ArticlePLoS neglected tropical diseases2023
Impact of a bi-annual community-directed treatment with ivermectin programme on the incidence of epilepsy in an onchocerciasis-endemic area of Mahenge, Tanzania: A population-based prospective study.
Article in PLoS neglected tropical diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 24 citations in OpenAlex.
- Nodding Syndrome: The Need to Strengthen Epilepsy Care in Onchocerciasis-Endemic Areas and to Investigate the Pathogenesis of Onchocerciasis-Associated Epilepsy.The American journal of tropical medicine and hygiene · 2026Article
- HISTONCHO: A dataset of intervention histories for onchocerciasis control & elimination in sub-Saharan Africa.Scientific data · 2026Article
- Investigating HLA haplotypes as a potential risk factor for nodding syndrome: A case-control study in the Mahenge area, Tanzania.PLoS neglected tropical diseases · 2025Article
- Utilization of health facilities and schools in onchocerciasis elimination efforts.IJID regions · 2025Review
- Community-directed treatment with ivermectin in Maridi, South Sudan: Impact of an onchocerciasis awareness campaign and bi-annual treatment on therapeutic coverage.PLoS neglected tropical diseases · 2025Article
- High epilepsy prevalence and excess mortality in onchocerciasis-endemic counties of South Sudan: A call for integrated interventions.PLoS neglected tropical diseases · 2025Article
- Epilepsy in low- to middle-income countries.Current opinion in neurology · 2025Review
- Recognising the neurological burden of onchocerciasis: the need to include onchocerciasis-associated epilepsy in onchocerciasis global health metrics.Infectious diseases of poverty · 2025Article
- Community-based epilepsy care in an onchocerciasis-endemic area: A 3-year cohort study in Mahenge, Tanzania.Epilepsia · 2025Article
- Epidemiology of epilepsy in Wulu County, an onchocerciasis-endemic area in South Sudan.Heliyon · 2024Article
- Attitudes and perceptions towards epilepsy in an onchocerciasis-endemic region of Tanzania: a mixed approach to determine the magnitude and driving factors.BMC public health · 2024Article
- Prevalence of onchocerciasis and epilepsy in a Tanzanian region after a prolonged community-directed treatment with ivermectin.PLoS neglected tropical diseases · 2024Article
- Onchocerciasis-associated epilepsy and biomarkers.PLoS neglected tropical diseases · 2024Article
- Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study.PLoS neglected tropical diseases · 2024Article
- Integration of onchocerciasis morbidity management and disability prevention services in the healthcare system in Tanzania: a call for action and recommendations.Tropical diseases, travel medicine and vaccines · 2024Article
- The Spectrum of Ocular Diseases in the Onchocerciasis-Endemic Focus of Raga in South Sudan.Research and reports in tropical medicine · 2024Article
- The onchocerciasis hypothesis of nodding syndrome.PLoS neglected tropical diseases · 2023Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity-directed treatment with ivermectin (CDTi) is used to eliminate onchocerciasis. However, despite 25 years of annual CDTi in Mahenge, Tanzania, the prevalence of onchocerciasis and onchocerciasis-associated epilepsy remained high in certain rural villages. Therefore, in 2019, bi-annual CDTi was introduced in the area. This study assessed the impact of the programme on the incidence of epilepsy in four villages. METHODOLOGY: Door-to-door epilepsy surveys were conducted prior to (2017/18) and after (2021) implementing a bi-annual CDTi program. All household members were screened for epilepsy symptoms using a validated questionnaire, and suspected cases were examined by a medical doctor to confirm/reject the diagnosis of epilepsy. The prevalence and annual incidence of epilepsy, including nodding syndrome, were calculated with 95% Wilson confidence intervals with continuity correction. The latter was also done for CDTi coverage in 2016 and 2021.
resultsPrecisely 5,444 and 6,598 persons were screened for epilepsy before and after implementing the intervention. The CDTi coverage of the overall population was 82.3% (95%CI: 81.3-83.2%) in 2021 and sustained in both distribution rounds (81.5% and 76.8%). The coverage was particularly high in children and teenagers aged 6 to 18 years (93.2%, 95%CI: 92.1-94.2%). The epilepsy prevalence remained similar: 3.3% (95%CI: 2.9-3.9%) in 2017/18 versus 3.1% (95%CI: 2.7-3.5%) in 2021. However, the incidence of epilepsy declined from 177.6 (95%CI: 121.2-258.5) in 2015-2017 and 2016-2018 to 45.5 (95%CI: 22.2-89.7) in 2019-2021 per 100,000 persons-years. The incidence of probable nodding syndrome varied from 18.4 (95%CI: 4.7-58.5) to 5.1 (95%CI: 0.3-32.8). None of the nine incidence cases of epilepsy for which information on ivermectin intake was available took ivermectin in the year they developed their first seizures.
conclusionA bi-annual CDTi programme should be implemented in areas with high prevalence of onchocerciasis and epilepsy. High CDTi coverage among children is particularly important to prevent onchocerciasis-associated epilepsy.
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