Rue des Campanules, Ornex, France.

出版信息

Int Health. 2020 May 1;12(3):192-202. doi: 10.1093/inthealth/ihaa012.

DOI:10.1093/inthealth/ihaa012
PMID:32141502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7320426/
Abstract

BACKGROUND

A high prevalence and incidence of epilepsy has been reported in onchocerciasis-endemic regions in Central and East Africa. There is compelling epidemiological evidence suggesting that this high burden is caused by onchocerciasis-associated epilepsy (OAE). We hypothesized that OAE had also occured in West African onchocerciasis foci.

METHODS

We searched PubMed, the African Journals Online platform and grey literature for population-based epilepsy studies in West African countries. Epilepsy and onchocerciasis prevalence data were extracted. The pre-control onchocerciasis endemicity in the study sites was estimated from historical data of onchocerciasis control programmes. The prevalence of epilepsy in different sites was analysed, taking into account onchocerciasis endemicity and the duration of control.

RESULTS

The pooled prevalence of epilepsy in the West African study sites was 13.14 per 1000 (95% confidence interval 11.28-15.00). Higher pre-control endemicity and a shorter duration of onchocerciasis control were both associated with increased epilepsy prevalence (p<0.001). Two studies in Ivory Coast that provided detailed descriptions of persons with epilepsy in onchocerciasis-endemic settings revealed that most of them had features of OAE (73.7% and 83.3%, respectively).

CONCLUSIONS

Our findings suggest that before and during the early years of implementing onchocerciasis control in West Africa, high onchocerciasis endemicity resulted in a high prevalence of OAE and that subsequent control efforts significantly reduced the prevalence of OAE.

摘要

背景

在中非和东非的盘尾丝虫病流行地区，癫痫的患病率和发病率都很高。有强有力的流行病学证据表明，这种高负担是由盘尾丝虫病相关癫痫（OAE）引起的。我们假设西非的盘尾丝虫病流行地区也发生了 OAE。

方法

我们在 PubMed、African Journals Online 平台和灰色文献中搜索了西非国家的基于人群的癫痫研究。提取了癫痫和盘尾丝虫病的患病率数据。根据盘尾丝虫病控制项目的历史数据，估计了研究地点在控制前的盘尾丝虫病流行程度。分析了不同地点的癫痫患病率，考虑了盘尾丝虫病的流行程度和控制的持续时间。

结果

西非研究地点的癫痫总患病率为 13.14/1000（95%置信区间 11.28-15.00）。较高的控制前流行程度和较短的盘尾丝虫病控制持续时间都与癫痫患病率的增加有关（p<0.001）。科特迪瓦的两项研究详细描述了盘尾丝虫病流行地区的癫痫患者，发现他们大多数人都有 OAE 的特征（分别为 73.7%和 83.3%）。

结论

我们的发现表明，在西非实施盘尾丝虫病控制之前和早期，高盘尾丝虫病流行程度导致了 OAE 的高患病率，随后的控制努力显著降低了 OAE 的患病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/586d910419ec/ihaa012f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/362ac71f7519/ihaa012f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/325eb26c559a/ihaa012f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/79014e7fa1c9/ihaa012f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/40841c1c6feb/ihaa012f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/175e0ae50ede/ihaa012f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/586d910419ec/ihaa012f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/362ac71f7519/ihaa012f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/325eb26c559a/ihaa012f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/79014e7fa1c9/ihaa012f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/40841c1c6feb/ihaa012f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/175e0ae50ede/ihaa012f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9854/7320426/586d910419ec/ihaa012f6.jpg

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