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Pathogens Webinar | Epilepsy in Onchocerciasis Endemic Areas

9 Jun 2021, 10:00

Pathogens, Human Onchocerciasis, Onchocerciasis-Associated Epilepsy
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Webinar Information

1st Pathogens Webinar

Epilepsy in Onchocerciasis Endemic Areas

Human Onchocerciasis is a parasitic disease caused by a filarial nematode (Onchocerca volvulus) and transmitted to humans by repeated bites of infected blackflies (Simulium spp.). Blackflies breed along fast-flowing rivers. In infected persons, adult worms are located in subcutaneous nodules where they can live for 15 years. Female worms produce around 1000 embryonic larvae per day (microfilariae) which migrate to the skin and eyes. Dying microfilariae are responsible for inflammatory reactions causing debilitating itching, skin lesions, and visual impairment leading to blindness (river blindness). Recent epidemiological studies strongly suggest that onchocerciasis also may induce epilepsy (onchocerciasis-associated epilepsy or river epilepsy). Onchocerciasis-associated epilepsy appears among children aged 5-18 years who were hitherto perfectly healthy. If left untreated, recurrent seizures can affect the brain causing significant mental damage. One of the clinical manifestations of onchocerciasis-associated epilepsy is nodding syndrome. Until recently nodding syndrome was considered to be a mysterious, untreatable, debilitating condition with very high mortality that only occurred in onchocerciasis –endemic regions in Uganda, South Sudan and Tanzania. Recent epidemiological studies have shown that nodding syndrome also occurs in many other onchocerciasis-endemic areas with high ongoing O. volvulus transmission, such as in regions of the Democratic Republic of the Congo, Cameroon and the Central African Republic. The exact pathophysiological mechanism of onchocerciasis-associated epilepsy is still unknown but the condition is preventable by strengthening onchocerciasis elimination efforts.

Prof. Robert Colebunders
Global Health Institute, University of Antwerp, Belgium
Institute of Tropical Medicine, Antwerp, Belgium

Date: 9 June 2021

Time: 10:00am CEST

Webinar ID: 893 9654 4071

Webinar Secretariat:

Chair: Prof. Robert Colebunders

The following experts will present and talk:

Prof. Robert Colebunders, Global Health Institute, University of Antwerp, Institute of Tropical Medicine, Belgium

Robert Colebunders is an Emeritus Professor of infectious diseases at the Global Health Institute of the University of Antwerp, and the Institute of Tropical Medicine, Antwerp Belgium. He was involved in numerous HIV and TB research and capacity building projects in Africa. He was a member of the international team that investigated the Kikwit Ebola and the Durba Marburg outbreak. Since 2013 he is involved in research to identify the cause of the nodding syndrome and epilepsy in onchocerciasis endemic regions.

Dr. Joseph N. Siewe Fodjo, Brain Research Africa Initiative (BRAIN), Cameroon

Dr Siewe Fodjo, MD, PhD is a research physician in the field of tropical neurology. His PhD project at the University of Antwerp (Belgium) focused on investigating the association between onchocerciasis and epilepsy in several African countries. Currently, he is pursuing a post-doctoral career at the Brain Research Africa Initiative (BRAIN) in Cameroon where he spearheads the implementation of a novel vector control method "Slash and Clear" for onchocerciasis control and epilepsy prevention.

Dr. Stephen Raimon Jada, Amref Health Africa, South Sudan

Dr. Stephen Jada, Physician and National Research Coordinator at Amref Health Africa, South Sudan, currently working on a research project to evaluate community-based approaches to prevent and treat people with epilepsy in onchocerciasis endemic villages in South Sudan.

Mr. Jacopo Mattia Rovarini, Amref Health Africa, South Sudan

Jacopo Mattia Rovarini, MA, MPH, is an international development professional and a public health practitioner, working with Amref Health Africa in South Sudan. He currently coordinates a consortium of national and international organizations, the so-called "Nodding Syndrome Alliance", responding to multi-sectoral needs of people with epilepsy/Nodding Syndrome in the Western Equatoria region of the above-mentioned country.

Ms. Melissa Krizia Vieri, Global Health Institute, University of Antwerp, Belgium

Melissa Krizia Vieri is a PhD student in medical sciences at the Global Health Institute, University of Antwerp, Belgium (The NSETHIO research group). The focus of her research is to decrease/stop the burden of the river epilepsy now called onchocerciasis associated epilepsy (OAE) by identifying the underlying mechanism of OAE.



Time in CEST

Prof. Robert Colebunders

Chair Introduction

10:00 – 10:10 am

Dr. Joseph N. Siewe Fodjo

Epidemiological Studies Concerning Onchocerciasis-Associated Epilepsy

10:10 – 10:35 am

(with Q&A)

Dr. Stephen Raimon Jada

Onchocerciasis-Associated Epilepsy in South Sudan and How to Prevent It

10:35 – 10:55 am

(with Q&A)

Mr. Jacopo Mattia Rovarini

An Epilepsy Treatment Program in Onchocerciasis-Endemic Regions in South Sudan

10:55 – 11:15 am

(with Q&A)

Ms. Melissa Krizia Vieri

The Pathogenesis of Onchocerciasis-Associated Epilepsy

11:15 – 11:35 am

(with Q&A)


11:35 – 11:55 am

Closing of Webinar
Prof. Robert Colebunders

11:55 am – 12:00 pm

Webinar Content

On Wednesday 9 June 2021, MDPI and the Journal Pathogens organized their 1st webinar entitled "Epilepsy in Onchocerciasis Endemic Areas".

The introduction was held by the Chair of the webinar, Prof. Robert Colebunders, Emeritus Professor of infectious diseases at the Global Health Institute of the University of Antwerp, Belgium. He made an overview of the Epilepsy epidemiology in the context of Onchocerciasis Endemic Areas.

The first speaker was Dr. Joseph N. Siewe Fodjo of the Brain Research Africa Initiative (BRAIN) in Cameroon, who reviewed the epidemiological studies concerning onchocerciasis-associated epilepsy and showed that there is strong epidemiological evidence for this association. Indeed this form of epilepsy appears in areas with high ongoing onchocerciasis transmission in children with a high level of onchocerciasis infection and disappears when onchocerciasis is eliminated.

After his presentation, Dr. Stephen Raimon Jada from Amref Health Africa, coordinator of the R2HC studies in South Sudan, described the enormous disease burden caused by onchocerciasis associated epilepsy in Maridi and Mvolo and also showed that with an onchocerciasis and epilepsy awareness programme the ivermectin coverage can be increased drastically and that with a community based simple and cheap “slash and clear” vector control method blackfly biting rates drop rapidly.

The third speaker, Jacopo Mattia Rovarini, coordinator of the Nodding syndrome alliance also working for Amref Health Africa in South Sudan, presented a community based epilepsy treatment programme in Maridi and Mundri that is treating more than 2000 persons, mainly children with epilepsy.

The final presentation was given by Melissa Krizia Vieri from the Global Health Institute of the University of Antwerp reviewed to most recent studies investigating the pathogenesis of onchocerciasis-associated epilepsy. It is clear that neither the Onchocerca volvulus parasite nor its endosymbiont Wolbachia are able to enter the brain. Therefore another mechanism, maybe an immunological one needs to be further investigated.

In the discussion, with the participation of Maria Gloria Basanez and Adrian Hopkins, it was stressed that more advocacy is needed to convince public health decision makers and funders to address this neglected/unrecognised important public health problem.

The presentations were followed by a Q&A and a discussion, moderated by the Chair. The webinar was offered via Zoom and required registration to attend. The full recording can be found here on Sciforum website. In order to stay updated on the next webinars on Pathogens, be sure to sign up for our newsletter by clicking on “Subscribe” at the top of the page.


In order to attend the webinar, please register by clicking on the button below.

This is a FREE webinar. The number of participants to the live session is limited but the recording will be made available on Sciforum shortly afterwards. Registrations with academic institutional email addresses will be prioritized. People can send in their questions by email to

Relevant Special Issues

Onchocerciasis and River Epilepsy
Guest Editors: Prof. Dr. Robert Colebunders, Prof. Dr. Jacob Souopgui
Deadline for manuscript submissions: 31 December 2021

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