An unusually high number of patients with epilepsy was observed in Kyarusozi sub-county, where infection with Onchocerca volvulus is hyperendemic. A preliminary survey was carried out in April 1991, when all patients with epilepsy and growth retardation were invited for medical examination. Two hundred and thirty one patients were screened, of whom, 91% were below the age of 19 years. The infection rate with Onchocerca volvulus in patients with epilepsy (61%) and retarded growth (70%) was significantly higher than in the general population of Kyarusozi sub-county. The prevalence of epilepsy in the study area was estimated to be at least 2%. Psychological impairment was more often observed among patients with a combination of onchocerciasis, epilepsy and/or growth retardation than the patients with onchocerciasis, epilepsy or growth retardation alone.
PIP: A remarkably high number of patients with epilepsy was observed in Kyarusozi subcounty, Uganda, where infection with Onchocerca volvulus is hyperendemic. A survey was conducted from April 22 to May 4, 1991, in Kyarusozi subcounty when all patients with epilepsy and growth retardation were invited for medical examination. A full history was taken and a physical examination as well as a mental state assessment were carried out for all patients. A total of 231 persons were screened, of whom, 91% were below the age of 19 years. The infection rate with Onchocerca volvulus in patients with epilepsy (61%) and retarded growth (70%) was significantly higher than in the general population of Kyarusozi subcounty. The prevalence of epilepsy in the study area was estimated to be at least 2%. The cardinal clinical features were pigeon chest, increased curvature of the dorsum, hyperextended joints, poor oral hygiene, and dental caries with disproportionately large, and displaced maloccluded teeth. Additional features were malnutrition, including dry atrophic scaly skin, skin sores, and golden hair. The thyroid gland was enlarged in 7.4% of the children with physical growth retardation. Secondary sexual characteristics were absent or poorly developed in a further 1.3%. The data seemed to indicate that social adaptation and psychological functioning are more often disturbed in individuals who suffer from the combined effects of epilepsy, onchocerciasis, and growth retardation than in patients with onchocerciasis, epilepsy, or growth retardation along. This investigation suggests that onchocerciasis is associated with epilepsy, psychological impairment, retarded growth, and retarded sexual development. Should further studies confirm a relationship between Onchocerca volvulus infection, epilepsy, and mental development, the public health importance of onchocerciasis would have the be reconsidered to control Onchocerca volvulus infection more vigorously.