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Surveillance for Onchocerciasis-Associated Epilepsy and OV16 IgG4 Testing of Children 6–10 Years Old Should Be Used to Identify Areas Where Onchocerciasis Elimination Programs Need Strengthening
Article

The Prevalence of Onchocerciasis-Associated Epilepsy in Mundri West and East Counties, South Sudan: A Door-to-Door Survey

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Amref Health Africa, Juba P.O. Box 410, South Sudan
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Global Health Institute, University of Antwerp, 2016 Antwerp, Belgium
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Amsterdam Center for Global Health, Department of Paediatrics and Department of Global Health, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
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Amsterdam Institute for Global Health and Development, 1105 AZ Amsterdam, The Netherlands
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Centre for Translational Microbiome Research, Karolinska Institutet, 17177 Stockholm, Sweden
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Amref Health Africa Headquarters, Nairobi P.O. Box 30125, Kenya
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Neglected Tropical Diseases Unit, Ministry of Health, Juba P.O. Box 410, South Sudan
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Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK
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Author to whom correspondence should be addressed.
Academic Editor: Petr Horák
Pathogens 2022, 11(4), 396; https://doi.org/10.3390/pathogens11040396
Received: 21 February 2022 / Revised: 16 March 2022 / Accepted: 22 March 2022 / Published: 24 March 2022
(This article belongs to the Special Issue Onchocerciasis and River Epilepsy in 2022)
A two-phase survey of epilepsy was conducted in selected villages in Mundri West and East Counties (26 June–8 July, 2021), an onchocerciasis-endemic area in Western Equatoria State in South Sudan. In the first phase, households were visited by a trained research team to identify persons suspected to have epilepsy. In the second phase, persons suspected to have epilepsy were interviewed and examined by a clinician to confirm the diagnosis. A total of 364 households agreed to participate in the survey, amounting to 2588 individuals. The epilepsy screening questionnaire identified 91 (3.5%) persons with suspected epilepsy, of whom the diagnosis of epilepsy was confirmed by a clinician in 86 (94.5%). The overall prevalence of confirmed epilepsy was 3.3% (95% CI: 2.7–4.1%), and of nodding syndrome was 0.9% (95% CI: 0.6–1.4%). In 61 (16.8%) households there was at least one person with epilepsy. Only 1212 (46.9%) of 2583 people took ivermectin during the last distribution round in 2021. The annual epilepsy incidence was 77.3/100,000 (95% CI: 9.4–278.9/100,000) and the annual epilepsy mortality was 251.2/100,000 (95% CI: 133.8–428.7/100,000). In conclusion, a high prevalence and incidence of epilepsy was observed in villages in Mundri. Urgent action is needed to prevent children from developing onchocerciasis-associated epilepsy by strengthening the local onchocerciasis-elimination programme. View Full-Text
Keywords: onchocerciasis; Onchocerca volvulus; epilepsy; nodding syndrome; ivermectin onchocerciasis; Onchocerca volvulus; epilepsy; nodding syndrome; ivermectin
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MDPI and ACS Style

Jada, S.R.; Dusabimana, A.; Abd-Elfarag, G.; Okaro, S.; Brusselaers, N.; Carter, J.Y.; Logora, M.Y.; Rovarini, J.M.; Newton, C.R.; Colebunders, R. The Prevalence of Onchocerciasis-Associated Epilepsy in Mundri West and East Counties, South Sudan: A Door-to-Door Survey. Pathogens 2022, 11, 396. https://doi.org/10.3390/pathogens11040396

AMA Style

Jada SR, Dusabimana A, Abd-Elfarag G, Okaro S, Brusselaers N, Carter JY, Logora MY, Rovarini JM, Newton CR, Colebunders R. The Prevalence of Onchocerciasis-Associated Epilepsy in Mundri West and East Counties, South Sudan: A Door-to-Door Survey. Pathogens. 2022; 11(4):396. https://doi.org/10.3390/pathogens11040396

Chicago/Turabian Style

Jada, Stephen R., Alfred Dusabimana, Gasim Abd-Elfarag, Samuel Okaro, Nele Brusselaers, Jane Y. Carter, Makoy Y. Logora, Jacopo M. Rovarini, Charles R. Newton, and Robert Colebunders. 2022. "The Prevalence of Onchocerciasis-Associated Epilepsy in Mundri West and East Counties, South Sudan: A Door-to-Door Survey" Pathogens 11, no. 4: 396. https://doi.org/10.3390/pathogens11040396

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