Ways to mitigate the public health problem caused by onchocerciasis-associated epilepsy.

Accumulating evidence suggests that onchocerciasis could trigger epilepsy. Indeed, after an introduction of bi-annual community-based treatment with ivermectin and use of ground larviciding to control blackfly breeding sites in rivers in 2012 in northern Uganda, no new nodding syndrome cases have been reported and the number of persons developing other forms of epilepsy also decreased. In Western Uganda onchocerciasis-associated epilepsy (OAE) stopped to appear when onchocerciasis was eliminated. Until now the pathophysiological mechanism of OAE remains unclear. Therefore there is still a lot of skepticism among scientists and public health decision makers whether onchocerciasis is able to cause epilepsy. As a consequence there is little international support for interventions to prevent OAE. Therefore additional research is needed to prove the causal relationship between onchocerciasis and epilepsy and to investigate ways to prevent OAE. There is also a need to reduce the epilepsy treatment gap and to improve the care for persons with epilepsy in onchocerciasis endemic regions. To do so, a decentralized community based treatment system will be needed.

Keywords:ONCHOCERCIASIS, TREATMENT RESPONSE EVALUATION, EPILEPSY, STIGMA

Disciplines:Health care administration, Health management, Biostatistics, Epidemiology, Health and community services