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The temporal relationship between onchocerciasis and epilepsy: a population-based cohort study
Cédric B Chesnais1, Hugues C Nana-Djeunga2, Alfred K Njamnshi3
1UMI 233, Institut de Recherche pour le Développement, Montpellier, France; Université Montpellier, Montpellier, France; INSERM Unité 1175, Montpellier, France.
The Lancet. Infectious Diseases
|October 1, 2018
Summary
Childhood onchocerciasis infection, measured by microfilarial density (MFD), significantly increases epilepsy risk. This study suggests a potential causal link between onchocerciasis and epilepsy, highlighting the need for targeted interventions.
Area of Science:
- Tropical medicine
- Epidemiology
- Neurology
Background:
- Onchocerciasis, a parasitic disease, has been anecdotally linked to epilepsy.
- A definitive understanding of this association and its temporal relationship is lacking.
Purpose of the Study:
- To investigate the incidence of epilepsy in relation to childhood Onchocerca volvulus microfilarial density (MFD).
- To explore a potential temporal link between onchocerciasis and epilepsy development.
Main Methods:
- A cohort study was conducted in Cameroon, measuring MFD in individuals aged 5-10 years (1991-93).
- Epilepsy occurrence was assessed in 2017 using questionnaires in 856 individuals from the original cohort.
- Multivariable analyses examined incidence ratios adjusted for age, sex, MFD, and village endemicity.
Main Results:
- Data on epilepsy history were obtained for 729 individuals (85%); 60 were suspected epilepsy cases.
- Overall epilepsy incidence was 350 per 100,000 person-years.
- Higher childhood MFD showed a dose-dependent increase in epilepsy risk, with adjusted incidence ratios ranging from 7.07 to 28.50 compared to uninfected individuals.
Conclusions:
- Childhood Onchocerca volvulus MFD is significantly associated with an increased risk of epilepsy.
- The observed temporal relationship supports a potential causal link between onchocerciasis and epilepsy.
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