{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:44:03Z","timestamp":1780584243351,"version":"3.54.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009206","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000}}],"reference-count":78,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ITM\u2019s SOFI programme supported by the Flemish Government, Science & Innovation","award":["EE145 4150"],"award-info":[{"award-number":["EE145 4150"]}]},{"name":"ITM\u2019s SOFI programme supported by the Flemish Government, Science & Innovation","award":["EE145 4150"],"award-info":[{"award-number":["EE145 4150"]}]},{"name":"ITM\u2019s SOFI programme supported by the Flemish Government, Science & Innovation","award":["EE145 4150"],"award-info":[{"award-number":["EE145 4150"]}]},{"name":"ITM\u2019s SOFI programme supported by the Flemish Government, Science & Innovation","award":["EE145 4150"],"award-info":[{"award-number":["EE145 4150"]}]},{"name":"ITM\u2019s SOFI programme supported by the Flemish Government, Science & Innovation","award":["EE145 4150"],"award-info":[{"award-number":["EE145 4150"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>A high prevalence of epilepsy has been observed in several onchocerciasis-endemic villages in the Sanaga River basin, Cameroon. Recent studies suggest that ivermectin, a drug that is distributed annually with the aim of eliminating onchocerciasis, may have a protective effect against acquiring onchocerciasis-associated epilepsy (OAE). This study, therefore, provides an in-depth understanding of both the complex therapeutic landscape for epilepsy as well as the experiences related to the \u2018community-directed treatment with ivermectin\u2019 (CDTI) campaign in order to identify a more trenchant path forward in the fight against epilepsy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>Based on a mixed methods study combining a qualitative strand with a quantitative survey, we found that epilepsy was perceived to have had an epidemic emergence in the past and was still considered an important health issue in the study area. Socio-economic status, availability and accessibility of drugs and practitioners, as well as perceived aetiology shaped therapeutic itineraries for epilepsy, which included frequenting (in)formal biomedical health care providers, indigenous and\/or faith healing practitioners. Ivermectin uptake for onchocerciasis was generally well known and well regarded. The CDTI faced structural and logistical bottlenecks undermining equal access and optimal adherence to the drug.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>Locally accessible, uninterrupted, sustainable and comprehensive health-service delivery is essential to help alleviate the epilepsy burden on afflicted households. Addressing structural challenges of CDTI and communicating the potential link with epilepsy to local populations at risk could optimize the uptake of this potentially significant tool in OAE prevention.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009206","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T19:59:20Z","timestamp":1614110360000},"page":"e0009206","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["In pursuit of a cure: The plural therapeutic landscape of onchocerciasis-associated epilepsy in Cameroon \u2013 A mixed methods study"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7182-6940","authenticated-orcid":true,"given":"Maya","family":"Ronse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0224-1794","authenticated-orcid":true,"given":"Julia","family":"Irani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8963-4469","authenticated-orcid":true,"given":"Charlotte","family":"Gryseels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3599-1719","authenticated-orcid":true,"given":"Tom","family":"Smekens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Ekukole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Teh Monteh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tatah Ntaimah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Dierickx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1153-4078","authenticated-orcid":true,"given":"Kristien","family":"Verdonck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-1340","authenticated-orcid":true,"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0052-1511","authenticated-orcid":true,"given":"Alfred K.","family":"Njamnshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"O\u2019Neill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6570-9887","authenticated-orcid":true,"given":"Koen","family":"Peeters Grietens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"pntd.0009206.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13071-019-3345-7","article-title":"Impact of 19 years of mass drug administration with ivermectin on epilepsy burden in a hyperendemic onchocerciasis area in Cameroon","volume":"12","author":"C Boull\u00e9","year":"2019","journal-title":"Parasit Vectors"},{"key":"pntd.0009206.ref002","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S0035-9203(02)90433-5","article-title":"Relationship between onchocerciasis and epilepsy: a matched case-control study in the Mbam Valley, Republic of Cameroon","volume":"96","author":"M Boussinesq","year":"2002","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0009206.ref003","first-page":"0","article-title":"The temporal relationship between onchocerciasis and epilepsy: a population-based cohort study","author":"CB Chesnais","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"pntd.0009206.ref004","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.yebeh.2018.11.008","article-title":"Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon","volume":"90","author":"JFN Siewe","year":"2019","journal-title":"Epilepsy Behav"},{"key":"pntd.0009206.ref005","unstructured":"Epilepsy: a public health imperative. 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