Table 1 Onchocerciasis-associated epilepsy (OAE), challenges and opportunities

Burden of disease caused by onchocerciasis is more important than previously estimated

Accurate estimation of burden of disease due to onchocerciasis, including OAE, is a pressing need

Determination of OAE prevalence and incidence provides an argument to strengthen and accelerate onchocerciasis elimination programmes by identifying areas of weakness

OAE awareness and advocacy are inadequate

Determination of OAE prevalence and incidence provides an argument to obtain more funding for operational research for onchocerciasis elimination efforts

High prevalence/ incidence of OAE suggest ongoing onchocerciasis transmission

Strengthen epilepsy surveillance in onchocerciasis endemic regions

CDDs could be engaged in assisting with epilepsy surveillance

OAE is preventable

Biannual CDTI should be promoted

Message will increase the motivation of populations to take ivermectin, potentially increasing compliance

Misconceptions and stigma associated with epilepsy

Health promotion activities to reduce misconceptions and stigma among populations

OAE is treatable

In onchocerciasis-endemic regions, a decentralised system is needed to diagnose and treat epilepsy early and appropriately

CDDs could be trained to monitor antiepileptic treatment adherence

Little collaboration between onchocerciasis elimination and mental health programmes

Onchocerciasis and public mental health programmes working together