Effect of Onchocerciasis Elimination Measures on the Incidence of Epilepsy in Maridi, South Sudan
NCT ID: NCT05750043
Last Updated: 2023-11-30
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
17000 participants
OBSERVATIONAL
2018-03-01
2023-02-19
Brief Summary
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This study also shows that a community-based "Slash and Clear" vector control method can effectively decrease blackfly biting rates and potentially decrease onchocerciasis transmission.
Moreover, this study shows that epilepsy is a major cause of death in onchocerciasis endemic areas with high ongoing transmission.
Detailed Description
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Methods Annual community-directed treatment with ivermectin (CDTi) was implemented in 2019, temporarily interrupted in 2020 and reimplemented biannually in 2021. Additionally, a community-based "Slash and Clear" vector control method was initiated in 2019 at the Maridi dam. A two-stage house-to-house survey was conducted before (2018) and after (2022) implementing the interventions, consisting of initial screening by community workers to detect suspected cases of epilepsy, followed by confirmation of the diagnosis by a trained clinician.
Finding Overall, 17,652 and 14,402 individuals participated in the pre- and post-intervention surveys, respectively. The epilepsy incidence decreased from 313·0 (95% confidence intervals (CI):273·7-357·7) to 34·7 (95%CI:17·6-66·1) per 100,000 person-years. Similarly, the incidence of NS decreased from 120·4 (95%CI:96·7-149·6) to 10·4 (95%CI:2·7-33·2) per 100,000 person-years. Despite biannual CDTi, only 56·6% of the population took ivermectin in 2021. Mortality of persons with epilepsy accounted for 17·1% (95%CI:14·0-20·7%) of the overall number of deaths in the population.
Interpretation In onchocerciasis-endemic areas with high prevalence of epilepsy, strengthening onchocerciasis elimination interventions can decrease the incidence of epilepsy, including NS. Additional efforts are needed in Maridi, where epilepsy is a major cause of mortality, to increase CDTi coverage and sustain blackfly control.
Conditions
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Study Design
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OTHER
PROSPECTIVE
Study Groups
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Population of selected villages in Maridi county
A total of 2,511 households containing 17,652 individuals were visited in 2018, and 2,254 households containing 14,402 individuals in 2022.
bi-annual CDTI
bi-annual community directed treatment with ivermectin (CDTI) and community-based "slash and clear" vector control intervention
Interventions
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bi-annual CDTI
bi-annual community directed treatment with ivermectin (CDTI) and community-based "slash and clear" vector control intervention
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
ALL
No
Sponsors
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Amref Health Africa
OTHER
Universiteit Antwerpen
OTHER
Responsible Party
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Robert Colebunders
Professor
Principal Investigators
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Jane Carter, MD
Role: PRINCIPAL_INVESTIGATOR
Amref Health Africa
Locations
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Amref Health Africa
Juba, Central, South Sudan
Countries
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Other Identifiers
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Project Code AID 011898
Identifier Type: -
Identifier Source: org_study_id