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Title: | Single versus Multiple Dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo | Authors: | Mandro, Michel Fodjo, Joseph Nelson Siewe Dusabimana, Alfred Mukendi, Deby HAESENDONCKX, Steven Lokonda, Richard Nakato, Swabra Nyisi, Francoise Abhafule, Germain Wonya'rossi, D. Hotterbeekx, An ABRAMS, Steven Colebunders, Robert |
Issue Date: | 2020 | Publisher: | MDPI | Source: | PATHOGENS, 9 (3) (Art N° 205) | Abstract: | Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in Onchocerca volvulus-infected persons with epilepsy (PWE). Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing >= 2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2). All participants also received anti-epileptic drugs. Data was analyzed using multiple logistic regression. Results: We enrolled 197 participants. In an intent-to-treat analysis (data from group 1 and 2 combined), seizure freedom was more likely among OIPWE treated with ivermectin thrice (OR: 5.087, 95% CI: 1.378-19.749; p = 0.018) and twice (OR: 2.471, 95% CI: 0.944-6.769; p = 0.075) than in those treated once. Similarly, >50% seizure reduction was more likely among those treated with ivermectin twice (OR: 4.469, 95% CI: 1.250-16.620) and thrice (OR: 2.693, 95% CI: 1.077-6.998). Absence of microfilariae during the last 4 months increased the odds of seizure freedom (p = 0.027). Conclusions: Increasing the number of ivermectin treatments was found to suppress both microfilarial density and seizure frequency in OIPWE, suggesting that O. volvulus infection plays an etiological role in causing seizures. | Notes: | Colebunders, R (reprint author), Univ Antwerp, Global Hlth Inst, B-2610 Antwerp, Belgium. Michel.MandroNdahura@student.uantwerpen.be; JosephNelson.SieweFodjo@uantwerpen.be; Alfred.Dusabimana@uantwerpen.be; debymukendi@yahoo.fr; haesendonckx.steven@gmail.com; lokondarichard@gmail.com; Swabra.Nakato@uantwerpen.be; fnyisi@gmail.com; abhafule@gmail.com; deogratiasrossy@yahoo.fr; an.hotterbeekx@uantwerpen.be; Steven.Abrams@uantwerpen.be; robert.colebunders@uantwerpen.be |
Other: | Colebunders, R (reprint author), Univ Antwerp, Global Hlth Inst, B-2610 Antwerp, Belgium. Michel.MandroNdahura@student.uantwerpen.be; JosephNelson.SieweFodjo@uantwerpen.be; Alfred.Dusabimana@uantwerpen.be; debymukendi@yahoo.fr; haesendonckx.steven@gmail.com; lokondarichard@gmail.com; Swabra.Nakato@uantwerpen.be; fnyisi@gmail.com; abhafule@gmail.com; deogratiasrossy@yahoo.fr; an.hotterbeekx@uantwerpen.be; Steven.Abrams@uantwerpen.be; robert.colebunders@uantwerpen.be | Keywords: | onchocerciasis;epilepsy;ivermectin;trial;seizures | Document URI: | http://hdl.handle.net/1942/31190 | e-ISSN: | 2076-0817 | DOI: | 10.3390/pathogens9030205 | ISI #: | WOS:000524306100050 | Rights: | 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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pathogens-09-00205.pdf | Published version | 2.26 MB | Adobe PDF | View/Open |
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