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Title
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Single versus multiple dose ivermectin regimen in onchocerciasis-infected persons with epilepsy treated with phenobarbital : a randomized clinical trial in the Democratic Republic of Congo
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Author
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Abstract
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| Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in Onchocerca volvulus-infected persons with epilepsy (PWE). Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing >= 2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2). All participants also received anti-epileptic drugs. Data was analyzed using multiple logistic regression. Results: We enrolled 197 participants. In an intent-to-treat analysis (data from group 1 and 2 combined), seizure freedom was more likely among OIPWE treated with ivermectin thrice (OR: 5.087, 95% CI: 1.378-19.749; p = 0.018) and twice (OR: 2.471, 95% CI: 0.944-6.769; p = 0.075) than in those treated once. Similarly, >50% seizure reduction was more likely among those treated with ivermectin twice (OR: 4.469, 95% CI: 1.250-16.620) and thrice (OR: 2.693, 95% CI: 1.077-6.998). Absence of microfilariae during the last 4 months increased the odds of seizure freedom (p = 0.027). Conclusions: Increasing the number of ivermectin treatments was found to suppress both microfilarial density and seizure frequency in OIPWE, suggesting that O. volvulus infection plays an etiological role in causing seizures. |
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Language
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English
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Source (journal)
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Pathogens
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Related dataset(s)
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Publication
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2020
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ISSN
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2076-0817
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DOI
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10.3390/PATHOGENS9030205
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Volume/pages
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9
:3
(2020)
, p. 1-18
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Article Reference
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205
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ISI
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000524306100050
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Pubmed ID
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32164367
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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