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Modelling onchocerciasis-associated epilepsy and the impact of ivermectin treatment on its prevalence and incidence

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  • Jacob N. Stapley

    (Imperial College London
    Imperial College London)

  • Jonathan I. D. Hamley

    (Imperial College London
    Imperial College London
    University of Bern
    University of Bern)

  • Martin Walker

    (Imperial College London
    Imperial College London
    Royal Veterinary College)

  • Matthew A. Dixon

    (Imperial College London
    Imperial College London)

  • Robert Colebunders

    (University of Antwerp)

  • Maria-Gloria Basáñez

    (Imperial College London
    Imperial College London)

Abstract

Retrospective cohort studies in Cameroon found an association between Onchocerca volvulus microfilarial load in childhood (measured in 1991–1993) and risk of developing epilepsy later in life (measured in 2017). We parameterised and integrated this relationship (across children aged 3–15 years) into the previously published, stochastic transmission model, EPIONCHO-IBM, for Simulium damnosum sensu lato-transmitted onchocerciasis. We simulated 19 years (1998–2017) of annual ivermectin mass drug administration (MDA) reflecting coverage in the study area, and modelled epilepsy prevalence and incidence. Scenario-based simulations of 25 years of (annual and biannual) MDA in hyper- and holoendemic settings, with 65% and 80% therapeutic coverage, were also conducted. EPIONCHO-IBM predicted 7.6% epilepsy prevalence (compared to 8.2% in the Cameroon study) and incidence of 317 cases/100,000 person-years (compared to 350). In hyperendemic areas, 25 years of biannual MDA (80% coverage) eliminated onchocerciasis-associated epilepsy (OAE) and protected untreated under-fives from its development. Strengthening onchocerciasis programmes, implementing alternative strategies, and evaluating treatment for under-fives and school-age children are crucial to prevent OAE in highly-endemic settings.

Suggested Citation

  • Jacob N. Stapley & Jonathan I. D. Hamley & Martin Walker & Matthew A. Dixon & Robert Colebunders & Maria-Gloria Basáñez, 2024. "Modelling onchocerciasis-associated epilepsy and the impact of ivermectin treatment on its prevalence and incidence," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-50582-9
    DOI: 10.1038/s41467-024-50582-9
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    References listed on IDEAS

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    1. Martin Walker & Mark P Little & Karen S Wagner & Edoh W Soumbey-Alley & Boakye A Boatin & María-Gloria Basáñez, 2012. "Density-Dependent Mortality of the Human Host in Onchocerciasis: Relationships between Microfilarial Load and Excess Mortality," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(3), pages 1-13, March.
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    1. Hugo C Turner & Thomas S Churcher & Martin Walker & Mike Y Osei-Atweneboana & Roger K Prichard & María-Gloria Basáñez, 2013. "Uncertainty Surrounding Projections of the Long-Term Impact of Ivermectin Treatment on Human Onchocerciasis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(4), pages 1-10, April.

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