Definition, Classification, and Burden of Epilepsy

Epilepsy is one of the most common neurological diseases in the world, and is characterized by recurrent unprovoked seizures (fits) that can occur at all ages. The causes of epilepsy are multiple, ranging from perinatal problems, traumatic brain insults, metabolic abnormalities, to infections of the central nervous system; sometimes, the causes are not known. Consensual international norms have been established for the proper diagnosis and management of epilepsy, including specificities for vulnerable populations such as children and pregnant women. Specific emphasis must be laid on low and middle income countries, where about 80% of all persons with epilepsy reside. In such resource-limited settings, epilepsy patients are often confronted with sub-optimal care, reduced access to treatment, and frequent epilepsy complications. Early epilepsy diagnosis and proper anti-epileptic treatment usually result in satisfactory seizure control, and enable persons with epilepsy to lead a normal life. Besides the usual medications, psychosocial support and stigma reducing interventions are crucial to improve the quality of life of affected persons and their families

Factors associated with access to food and essential medicines among Ugandans during the COVID-19 lockdown: a cross-sectional study

Introduction: Many sub-Saharan African countries implemented lockdowns, curfew, and restricted movements among other strategies to control and prevent the spread of COVID-19. These measures caused problems of access to food and essential medicines. We evaluated the importance of this problem in Uganda. Methods: In April 2020, we organized an online survey using a questionnaire to investigate the adherence to COVID-19 preventive measures and the impact of COVID-19. We used a modified Poisson regression analysis to identify factors associated with difficulties to access food or essential medicines. Results: Of the 1,726 study participants, 1,015 (58.8%) were males, 1,660 (92.6%) had at least tertiary level of education, 734 (42.5%) reported difficulties to obtain food. Of the 300 with a chronic illness, 107 (35.7%) experienced difficulties in accessing medication and 40 (13.3%) completely discontinued medication in the past week. Experiencing violence (Adjusted POR=1.61 CI:1.31 -1.99) was associated with difficulties accessing food or essential medicines while increasing age was associated with lower odds of experiencing difficulties (Adjusted POR= 0.97 CI: 0.96 – 0.98). Conclusion: This study confirms the reports that the strict lockdown measures implemented in Uganda made it difficult for Ugandan citizens to access food and essential medicines. Lockdown measures should be accompanied by interventions that ensure the continuity of access to food and essential medicines

Vietnamese people’s well-being during the COVID- 19 pandemic: an online survey

Background: The COVID-19 pandemic, alongside the restrictive measures implemented for its control, may considerably affect people’s lives particularly vulnerable persons such as children, elderly and people with underlying diseases. This study aimed to assess the well-being of Vietnamese people after COVID-19 lockdown measures were lifted and life gradually returned to normal in Vietnam. Methods: An online survey was organized from 21 st to 25 th April 2020 among Vietnamese residents aged 18 and over. Data were collected concerning the participants’ health status, COVID-19 preventive behaviour, and consequences of the preventive measures. The WHO-5 Well-Being Index was used to score participants’ well-being. Results: A total of 1922 responses were analyzed (mean age was 31 years; range: 18-76). Factors associated with a high well-being score included older age, eating healthy food, practising physical exercise, working from home, and adherence to the COVID-19 preventive measures. Female participants, persons worried about their relatives’ health, and smokers were more likely to have a low well-being score. Conclusions: The Vietnamese people continued to follow COVID-19 preventive measures even after the lockdown was lifted. Most respondents scored high on the well-being scale. However, the emergence of a new COVID-19 outbreak with an epicenter in Da Nang city is expected to increase public anxiety and mental health problems. It is clear that together with preventive measures, developing strategies to guarantee the well-being of the Vietnamese people’s is equally important

Depression, anxiety and medication adherence among tuberculosis patients attending treatment centres in Fako Division, Cameroon: cross-sectional study

Background Tuberculosis remains a public health problem, particularly in developing countries. Patients with tuberculosis often suffer from anxiety and depression, which is likely to affect adherence to the long course of tuberculosis treatment. Aims This study sought to investigate depression, anxiety and medication adherence among Cameroonian tuberculosis patients. Method A cross-sectional study was conducted from March to June 2022 across five treatment centres in Fako Division, Southwest Region, Cameroon. Data were collected via face-to-face interviews with tuberculosis patients using a structured questionnaire. Sociodemographic information was obtained, and the following tools were administered to participants: the Hospital Anxiety and Depression Scale, the Oslo Social Support Scale, and the Medication Adherence Rating Scale. Multiple logistic regression models were fitted to investigate determinants of depression and anxiety. Results A total of 375 participants were recruited (mean age: 35 ± 12.2 years; 60.5% male). The prevalence rates of depression and anxiety among tuberculosis patients were 47.7% and 29.9%, respectively. After adjusting for confounders, the odds of depression were significantly increased by having extrapulmonary tuberculosis, non-adherence to treatment, having no source of income, household size <5 and poor social support. Predictors for anxiety included extrapulmonary tuberculosis, defaulting tuberculosis treatment for ≥2 months, family history of mental illness, HIV/tuberculosis co-infection, being married, poor social support and non-adherence to treatment. Conclusions The prevalence of depression and anxiety in tuberculosis patients is relatively high, and diverse factors may be responsible. Therefore, holistic and comprehensive care for tuberculosis patients by mental health practitioners is highly encouraged, especially for the high-risk groups identified

Chorioretinitis among Immigrant and Travellers. Comment on Mansour et al. Presumed Onchocerciasis Chorioretinitis Spilling over into North America, Europe and Middle East. Diagnostics 2023, 13, 3626

Comment on Mansour et al. Presumed Onchocerciasis Chorioretinitis Spilling over into North America, Europe and Middle East. Diagnostics 2023, 13, 362

"Slash and Clear", a Community-Based Vector Control Method to Reduce Onchocerciasis Transmission by Simulium sirbanum in Maridi, South Sudan: A Prospective Study

Background: High ongoing Onchocerca volvulus transmission was recently documented in Maridi County, South Sudan. To complement community-directed treatment with ivermectin (CDTI) as the main onchocerciasis control strategy, we initiated a community-based vector control method “slash and clear” at the Maridi dam, a Simulium damnosum s.l. breeding site, to reduce O. volvulus transmission. Methods: Simulium damnosum s.l. biting rates were collected before and during the twenty months following the “slash and clear” intervention using the human landing catches. Black flies were dissected to measure parity rates before and twelve months after the intervention. Larvae and pupae of S. damnosum s.l. were collected from the dam for morphological and chromosomal characterization to identify the cytospecies involved. Results: Biting rates of S. damnosum s.l. close to the Maridi dam spillway decreased by >90% post-“slash and clear” for more than six months. Twelve months after the “slash and clear” intervention, the reduction in biting rates was still at <50% (p = 0.0007). Parity rates reduced from 13% pre-“slash and clear” (November 2019) to 5.6% post-“slash and clear” (November 2020). Larvae collected from the dam were identified as Simulium sirbanum. Conclusion: The “slash and clear” method was found to be an effective and cheap community-based method to reduce black fly biting rates caused by S. sirbanum. When repeated at least annually together with a high CDTI coverage, this intervention has the potential to considerably accelerate onchocerciasis elimination

Dementia and cognitive impairment in French-speaking Sub-Saharan Africa: a comprehensive review on moving out of the shadows of neglect

Dementia is a global public health problem with increasing prevalence and incidence worldwide. The African continent is expected to bear the biggest brunt of the burden of dementia by 2050 because of the rapid demographic changes, including rapid population growth, an increase in life expectancy, and ageing. However, French-speaking Sub-Saharan African (FS-SSA) countries are underrepresented in research on dementia in Africa. While the reasons are diverse and complex, linguistic and cultural barriers to research, disproportionately affect these countries and may be significant factors. Any efforts, therefore, to redress the burden of dementia in Africa must consider the specific demographic, cultural, and linguistic characteristics of FS-SSA countries. This scoping review explores the current state of knowledge in dementia and cognitive impairment in Sub-Saharan Africa, highlighting research gaps and specific patterns unique to FS-SSA Africa. We identify pathways for research to bridge the knowledge gaps on dementia in FS-SSA as part of the global endeavor to tackle dementia worldwide

Elimination of onchocerciasis in Africa by 2025: an ambitious target requires ambitious interventions

To achieve the elimination of onchocerciasis transmission in all African countries will entail enormous challenges, as has been highlighted by the active discussion around onchocerciasis intervention strategies and evaluation procedures in this journal.Serological thresholds for onchocerciasis elimination, adapted for the African setting, need to be established. The Onchocerciasis Technical Advisory Subgroup of the World Health Organization is currently developing improved guidelines to allow country elimination commi

Kirigami stretchable strain sensors with enhanced piezoelectricity induced by topological electrodes

Objectives: To investigate the reasons for the high prevalence of epilepsy (>6%) discovered in 2015 in the Aketi health zone in the north of the Democratic Republic of the Congo. Methods: Persons with epilepsy (PWE) diagnosed in a door-to-door survey in 2015 were traced and re-examined in 2017 by a neurologist. Confirmed PWE were paired with matched controls. For onchocerciasis assessment, children 7–10 years old were tested for IgG4 Onchocerca volvulus (OV16) antibodies, a rapid epidemiological mapping of onchocerciasis (REMO) study was performed, and ivermectin coverage was investigated. Results: Forty-three (61.4%) previously diagnosed PWE were traced; the neurologist confirmed the epilepsy diagnosis in all of them. The overall OV16 positivity rate was 64.5%. Poor ivermectin coverage (55.9%) and a high prevalence of onchocercal nodules (>70%) were observed. The prevalence of epilepsy was 5.7% in Aketi rural town, with nine PWE (13.8%) experiencing head nodding seizures. A case-control study showed that PWE had lower body weight and higher ivermectin coverage in 2017 than healthy controls. Conclusions: The high prevalence of epilepsy in the Aketi health zone, despite 14 years of community-directed treatment with ivermectin (CDTI), was found to be associated with high onchocerciasis transmission and low ivermectin use. An awareness programme to increase ivermectin coverage and the introduction of a bi-annual CDTI programme should be considered. Keywords: Onchocerciasis, Epilepsy, Ivermectin, Prevalence, Incidence, Case–control, Focus group discussion, Stigm

Onchocerciasis-associated epilepsy: an explorative case-control study with viral metagenomic analyses on Onchocerca volvulus [version 2; peer review: 2 approved]

Background A high prevalence of onchocerciasis-associated epilepsy (OAE) has been observed in onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission. However, the pathogenesis of OAE remains to be elucidated. We hypothesise that the O. volvulus virome could be involved in inducing epilepsy. With this study, we aim to describe the O. volvulus virome and identify potential neurotropic viruses linked to OAE. Methods In Maridi County, an onchocerciasis endemic area in South Sudan with a high prevalence of OAE, we will conduct an exploratory case-control study enrolling 40 persons aged 12 years and above with palpable onchocerciasis nodules. Cases will be participants with OAE (n=20), who will be age- and village-matched with controls without epilepsy (n=20). For each study participant, two skin snips at the iliac crest will be obtained to collect O. volvulus microfilariae, and one nodulectomy will be performed to obtain adult worms. A viral metagenomic study will be conducted on microfilariae and adult worms, and the O. volvulus virome of persons with and without OAE will be compared. The number, size, and localisation of onchocerciasis nodules in persons with and without OAE will be described. Moreover, the pre- and post-nodulectomy frequency of seizures in persons with OAE will be compared. Ethics and dissemination The protocol has been approved by the Ethics Committee of the University of Antwerp and the Ministry of Health of South Sudan. Findings will be disseminated nationally and internationally via meetings and peer-reviewed publications. Registration ClinicalTrials.gov registration NCT05868551 (https://clinicaltrials.gov/study/NCT05868551). Protocol version 1.1, dated 09/05/2023