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Title
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Effect of ivermectin treatment on the frequency of seizures in persons with epilepsy infected with Onchocerca volvulus
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Author
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Abstract
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| A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency in PWE with and without anti-seizure medication in three onchocerciasis endemic areas (Maridi, South Sudan; Aketi, DRC; and Mahenge, Tanzania). Pre- and 3-5 months post-ivermectin microfilariae densities in skin snips and seizure frequency were assessed. After ivermectin, the median (IQR) percentage reduction in seizure frequency in the study sites ranged from 73.4% (26.0-90.0) to 100% (50.0-100.0). A negative binomial mixed model showed that ivermectin significantly reduced the seizure frequency, with a larger decrease in PWE with a high baseline seizure frequency. Mediation analysis showed that ivermectin reduced the seizure frequencies indirectly through reduction in microfilariae densities but also that ivermectin may have a direct anti-seizure effect. However, given the short half-life of ivermectin and the fact that ivermectin does not penetrate the healthy brain, such a direct anti-seizure effect is unlikely. A randomized controlled trial assessing the ivermectin effect in people infected with O. volvulus who are also PWE on a stable anti-seizure regimen may be needed to clarify the causal relationship between ivermectin and seizure frequency. |
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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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Publication
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2021
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ISSN
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2076-0817
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DOI
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10.3390/PATHOGENS10010021
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Volume/pages
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10
:1
(2021)
, 10 p.
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Article Reference
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21
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ISI
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000610716200001
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Pubmed ID
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33396221
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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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