Publications by authors named "Dan Bhwana"
Objective: In onchocerciasis-endemic areas, limited access to antiseizure medications (ASMs) contributes to a high epilepsy burden. This study evaluated the impact of a community-based epilepsy care program in Mahenge, Tanzania, an onchocerciasis-endemic area with high epilepsy prevalence.
Methods: A baseline survey (2017-2018) identified persons with epilepsy (PWE) in four rural villages.
Article Synopsis
- Epilepsy is a major public health issue in Tanzania, particularly in Mahenge, where stigma and misconceptions significantly impact the lives of affected individuals.
- A study involving 778 participants revealed that while most were aware of epilepsy, their knowledge was low, leading to negative attitudes and misconceptions about the disorder's causes, such as witchcraft and hereditary factors.
- Stigma towards individuals with epilepsy was prevalent, resulting in social isolation and barriers to education, with traditional healers often being the first point of treatment despite the lack of understanding of the condition.
Article Synopsis
- The study investigates the link between Onchocerca volvulus (causing onchocerciasis) and epilepsy in Mahenge, Tanzania, focusing on the prevalence of both conditions after 25 years of ivermectin treatment.
- A cross-sectional survey of 56,604 individuals was conducted, revealing onchocerciasis prevalence among children at 11.8%, higher in medium-altitude villages, and epilepsy incidence at 21.1 cases per 1,000 persons, also more prevalent in medium altitudes.
- Female gender, middle altitudes, and positive OV16 antibodies were associated with a higher likelihood of having epilepsy, highlighting ongoing public health challenges despite long-term ivermectin use.
Article Synopsis
- There is growing evidence linking onchocerciasis (a parasitic disease) to seizures, leading to the recognition of onchocerciasis-associated epilepsy (OAE) as a significant public health issue, especially in sub-Saharan Africa.
- A recent workshop highlighted the need for a clear case definition of OAE and emphasized the importance of integrating epilepsy care into ongoing onchocerciasis elimination efforts to reduce the incidence of seizures.
- Recommendations include enhancing collaboration between health programs, ensuring uninterrupted access to free anti-seizure medications in affected areas, and incorporating OAE into assessments of the overall onchocerciasis disease burden.
Background: Epilepsy is estimated to affect 50 million people globally, with 80% living in sub-Saharan Africa (SSA). Children with epilepsy (CWE) in SSA are often socially isolated, and many do not get access to school. This study aimed to explore the barriers hindering accessibility to formal education among CWE in Mahenge, Tanzania.
View Article and Find Full Text PDFBackground: A high prevalence of epilepsy has been observed in the onchocerciasis-endemic focus of Mahenge, Tanzania. This study sought to assess the degree of disability experienced by persons with epilepsy (PWE) in Mahenge and identify associations with sociodemographic and clinical features.
Method: This cross-sectional study was conducted in Mahenge, Tanzania, between February and July 2020.
Background: Community-directed treatment with ivermectin (CDTi) is used to eliminate onchocerciasis. However, despite 25 years of annual CDTi in Mahenge, Tanzania, the prevalence of onchocerciasis and onchocerciasis-associated epilepsy remained high in certain rural villages. Therefore, in 2019, bi-annual CDTi was introduced in the area.
View Article and Find Full Text PDFBackground: Nodding syndrome (NS) has been consistently associated with onchocerciasis. Nevertheless, a positive association between NS and a Mansonella perstans infection was found in South Sudan. We aimed to determine whether the latter parasite could be a risk factor for NS in Mahenge.
View Article and Find Full Text PDFObjective: This study investigated the quality of life (QoL) of adults with epilepsy living in Mahenge, an onchocerciasis-endemic area in Tanzania with a high prevalence of onchocerciasis-associated epilepsy (OAE).
Methods: Between February and December 2020, persons with epilepsy (PWE) were recruited from four rural villages in Mahenge: Mdindo, Msogezi, Mzelezi, and Sali. For PWE who could not answer the questionnaire due to their mental or physical disability, a family member was asked to answer the questions instead.
Background: Despite 20 years of ivermectin mass distribution in the Mahenge area, Tanzania, the prevalence of onchocerciasis and epilepsy has remained high in rural villages.
Objectives: We investigated the efficacy of ivermectin in reducing Onchocerca volvulus microfilariae and predictors for parasitic load following ivermectin treatment in persons with (PWE) and without epilepsy (PWOE).
Methods: Between April and September 2019, 50 PWE and 160 randomly selected PWOE from Msogezi and Mdindo villages participated in a follow-up study.
Onchocerciasis is known to cause skin lesions and blindness, but there is also epidemiological evidence that onchocerciasis is associated with epilepsy, including nodding syndrome. We carried out ocular exams in persons with epilepsy in Mahenge, an onchocerciasis endemic area with a high prevalence of epilepsy in Tanzania. We recruited 278 consecutive persons with epilepsy attending the epilepsy clinic at Mahenge hospital and satellite clinics in rural villages.
View Article and Find Full Text PDFBackground: Throughout Africa, epilepsy is a highly stigmatized condition. It is often considered to be contagious. This study aimed to assess community knowledge, attitude, and practices toward epilepsy in four villages namely Mdindo, Msogezi, Mzelezi, and Sali within Mahenge division, in Morogoro region, Tanzania.
View Article and Find Full Text PDFA high burden of epilepsy has been reported in sub-Saharan Africa (SSA) particularly in onchocerciasis endemic areas. To improve the quality of life of persons with epilepsy (PWE) in Mahenge, an onchocerciasis-endemic area in Tanzania, we established peer support groups (PSG) in two out of four rural villages (Mdindo, Msogezi, Mzelezi and Sali). One year later (between February and July 2020), we carried out a cross-sectional survey among PWE and their caregivers in the four rural villages with the aim of comparing perceived stigma among PWE in study sites with and without PSG.
View Article and Find Full Text PDFArticle Synopsis
- A clinical trial in the Democratic Republic of Congo found that ivermectin treatment may significantly reduce seizure frequency in individuals with epilepsy, both with and without anti-seizure medication.
- The study, conducted in onchocerciasis endemic areas, reported a median seizure frequency reduction ranging from 73.4% to 100% after ivermectin treatment.
- While the results suggest ivermectin could have both indirect and possibly direct effects on reducing seizures, further research is necessary to confirm these findings and establish a clear causal relationship.
There is growing epidemiological evidence that onchocerciasis may induce epilepsy. High prevalence of onchocerciasis has been reported in onchocerciasis-meso and hyper-endemic regions. We aimed to determine the OV16 antibody prevalence in persons with epilepsy (PWE) in four onchocerciasis-endemic regions.
View Article and Find Full Text PDFDespite a long history of community-directed treatment with ivermectin (CDTI), a high ongoing transmission is observed in certain onchocerciasis-endemic regions in Africa with a high prevalence of epilepsy. We investigated factors associated with higher microfilarial (mf) density after ivermectin treatment. Skin snips were obtained from infected persons with epilepsy before, and 3 to 5 months after ivermectin treatment.
View Article and Find Full Text PDFTo describe the clinical manifestations of epilepsy and access to antiseizure treatment in Mahenge in Central Tanzania, an onchocerciasis endemic area with a high prevalence of epilepsy. A door-to-door epilepsy prevalence survey was conducted in four rural and two sub-urban villages. Trained community workers used five screening questions to identify persons suspected to have epilepsy.
View Article and Find Full Text PDFBackground: Epilepsy is one of the commonest neurological conditions affecting women of reproductive age. Epilepsy management during pregnancy is a clinical conundrum, requiring a balance between seizure control and risk minimization for the women with epilepsy (WWE) as well as for their fetuses. The objective of this comprehensive review is to explore the reproductive health challenges of WWE in sub-Saharan Africa (SSA) and ways to address them.
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