@article{fdi:010074342,
  title = {{T}he temporal relationship between onchocerciasis and epilepsy : a population-based cohort study},
  author = {{C}hesnais, {C}{\'e}dric and {N}ana-{D}jeunga, {H}. {C}. and {N}jamnshi, {A}. {K}. and {L}enou-{N}anga, {C}. {G}. and {B}oulle, {C}. and {B}issek, {A}czk and {K}amgno, {J}. and {C}olebunders, {R}. and {B}oussinesq, {M}ichel},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {M}any studies have suggested that onchocerciasis might be associated with epilepsy. {T}herefore, we did a cohort study to assess the incidence of epilepsy relative to {O}nchocerca volvulus skin microfilarial density ({MFD}) measured during childhood and to assess the possibility of a temporal relationship. {M}ethods {D}uring onchocerciasis surveys undertaken in 25 villages in {C}ameroon during 1991-93, we measured {MFD} in individuals aged 5 years or older. {I}n 2017, we revisited seven of these villages. {W}ith a standardised five-item questionnaire, we collected information on the occurrence of epilepsy in 856 individuals who were aged 5-10 years in 1991-93, and had {MFD} determined during the original surveys. {W}e did multivariable analyses to assess the overall incidence and incidence ratios taking into account age, sex, individual {MFD} in 1991-93, and onchocerciasis endemicity level in the village. {F}indings {I}n 2017, we obtained data on the history of epilepsy for 85% (729 of 856) of individuals. {A}mong these individuals, we classified 60 as being suspected cases of epilepsy. {T}he overall incidence of epilepsy was 350 per 100 000 person-years (95% {CI} 270-450). {T}he adjusted incidence ratio for developing epilepsy was 7.07 (95% {CI} 0.98-51.26; p=0.0530) in individuals with initial {MFD} of one to five microfilariae per skin snip (mf per snip), 11.26 (2.73-46.43) in individuals with six to 20 mf per snip, 12.90 (4.40-37.83) in individuals with 21-50 mf per snip, 20.00 (3.71-108.00) in individuals with 51-100 mf per snip, 22.58 (3.21-158.56) in individuals with 101-200 mf per snip, and 28.50 (95% {CI} 3.84-211.27; 13=0.0010) in individuals with more than 200 mf per snip, compared with that of individuals without detectable densities of skin microfilariae. {I}nterpretation {I}ndividual {O} volvulus {MFD} in childhood was associated with the risk of either seizures or epilepsy in an onchocerciasis focus in {C}ameroon. {T}his temporal relationship suggests a potential causal link between onchocerciasis and epilepsy.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{L}ancet {I}nfectious {D}iseases},
  volume = {18},
  numero = {11},
  pages = {1278--1286},
  ISSN = {1473-3099},
  year = {2018},
  DOI = {10.1016/s1473-3099(18)30425-0},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074342},
}