Siewe Fodjo Joseph Nelson, Jada Stephen Raimon, Taban Abraham, Bebe John, Yak Bol Yak, Carter Jane Y, Colebunders Robert
Global Health Institute, University of Antwerp, Antwerp, Belgium.
Amref Health Africa, Juba, South Sudan.
Heliyon. 2024 Sep 6;10(18):e37537. doi: 10.1016/j.heliyon.2024.e37537. eCollection 2024 Sep 30.
We sought to investigate the epidemiology of epilepsy in Wulu County (Lakes State, South Sudan), and document the onchocerciasis transmission status in the study villages.
In February 2024, a community-based epilepsy study was conducted Wulu County and participants were surveyed via a door-to-door approach in five villages, namely: Kombi, Makundi Center, Tonjo, War-Pac, and Woko. All village residents were asked about ivermectin intake during the 2023 round of community-directed treatment with ivermectin (CDTI). In addition, children aged 3-9 years were tested for Ov16 antibodies using a rapid diagnostic test. Epilepsy diagnosis in screened individuals was confirmed by a physician.
We surveyed 1355 persons in the five study sites. The overall CDTI coverage in 2023 was 67.4 %. Fifty-five persons with epilepsy (PWE) were identified (prevalence 4.1 %) and a history of nodding seizures was noted in 11/55 (20 %) PWE. The mean age of PWE was 21.5 ± 9.6 years, with 32 (58.2 %) being males. Epilepsy onset frequently occurred under 5 years of age (38.6 % of cases). In two PWE, seizure onset occurred during the past 12 months (annual incidence: 147.6 per 100,000 persons). Twenty-nine PWE (52.7 %) were taking anti-seizure medicines, but only five were taking them daily. Overall, Ov16 seroprevalence in children aged 3-9 years (n = 119) was 15.1 % and differed across villages, peaking at 30.9 % in Woko village where epilepsy prevalence was also highest (7.1 %). Of the 35 recorded deaths during the past two years, 9 (25.7 %) occurred in PWE. Annual estimates for epilepsy mortality and fatality rates were 323.7 per 100,000 persons and 7031.3 per 100,000 PWE, respectively.
High epilepsy prevalence was found in Wulu, particularly in villages with persistent onchocerciasis transmission. Frequent epilepsy onset among under-fives suggests that perinatal/early childhood etiologies are common. Appropriate measures should be instituted to prevent and treat epilepsy in Wulu villages.
我们试图调查南苏丹湖州乌卢县的癫痫流行病学情况，并记录研究村庄的盘尾丝虫病传播状况。
2024年2月，在乌卢县开展了一项基于社区的癫痫研究，通过挨家挨户的方式对五个村庄（即孔比、马昆迪中心、通乔、瓦尔 - 帕克和沃科）的参与者进行了调查。所有村民都被问及在2023年一轮社区定向伊维菌素治疗（CDTI）期间是否服用过伊维菌素。此外，对3至9岁的儿童使用快速诊断检测法检测了Ov16抗体。经医生确认筛查个体的癫痫诊断。
我们在五个研究地点调查了1355人。2023年的总体CDTI覆盖率为67.4%。共识别出55名癫痫患者（PWE）（患病率4.1%），其中11/55（20%）的PWE有点头样发作史。PWE的平均年龄为21.5±9.6岁，其中32名（58.2%）为男性。癫痫发作常发生在5岁以下（占病例的38.6%）。在两名PWE中，发作在过去12个月内开始（年发病率：每10万人中147.6例）。29名PWE（52.7%）正在服用抗癫痫药物，但只有5人每天服药。总体而言，3至9岁儿童（n = 119）的Ov16血清阳性率为15.1%，且各村之间存在差异，在癫痫患病率也最高（7.1%）的沃科村达到峰值30.9%。在过去两年记录的35例死亡中，9例（25.7%）发生在PWE中。癫痫死亡率和病死率的年度估计分别为每10万人中323.7例和每10万PWE中7031.3例。
在乌卢发现癫痫患病率很高，尤其是在盘尾丝虫病持续传播的村庄。五岁以下儿童癫痫发作频繁表明围产期/幼儿期病因很常见。应采取适当措施在乌卢各村预防和治疗癫痫。
