Evidence map›Paper›PMID 38512994›Full record

ArticlePLoS neglected tropical diseases2024

Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study.

Luís-Jorge Amaral, Stephen Raimon Jada, Aimee Kemayou Ndjanfa, Jane Y Carter, Gasim Abd-Elfarag, Samuel Okaro, Makoy Yibi Logora, Yak Yak Bol, Thomson Lakwo, Joseph N Siewe Fodjo and 1 more

Open access · goldAbstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Article
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  6. Epilepsy in low- to middle-income countries.Current opinion in neurology · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 4 countries.

Luís-Jorge AmaralGlobal Health Institute, University of Antwerp, Antwerp, Belgium.ORCID 0000-0001-8155-9014
Stephen Raimon JadaAmref Health Africa, South Sudan.
Aimee Kemayou NdjanfaGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
Jane Y CarterAmref Health Africa Headquarters, Nairobi, Kenya.
Gasim Abd-ElfaragAmref Health Africa, South Sudan.
Samuel OkaroAmref Health Africa, South Sudan.
Makoy Yibi LogoraNeglected Tropical Diseases Unit, Ministry of Health, Juba, South Sudan.
Yak Yak BolNeglected Tropical Diseases Unit, Ministry of Health, Juba, South Sudan.
Thomson LakwoVector Control Division, Ministry of Health, Kampala, Uganda.
Joseph N Siewe FodjoGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
Robert ColebundersGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
University of Antwerp · BEUniversity of Juba · SSAmref Health Africa · KEMinistry of Health · UG

Funding

European Research CouncilLa Caixa FoundationResearch Foundation – Flanders
6 · The paper itself

Abstract

objectivesThe potential impact of cumulative community-directed treatment with ivermectin (CDTI) on epilepsy epidemiology in Mvolo County, South Sudan, an onchocerciasis-endemic area with high epilepsy prevalence, was investigated. Annual CDTI was introduced in 2002 in Mvolo, with interruptions in 2016 and 2020.

methodsComprehensive house-to-house surveys in Mvolo (June 2020 and 2022) identified cases of epilepsy, including probable nodding syndrome (pNS). Community workers screened households in selected sites for suspected epilepsy, and medical doctors confirmed the diagnosis and determined the year of seizure onset. The incidence of epilepsy, including pNS, was analysed using 95% confidence intervals (CIs). Data on ivermectin intake and onchocerciasis-associated manifestations (itching and blindness) were collected.

resultsThe surveys covered 15,755 (2020) and 15,092 (2022) individuals, identifying 809 (5.2%, 95% CI: 4.8-5.5%) and 672 (4.5%, 95% CI: 4.1-4.8%) epilepsy cases, respectively. Each survey reported that a third of the surveyed population experienced skin itching, and 3% were blind. Epilepsy incidence per 100,000 person-years gradually declined, from 326.5 (95% CI: 266.8-399.1) in 2013-2015 to 96.6 (95% CI: 65.5-141.7) in 2019-2021. Similarly, pNS incidence per 100,000 person-years decreased from 151.7 (95% CI: 112.7-203.4) to 27.0 (95% CI: 12.5-55.5). Coverage of CDTI was suboptimal, reaching only 64.0% of participants in 2019 and falling to 24.1% in 2021 following an interruption in 2020 due to COVID-19 restrictions. Additionally, while 99.4% of cases had active epilepsy in 2022, less than a quarter of these had access to antiseizure medication.

conclusionsThe observed decrease in epilepsy incidence despite suboptimal CDTI coverage highlights the potential impact of onchocerciasis control efforts and underscores the need to strengthen these efforts in Mvolo County and across South Sudan. As a proactive measure, Mvolo and neighbouring counties are transitioning to biannual CDTI. Furthermore, the substantial epilepsy treatment gap in Mvolo should be addressed.

Indexed as

EpilepsyNodding SyndromeOnchocerciasisHumansIncidenceIvermectinPrevalenceProspective StudiesPruritusIvermectin

Identifiers

PMID38512994
PMCPMC10986994
OpenAlexW4393056685

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.