Research Officer at Brain Research Africa Initiative (BRAIN)
"Slash and Clear" for ONchocerciasis control and Epilepsy prevention (SCONE)
Career Development Fellowship (CDF)
The overall objective of this study is to implement the "Slash and Clear" (S&C) vector control intervention (as a complementary strategy to community-directed treatment with ivermectin) along rivers near onchocerciasis-endemic villages and assess its potential impact on onchocerciasis and epilepsy. Specifically, we seek to: • Map blackfly breeding sites and obtain updated data on onchocerciasis endemicity and ongoing transmission in the Mbam and Sanaga river valleys of Cameroon • Investigate the feasibility and acceptability of S&C in selected Cameroonian villages which are meso/hyperendemic for onchocerciasis • Evaluate the impact of repeated annual S&C on transmission patterns and infection trends of onchocerciasis, as well as on epilepsy incidence in the study villages
Prospective, community-based, cluster randomized trial with a duration of three years.
Onchocerciasis is a parasitic disease caused by Onchocerca volvulus and transmitted to humans via blackfly bites. Besides the usual skin and eye symptoms reported in persons with onchocerciasis, it is becoming obvious that the parasite also causes epileptic disorders. Despite years of annual mass treatment with ivermectin, onchocerciasis transmission persists in Cameroon especially in villages with loasis co-endemicity. Moreover, with the preventive measures instituted to limit COVID-19 transmission, the usual door-to-door distribution of ivermectin for onchocerciasis control may be implausible until the pandemic has been fully contained. Alternative elimination strategies are urgently needed to curtail onchocerciasis transmission and reduce its disease burden without violating the health safety guidelines in place. The effectiveness of the “slash and clear” (S&C) method in reducing blackfly biting rates has been demonstrated in hypoendemic onchocerciasis foci in Uganda. However S&C has not been evaluated in meso/hyperendemic settings, and there are no empirical data showing that this intervention is able to reduce onchocerciasis transmission and epilepsy incidence in the short term. This project seeks to follow-up on the transmission of onchocerciasis when annual S&C is implemented in affected Cameroonian villages, and the consequences on new cases of epilepsy after two consecutive years of intervention. Study villages with similar onchocerciasis endemicity levels at baseline will be randomised to annual S&C and no S&C. Outcome parameters such as Ov16 seroprevalence in children < 10 years, O. volvulus microfilarial load in the general population, and entomological measures (blackfly biting rates, blackfly infectivity rates) will be investigated prospectively to monitor onchocerciasis transmission patterns. The collected data will be used to construct mathematical models to predict onchocerciasis transmission and assess the added benefits of annual S&C interventions. At the start of the project and after the repeated S&C interventions, epilepsy surveys will be conducted in all study sites. Based on the reported year of seizure onset among the identified persons with epilepsy, year-by-year epilepsy incidence will be established retrospectively and compared across studies villages with and without S&C.
|Brain Research Africa Initiative (BRAIN)
Brain Research Africa Initiative (BRAIN)