Retrospective cohort studies in Cameroon found an association between Onchocerca volvulus microfilarial load in childhood (measured in 1991–1993) and risk of developing epilepsy later in life (measured in 2017). We parameterised and integrated this relationship (across children aged 3–15 years) into the previously published, stochastic transmission model, EPIONCHO-IBM, for Simulium damnosum sensu lato-transmitted onchocerciasis. We simulated 19 years (1998–2017) of annual ivermectin mass drug administration (MDA) reflecting coverage in the study area, and modelled epilepsy prevalence and incidence. Scenario-based simulations of 25 years of (annual and biannual) MDA in hyper- and holoendemic settings, with 65% and 80% therapeutic coverage, were also conducted. EPIONCHO-IBM predicted 7.6% epilepsy prevalence (compared to 8.2% in the Cameroon study) and incidence of 317 cases/100,000 person-years (compared to 350). In hyperendemic areas, 25 years of biannual MDA (80% coverage) eliminated onchocerciasis-associated epilepsy (OAE) and protected untreated under-fives from its development. Strengthening onchocerciasis programmes, implementing alternative strategies, and evaluating treatment for under-fives and school-age children are crucial to prevent OAE in highly-endemic settings.

喀麦隆的回顾性队列研究发现，儿童时期盘尾丝虫微丝虫载量（1991-1993 年测量）与晚年患癫痫的风险（2017 年测量）之间存在关联。我们将这种关系（跨 3-15 岁的儿童）参数化并整合到之前发布的随机传播模型 EPIONCHO-IBM​​ 中，用于模拟Simuliumdamnosum sensu lato 传播的盘尾丝虫病。我们模拟了 19 年（1998 年至 2017 年）的年度伊维菌素大规模用药（MDA），反映了研究区域的覆盖范围，并模拟了癫痫患病率和发病率。还对高流行和全流行环境中 25 年（每年一次和每年两次）的 MDA 进行了基于场景的模拟，治疗覆盖率分别为 65% 和 80%。 EPIONCHO-IBM​​ 预测癫痫患病率为 7.6%（喀麦隆研究中为 8.2%），发病率为 317 例/10 万人年（相比之下喀麦隆研究中为 350 例）。在高流行地区，25 年一次的 MDA（覆盖率达到 80%）消除了盘尾丝虫病相关癫痫 (OAE)，并保护未经治疗的 5 岁以下儿童免受其发展。加强盘尾丝虫病规划、实施替代策略以及评估五岁以下和学龄儿童的治疗对于在高流行地区预防 OAE 至关重要。