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Title: | Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus | Authors: | Dusabimana, Alfred Tsebeni Wafula, Solomon Raimon, Stephen Jada Fodjo, Joseph Nelson Siewe Bhwana, Dan Tepage, Floribert Abd-Elfarag, Gasim Hotterbeekx, An ABRAMS, Steven Colebunders, Robert |
Issue Date: | 2021 | Publisher: | MDPI | Source: | Pathogens, 10 (1) (Art N° 21) | Abstract: | A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency in PWE with and without anti-seizure medication in three onchocerciasis endemic areas (Maridi, South Sudan; Aketi, DRC; and Mahenge, Tanzania). Pre- and 3-5 months post-ivermectin microfilariae densities in skin snips and seizure frequency were assessed. After ivermectin, the median (IQR) percentage reduction in seizure frequency in the study sites ranged from 73.4% (26.0-90.0) to 100% (50.0-100.0). A negative binomial mixed model showed that ivermectin significantly reduced the seizure frequency, with a larger decrease in PWE with a high baseline seizure frequency. Mediation analysis showed that ivermectin reduced the seizure frequencies indirectly through reduction in microfilariae densities but also that ivermectin may have a direct anti-seizure effect. However, given the short half-life of ivermectin and the fact that ivermectin does not penetrate the healthy brain, such a direct anti-seizure effect is unlikely. A randomized controlled trial assessing the ivermectin effect in people infected with O. volvulus who are also PWE on a stable anti-seizure regimen may be needed to clarify the causal relationship between ivermectin and seizure frequency. | Notes: | Dusabimana, A; Colebunders, R (corresponding author), Univ Antwerp, Global Hlth Inst, Doornstr 331, B-2610 Antwerp, Belgium. alfred.dusabimana@uantwerpen.be; swafula@musph.ac.ug; Stephen.Jada@amref.org; josephnelson.siewefodjo@uantwerpen.be; dan.bhwana@nimr.or.tz; floritepage@yahoo.fr; gasim4u83@gmail.com; an.hotterbeekx@uantwerpen.be; steven.abrams@uantwerpen.be; robert.colebunders@uantwerpen.be |
Other: | Dusabimana, A; Colebunders, R (corresponding author), Univ Antwerp, Global Hlth Inst, Doornstr 331, B-2610 Antwerp, Belgium. alfred.dusabimana@uantwerpen.be; swafula@musph.ac.ug; Stephen.Jada@amref.org; josephnelson.siewefodjo@uantwerpen.be; dan.bhwana@nimr.or.tz; floritepage@yahoo.fr; gasim4u83@gmail.com; an.hotterbeekx@uantwerpen.be; steven.abrams@uantwerpen.be; robert.colebunders@uantwerpen.be | Keywords: | epilepsy;ivermectin;onchocerciasis;seizures | Document URI: | http://hdl.handle.net/1942/33468 | e-ISSN: | 2076-0817 | DOI: | 10.3390/pathogens10010021 | ISI #: | WOS:000610716200001 | Rights: | Copyright: © 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 (https:// creativecommons.org/licenses/by/ 4.0/). | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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