{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:30:42Z","timestamp":1790400642948,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":59,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Aims<\/jats:italic>. To 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.<\/jats:p><jats:p><jats:italic>Methods<\/jats:italic>. A door\u2010to\u2010door epilepsy prevalence survey was conducted in four rural and two sub\u2010urban villages. Trained community workers used five screening questions to identify persons suspected to have epilepsy. Such individuals were interviewed and examined by a neurologist or a medical doctor with additional training in epilepsy, and were tested for <jats:italic>Onchocerca volvulus<\/jats:italic> antibodies.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>. A total of 221 out of 8,062 (2.74%) surveyed individuals were confirmed to have epilepsy. The median age at seizure onset was 12 years (interquartile range: 7\u201316). Seventy\u2010nine persons with epilepsy (PWE) (36.1%) had a family member with epilepsy, which was a sibling in 52.1%. Tonic\u2010clonic seizures (142 individuals; 64.2%) were the most common seizure type. Nodding seizures were reported in 12.7% of PWE; the majority of them living in rural villages. Persons with nodding seizures reported more frequent seizures, presented with more psychiatric symptoms, and more often had onchocerciasis antibodies than those with other seizure types. The high rate of individuals with a seizure onset at between seven and 16 years is characteristic of onchocerciasis\u2010associated epilepsy (OAE). Of the PWE, 77.9% met the criteria for the clinical case definition of OAE. Eighty\u2010three PWE (37.6%) were not taking any antiepileptic medication. Phenobarbital was the antiepileptic drug most commonly prescribed in 76.1% of treated PWE.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>. The high prevalence of epilepsy in rural villages in Mahenge most likely is related to the high prevalence of OAE. To prevent children developing OAE, strengthening the onchocerciasis elimination programme in Mahenge is urgently needed. Moreover, a decentralised epilepsy treatment programme is also needed to provide uninterrupted access to affordable antiepileptic drugs for the many PWE living in rural villages in the Mahenge area.<\/jats:p>","DOI":"10.1684\/epd.2019.1093","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T16:27:53Z","timestamp":1706027273000},"page":"425-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Clinical presentation of epilepsy in six villages in an onchocerciasis endemic area in Mahenge, Tanzania"],"prefix":"10.1002","volume":"21","author":[{"given":"Dan","family":"Bhwana","sequence":"first","affiliation":[{"name":"Tanga Research Centre, National Institute for Medical Research, Tanga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno P.","family":"Mmbando","sequence":"additional","affiliation":[{"name":"Tanga Research Centre, National Institute for Medical 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