Dataset Information

Onchocerca volvulus and epilepsy: A comprehensive review using the Bradford Hill criteria for causation.

ABSTRACT:

Background

The possibility that onchocerciasis may cause epilepsy has been suggested for a long time, but thus far, an etiological link has not been universally accepted. The objective of this review is to critically appraise the relationship between Onchocerca volvulus and epilepsy and subsequently apply the Bradford Hill criteria to further evaluate the likelihood of a causal association.

Methods

PubMed and gray literature published until September 15, 2020, were searched and findings from original research were synthesized. Adherence to the 9 Bradford Hill criteria in the context of onchocerciasis and epilepsy was determined to assess whether the criteria are met to strengthen the evidence base for a causal link between infection with O. volvulus and epilepsy, including the nodding syndrome.

Results

Onchocerciasis as a risk factor for epilepsy meets the following Bradford Hill criteria for causality: strength of the association, consistency, temporality, and biological gradient. There is weaker evidence supporting causality based on the specificity, plausibility, coherence, and analogy criteria. There is little experimental evidence. Considering the Bradford Hill criteria, available data suggest that under certain conditions (high microfilarial load, timing of infection, and perhaps genetic predisposition), onchocerciasis is likely to cause epilepsy including nodding and Nakalanga syndromes.

Conclusion

Applying the Bradford Hill criteria suggests consistent epidemiological evidence that O. volvulus infection is a trigger of epilepsy. However, the pathophysiological mechanisms responsible for seizure induction still need to be elucidated.

SUBMITTER: Colebunders R

PROVIDER: S-EPMC7790236 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Onchocerca volvulus and epilepsy: A comprehensive review using the Bradford Hill criteria for causation.

Colebunders Robert R Njamnshi Alfred K AK Menon Sonia S Newton Charles R CR Hotterbeekx An A Preux Pierre-Marie PM Hopkins Adrian A Vaillant Michel M Siewe Fodjo Joseph Nelson JN

PLoS neglected tropical diseases 20210107 1

<h4>Background</h4>The possibility that onchocerciasis may cause epilepsy has been suggested for a long time, but thus far, an etiological link has not been universally accepted. The objective of this review is to critically appraise the relationship between Onchocerca volvulus and epilepsy and subsequently apply the Bradford Hill criteria to further evaluate the likelihood of a causal association.<h4>Methods</h4>PubMed and gray literature published until September 15, 2020, were searched and fi ...[more]

PMID: 33411705

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Project description:ObjectivesTo assess the evidence for price-based alcohol policy interventions to determine whether minimum unit pricing (MUP) is likely to be effective.DesignSystematic review and assessment of studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, against the Bradford Hill criteria for causality. Three electronic databases were searched from inception to February 2017. Additional articles were found through hand searching and grey literature searches.Criteria for selecting studiesWe included any study design that reported on the effect of price-based interventions on alcohol consumption or alcohol-related morbidity, mortality and wider harms. Studies reporting on the effects of taxation or affordability and studies that only investigated price elasticity of demand were beyond the scope of this review. Studies with any conflict of interest were excluded. All studies were appraised for methodological quality.ResultsOf 517 studies assessed, 33 studies were included: 26 peer-reviewed research studies and seven from the grey literature. All nine of the Bradford Hill criteria were met, although different types of study satisfied different criteria. For example, modelling studies complied with the consistency and specificity criteria, time series analyses demonstrated the temporality and experiment criteria, and the analogy criterion was fulfilled by comparing the findings with the wider literature on taxation and affordability.ConclusionsOverall, the Bradford Hill criteria for causality were satisfied. There was very little evidence that minimum alcohol prices are not associated with consumption or subsequent harms. However the overall quality of the evidence was variable, a large proportion of the evidence base has been produced by a small number of research teams, and the quantitative uncertainty in many estimates or forecasts is often poorly communicated outside the academic literature. Nonetheless, price-based alcohol policy interventions such as MUP are likely to reduce alcohol consumption, alcohol-related morbidity and mortality.

Dataset Information

Onchocerca volvulus and epilepsy: A comprehensive review using the Bradford Hill criteria for causation.

Background

Methods

Results

Conclusion

Publications

Onchocerca volvulus and epilepsy: A comprehensive review using the Bradford Hill criteria for causation.

Similar Datasets

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