A high prevalence of epilepsy (up to 1.3%) was observed in an area hyperendemic for onchocerciasis in the province of Bururi, Burundi. Following this observation, epileptics and controls were examined in 2 communes (administrative units) with different endemicity for onchocerciasis. Altogether, onchocerciasis was more frequent in epileptics (81.8%) than in controls from the same households (68.3%; P < 0.05). This difference was more marked in the hyperendemic area. Other possible causes of epilepsy, including cysticercosis, were infrequent (18 possible cases among 110 epileptics). During this survey, 9 epileptics with growth retardation were seen. They showed most characteristics of Nakalanga syndrome, which was described from Uganda. All 9 such cases were suffering from onchocerciasis. These findings give more evidence of a possible association between onchocerciasis and epilepsy, and between onchocerciasis and Nakalanga syndrome.

In the province of Bururi in Burundi, 103 epileptics and 72 control subjects from the same households were examined for cysticercosis. Antigen was detected by enzyme-linked immunosorbent assay in 4.9% of epileptic persons and in 4.2% of controls. Antibody was detected by enzyme-linked electroimmunotransfer blot assay (EITB) in 11.7% of epileptics and in 2.8% of controls. Neither difference was statistically significant, nor was a history of taeniasis significantly more frequent in epileptics than in controls. However, cysticercosis was significantly more frequently diagnosed by EITB in people with a history of taeniasis than in those without such a history. The prevalence of taeniasis in schoolchildren ranged between 0 and 1.0%. Meat inspection detected cysticercosis in 2% and 39% of pigs in 2 localities, respectively.

SummaryBetween 1991 and 1994,4 annual treatments with ivermectin were offered to the population of an area hyperendemic for onchocerciasis in the province of Bururi (Burundi). In one place, Kinama,

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Ré suméUn échantillon de la population de 20 collines (unités administratives) de la province de Bururi (Burundi) a été examiné pour déterminer la prévalence et l'intensité de l'onchocercose dans cette région endémique. Globalement, 34,4% de la population y est parasitée, ce qui revient à environ 80 000 personnes pour la totalité du foyer. Autour de Rumonge se trouve une zone hyperendémique. Elle est entourée par une zone mésoendémique et à la périphérie se trouve une zone hypoendémique. L'examen clinique d'un sous-échantillon a montré que le prurit et les lésions cutanées ne sont pas très fréquents (respectivement 58,2% et 28,1% chez les sujets positifs). Les nodules sous-cutanés sont de petite taille et difficiles à trouver (21,3% chez les sujets positifs). L'acuité visuelle est 10/10 pour 92,2% des yeux examinés. Une légère diminution de la vision, chez 9,4% des cas positifs, pourrait être attribuée à l'onchocercose. Endemicity and clinical manifestations of onchocerciasis in the province of Bururi, Burundi SummaryA sample of the population of 20 'collines' (administrative units) of the province of Bururi (Burundi, Central Africa) was examined to determine the prevalence and intensity of onchocerciasis in this endemic region. In all, 34.4% of the population is infected, that is about 80 000 people for the whole area. Around Rumonge onchocerciasis is hyperendemic. This area is surrounded by a mesoendemic zone and at the periphery onchocerciasis is hypoendemic. The clinical examination of a subsample showed that pruritus and skin lesions are not very frequent (58.2 and 28.1% respectively in positive persons). Subcutaneous nodules are small and difficult to find (21.3% in positive cases). Vision is 10/10 in 92.2% of the examined eyes. A slight drop in visual acuity may be attributed to onchocerciasis in 9.4% of positive cases.