THE PREVALENCE OF EPILEPSY FOLLOWS THE DISTRIBUTION OF ONCHOCERCIASISIN A WEST UGANDAN FOCUS

Epidemiological surveys indicate that the prevalence of epilepsy is hi gher in developing countries than in industrialized countries, Except for neurocystocercosis due to Taenia solium, little is known about pos sible underlying causes. This article reports the relationship between epilepsy and onchocerciasis in an Onchocerca volvulus endemic area in West Uganda. individuals complaining of seizures were identified by m eans of a population census in 12 villages, Active epilepsy was confir med in 61 of 4743 inhabitants (crude prevalence rate = 1.3%; age-stand ardized rate = 1.1%). Distribution of epilepsy in the study area was c lustered, ranging from a prevalence of 0.2% to 3.4% in different villa ges, Age-specific prevalence was highest between 10 and 19 years, with a rate of 3.6% for the study area as a whole, and up to 10.0% in vill ages of high epilepsy prevalence. The prevalence of onchocerciasis in the 10-19-year-old age group was assessed by skin-snip biopsy and rang ed from 15% to 85% in different villages. Epilepsy was significantly m ore frequent in the three villages with the highest levels of O. volvu lus endemicity than in other villages (P < 0.0001). Serological testin g for T. solium infection was positive in one and borderline in three of 53 epilepsy patients tested The significant correlation between epi lepsy and onchocerciasis did not change when these four patients were excluded from the analysis. These findings suggest a strong associatio n between epilepsy and onchocerciasis in this area. This could have si gnificant implications for the concept of morbidity due to O. volvulus .