Luna Jaime, Metanmo Salvatore, Boumediene Farid, Mbelesso Pascal, Auditeau Emilie, Ajzenberg Daniel, Preux Pierre-Marie
INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.
Department of Neurology, Amitié Hospital, Bangui, Central African Republic.
J Neurol Sci. 2021 Feb 15;421:117314. doi: 10.1016/j.jns.2021.117314. Epub 2021 Jan 9.
Onchocerciasis is a serious problem in tropical areas. The role of the parasite as a factor associated with neurological diseases needs to be addressed because it might involve a reduction of the risk via elimination strategies. We performed a systematic scoping review to identify available studies on this association and put into perspective the different methodological approaches for interpreting the evidence.
A literature search was conducted using MEDLINE (Pubmed) through October 1, 2020. We included all the studies evaluating the association between onchocerciasis and four neurological diseases (epilepsy, nodding syndrome, Nakalanga syndrome, and encephalitis) in tropical countries. A descriptive and critical summary of the results was conducted to provide an overview of the findings.
Overall, 161 articles were identified in the literature search. After full-length examination, we included twelve articles for epilepsy and three for nodding syndrome. Two meta-analyses of case-control studies found a modest strength of the association between O. volvulus and epilepsy. Recent meta-analyses and original studies support a significant association. Epidemiological studies suggest an association between onchocerciasis and nodding syndrome, however, the level of evidence from case-control studies was relatively low. No measure of association was reported for Nakalanga syndrome. There was no specific study on the association between O. volvulus and encephalitis.
The association between onchocerciasis and epilepsy seems increasingly likely. However, there are still many unanswered questions about the different clinical presentations of this epilepsy. Strong international collaboration is essential to improve our understanding of risk factors and physiopathological mechanisms of these intriguing conditions.
盘尾丝虫病在热带地区是一个严重问题。该寄生虫作为与神经系统疾病相关的一个因素，其作用需要加以探讨，因为通过消除策略可能会降低风险。我们进行了一项系统的范围综述，以确定关于这种关联的现有研究，并对解释证据的不同方法进行审视。
通过MEDLINE（PubMed）对截至2020年10月1日的文献进行检索。我们纳入了所有评估热带国家盘尾丝虫病与四种神经系统疾病（癫痫、点头综合征、纳卡兰加综合征和脑炎）之间关联的研究。对结果进行了描述性和批判性总结，以概述研究发现。
总体而言，在文献检索中识别出161篇文章。经过全文审查，我们纳入了12篇关于癫痫的文章和3篇关于点头综合征的文章。两项病例对照研究的荟萃分析发现盘尾丝虫与癫痫之间的关联强度适中。近期的荟萃分析和原创研究支持显著关联。流行病学研究表明盘尾丝虫病与点头综合征之间存在关联，然而，病例对照研究的证据水平相对较低。未报告纳卡兰加综合征的关联度量。没有关于盘尾丝虫与脑炎之间关联的具体研究。
盘尾丝虫病与癫痫之间的关联似乎越来越有可能。然而，关于这种癫痫的不同临床表现仍有许多未解答的问题。强大的国际合作对于增进我们对这些有趣病症的危险因素和生理病理机制的理解至关重要。
