Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Robert Colebunders
* ORCID logo ,
Stephen Raimon Jada
,
Alfred Dusabimana
,
Gasim Abd-Elfarag
,
Samuel Okaro
,
Nele Brusselaers
,
Jane Y Carter
ORCID logo ,
Makoy Ybi Logora
,
Jacopo Mattia Rovarini
Version 1 : Received: 21 February 2022 / Approved: 22 February 2022 / Online: 22 February 2022 (11:10:26 CET)

A peer-reviewed article of this Preprint also exists.

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. 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.

Abstract

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 2,588 individuals. The epilepsy screening questionnaire identified 91 (3.5%) persons suspected to have epilepsy, of whom in 86 (94.5%) the diagnosis of epilepsy was confirmed by a clinician. The overall prevalence of confirmed epilepsy was 3.3% (95% CI: 2.7-4.1%), and of nodding syndrome 0.9% (95% CI: 0.6-1.4%). In 61 (16.8%) households there was at least one person with epilepsy. Only 1,212 (46.9%) of 2,583 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 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.

Keywords

Onchocerciasis; Onchocerca volvulus; epilepsy; nodding syndrome; ivermectin

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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