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首页> 中文期刊> 《贫困所致传染病（英文）》 >The effect of bi-annual community-directed treatment with ivermectin on the incidence of epilepsy in onchocerciasis endemic villages in South Sudan: a study protocol

The effect of bi-annual community-directed treatment with ivermectin on the incidence of epilepsy in onchocerciasis endemic villages in South Sudan: a study protocol

         
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摘要

Background:Nodding syndrome (NS) is a devastating epileptic illness of unknown aetiology mainly affecting children 5-15 years of age.Head nodding distinguishes NS from other forms of epilepsy.Other manifestations of the illness include mental and physical growth retardation.Many children die as a result of falling in fires or drowning.Recently,it was shown that NS is only one of the phenotypic presentations of onchocerciasis associated epilepsy (OAE).Despite the strong epidemiological association between epilepsy and onchocerciasis,the causal mechanism is unknown.After implementation of bi-annual community directed treatment with ivermectin (CDTi) and larviciding of rivers in northern Uganda,new cases of NS have ceased,while new cases continue to emerge in South Sudanese onchocerciasis-endemic areas with an interrupted CDTi programme.This study is designed to evaluate the potential effects of bi-annual CDTi on reducing the incidence of NS/OAE in onchocerciasisendemic areas in South Sudan.Methods:A pre-intervention door-to-door population-based household survey will be conducted in selected onchocerciasis-endemic villages in Mundri and Maridi Counties,which have a high prevalence of epilepsy.Using a validated questionnaire,the entire village will be screened by community research assistants for suspected epilepsy cases.Suspected cases will be interviewed and examined by a trained clinical officer or medical doctor who will confirm orreject the diagnosis of epilepsy.Bi-annual CDTi will be implemented in the villages and a surveillance system for epilepsy set up.By implementing an epilepsy onchocerciasis awareness campaign we expect to obtain ＞ 90％ CDTi coverage of eligible individuals.The door-to-door survey will be repeated two years after the baseline survey.The incidence of NS/OAE will be compared before and after bi-annual CDTi.Discussion:Our study is the first population-based study to evaluate the effect of bi-annual CDTi to reduce the incidence of NS/OAE.If the study demonstrates such a reduction,these findings are expected to motivate communities in onchocerciasis-endemic regions to participate in CDTi,and wilt encourage policy makers,funders and other stakeholders to increase their efforts to eliminate onchocerciasis.

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  • 来源
    《贫困所致传染病（英文）》 |2018年第006期|89-96|共8页
  • 作者

    Gasim Abd-Elfarag; Makoy Yibi Logora; Jane Y.Carter; Morrish Ojok; Jackson Songok; Sonia Menon; Ferdinand Wit; Richard Lako; Robert Colebunders;

  • 作者单位

    Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;

    Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands;

    Neglected Tropical Diseases Unit, Ministry of Health, Juba, Republic of South Sudan;

    Amref International University, Nairobi, Kenya;

    Amref Health Africa, Juba, South Sudan;

    Amref Health Africa, Juba, South Sudan;

    Global Health Institute, University of Antwerp, Antwerp, Belgium;

    Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;

    Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands;

    Policy, Planning, Budgeting and Research, Ministry of Health, Juba, Republic of South Sudan;

    Global Health Institute, University of Antwerp, Kinsbergen Centrum, Doornstraat 331, 2610 Antwerp, Belgium;

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  • 正文语种 eng
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