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Meta-analysis of epilepsy prevalence in West Africa and its relationship with onchocerciasis endemicity and control

Abstract : Background: A high prevalence and incidence of epilepsy has been reported in onchocerciasis-endemic regions in Central and East Africa. There is compelling epidemiological evidence suggesting that this high burden is caused by onchocerciasis-associated epilepsy (OAE).We hypothesized that OAE had also occured inWest African onchocerciasis foci. Methods: We searched PubMed, the African Journals Online platform and grey literature for population-based epilepsy studies inWest African countries. Epilepsy and onchocerciasis prevalence data were extracted. The precontrol onchocerciasis endemicity in the study siteswas estimated from historical data of onchocerciasis control programmes. The prevalence of epilepsy in different sites was analysed, taking into account onchocerciasis endemicity and the duration of control. Results: The pooled prevalence of epilepsy in theWest African study sites was 13.14 per 1000 (95% confidence interval 11.28–15.00). Higher pre-control endemicity and a shorter duration of onchocerciasis control were both associated with increased epilepsy prevalence (p<0.001). Two studies in Ivory Coast that provided detailed descriptions of persons with epilepsy in onchocerciasis-endemic settings revealed that most of them had features of OAE (73.7% and 83.3%, respectively). Conclusions: Our findings suggest that before and during the early years of implementing onchocerciasis control inWest Africa, high onchocerciasis endemicity resulted in a high prevalence of OAE and that subsequent control efforts significantly reduced the prevalence of OAE.
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https://hal-unilim.archives-ouvertes.fr/hal-02502239
Contributeur : Elisabeth Grelier <>
Soumis le : lundi 9 mars 2020 - 09:42:01
Dernière modification le : vendredi 4 septembre 2020 - 15:28:31

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Joseph Nelson Siewe Fodjo, Jan Remme, Pierre-Marie Preux, Robert Colebunders. Meta-analysis of epilepsy prevalence in West Africa and its relationship with onchocerciasis endemicity and control. Tropical Medicine & International Health, John Wiley & Sons Ltd, 2020, ⟨10.1093/inthealth/ihaa012⟩. ⟨hal-02502239⟩

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