Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa

BACKGROUND: Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa. MET...

पूर्ण विवरण

ग्रंथसूची विवरण
मुख्य लेखकों: Kamuyu, G, Bottomley, C, Mageto, J, Lowe, B, Wilkins, P, Noh, J, Nutman, T, Ngugi, A, Odhiambo, R, Wagner, R, Kakooza-Mwesige, A, Owusu-Agyei, S, Ae-Ngibise, K, Masanja, H, Osier, F, Odermatt, P, Newton, C
स्वरूप: Journal article
भाषा:English
प्रकाशित: Public Library of Science 2014
_version_ 1826289136184590336
author Kamuyu, G
Bottomley, C
Mageto, J
Lowe, B
Wilkins, P
Noh, J
Nutman, T
Ngugi, A
Odhiambo, R
Wagner, R
Kakooza-Mwesige, A
Owusu-Agyei, S
Ae-Ngibise, K
Masanja, H
Osier, F
Odermatt, P
Newton, C
author_facet Kamuyu, G
Bottomley, C
Mageto, J
Lowe, B
Wilkins, P
Noh, J
Nutman, T
Ngugi, A
Odhiambo, R
Wagner, R
Kakooza-Mwesige, A
Owusu-Agyei, S
Ae-Ngibise, K
Masanja, H
Osier, F
Odermatt, P
Newton, C
author_sort Kamuyu, G
collection OXFORD
description BACKGROUND: Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa. METHODS AND FINDINGS: A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52-2.58, p<0.001), Toxocara canis (OR = 1.52; 95%CI: 1.23-1.87, p<0.001), Toxoplasma gondii (OR = 1.28; 95%CI: 1.04-1.56, p = 0.018) and higher antibody levels (top tertile) to Toxocara canis (OR = 1.70; 95%CI: 1.30-2.24, p<0.001) were associated with an increased prevalence of ACE. Exposure to multiple infections was common (73.8% of cases and 65.5% of controls had been exposed to two or more infections), and for T. gondii and O. volvulus co-infection, their combined effect on the prevalence of ACE, as determined by the relative excess risk due to interaction (RERI), was more than additive (T. gondii and O. volvulus, RERI = 1.19). The prevalence of T. solium antibodies was low (2.8% of cases and 2.2% of controls) and was not associated with ACE in the study areas. CONCLUSION: This study investigates how the degree of exposure to parasites and multiple parasitic infections are associated with ACE and may explain conflicting results obtained when only seropositivity is considered. The findings from this study should be further validated.
first_indexed 2024-03-07T02:24:18Z
format Journal article
id oxford-uuid:a50e46f9-5ae9-44d9-8ec9-e3fb636a0a9d
institution University of Oxford
language English
last_indexed 2024-03-07T02:24:18Z
publishDate 2014
publisher Public Library of Science
record_format dspace
spelling oxford-uuid:a50e46f9-5ae9-44d9-8ec9-e3fb636a0a9d2022-03-27T02:37:51ZExposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan AfricaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a50e46f9-5ae9-44d9-8ec9-e3fb636a0a9dEnglishSymplectic Elements at OxfordPublic Library of Science2014Kamuyu, GBottomley, CMageto, JLowe, BWilkins, PNoh, JNutman, TNgugi, AOdhiambo, RWagner, RKakooza-Mwesige, AOwusu-Agyei, SAe-Ngibise, KMasanja, HOsier, FOdermatt, PNewton, CBACKGROUND: Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa. METHODS AND FINDINGS: A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52-2.58, p<0.001), Toxocara canis (OR = 1.52; 95%CI: 1.23-1.87, p<0.001), Toxoplasma gondii (OR = 1.28; 95%CI: 1.04-1.56, p = 0.018) and higher antibody levels (top tertile) to Toxocara canis (OR = 1.70; 95%CI: 1.30-2.24, p<0.001) were associated with an increased prevalence of ACE. Exposure to multiple infections was common (73.8% of cases and 65.5% of controls had been exposed to two or more infections), and for T. gondii and O. volvulus co-infection, their combined effect on the prevalence of ACE, as determined by the relative excess risk due to interaction (RERI), was more than additive (T. gondii and O. volvulus, RERI = 1.19). The prevalence of T. solium antibodies was low (2.8% of cases and 2.2% of controls) and was not associated with ACE in the study areas. CONCLUSION: This study investigates how the degree of exposure to parasites and multiple parasitic infections are associated with ACE and may explain conflicting results obtained when only seropositivity is considered. The findings from this study should be further validated.
spellingShingle Kamuyu, G
Bottomley, C
Mageto, J
Lowe, B
Wilkins, P
Noh, J
Nutman, T
Ngugi, A
Odhiambo, R
Wagner, R
Kakooza-Mwesige, A
Owusu-Agyei, S
Ae-Ngibise, K
Masanja, H
Osier, F
Odermatt, P
Newton, C
Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title_full Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title_fullStr Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title_full_unstemmed Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title_short Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa
title_sort exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub saharan africa
work_keys_str_mv AT kamuyug exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT bottomleyc exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT magetoj exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT loweb exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT wilkinsp exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT nohj exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT nutmant exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT ngugia exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT odhiambor exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT wagnerr exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT kakoozamwesigea exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT owusuagyeis exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT aengibisek exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT masanjah exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT osierf exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT odermattp exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica
AT newtonc exposuretomultipleparasitesisassociatedwiththeprevalenceofactiveconvulsiveepilepsyinsubsaharanafrica