TY - JOUR
T1 - Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin
AU - Otabil, Kenneth Bentum
AU - Ankrah, Blessing
AU - Bart-Plange, Emmanuel John
AU - Donkoh, Emmanuel Sam
AU - Avarikame, Fiona Amoabil
AU - Ofori-Appiah, Fredrick Obeng
AU - Babae, Theophilus Nti
AU - Kudzordzi, Prince-Charles
AU - Darko, Vera Achiaa
AU - Ameyaw, Joseph
AU - Bamfo, Joseph Gyekye
AU - Sakibu, Raji Abdul
AU - Antwi-Berko, Daniel
AU - Fodjo, Joseph Nelson Siewe
AU - Basáñez, María-Gloria
AU - Schallig, Henk D. F. H.
AU - Colebunders, Robert
N1 - Funding Information: This publication was supported by a grant from the United States Agency for International Development (USAID) and UK FCDO from the British people (UK FCDO) through the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) and administered by the African Research Network for Neglected Tropical Diseases (ARNTD). Its contents are solely the responsibility of the author(s) and do not necessarily represent the views of USAID, UK FCDO, COR-NTD, or the ARNTD. M-GB also acknowledges funding from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement and is also part of the EDCTP2 programme supported by the European Union. Funding Information: We thank all the staff and students of the Department of Biological Science and the Centre for Research in Applied Biology at the University of Energy and Natural Resources in Ghana who provided support in one way or the other to ensure the successful implementation of this research. We are especially grateful to the Director of the Tain District Health Directorate, Mr. Kennedy Ohene-Adjei, and Mr. Philip Yeboah for providing the coverage data for the Tain District from 2019 to 2021. We also acknowledge the efforts of the directors and staff of the Wenchi Municipal Health Directorate and the Subinso Health Center for their enormous contributions towards the study. Dr. Nana Kwadwo-Biritwum and Odame Asiedu shared the 2009–2010 coverage data. Our appreciation also goes to the chiefs and people of the study communities who partnered with us in this study. We would like to thank the referees who provided valuable comments on the original version of the manuscript and particularly the reviewer who shared an extensive knowledge of the study area and its history of control. Publisher Copyright: © 2023, National Institute of Parasitic Diseases.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: In 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). Methods: Between 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. Results: Of 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. Conclusions: The 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: [Figure not available: see fulltext.]
AB - Background: In 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). Methods: Between 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. Results: Of 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. Conclusions: The 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: [Figure not available: see fulltext.]
KW - Coverage
KW - Ivermectin
KW - Mass drug administration
KW - Microfilaria
KW - Onchocerca volvulus
KW - Onchocerciasis-associated epilepsy
KW - Seizure
UR - http://www.scopus.com/inward/record.url?scp=85168234763&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s40249-023-01117-9
DO - https://doi.org/10.1186/s40249-023-01117-9
M3 - Article
C2 - 37587500
SN - 2095-5162
VL - 12
JO - Infectious diseases of poverty
JF - Infectious diseases of poverty
IS - 1
M1 - 75
ER -