BACKGROUND: Community-based neurological data about human T lymphotropic virus type 1 (HTLV-1) morbidity in sub-Saharan Africa are scarce. OBJECTIVES: To ascertain the prevalence of neurological morbidity, in particular tropical spastic paraparesis (TSP), among HTLV-1-infected subjects and to compare TSP prevalence in HTLV-1-infected with that in non-infected subjects in a rural West African population. METHODS: A cross-sectional study of HTLV-1-infected cases and controls (ratio 4:1) from a rural community (population approximately 10 000, HTLV-1 prevalence 7.7%). One neurologist masked to HTLV-1 serological status assessed all subjects. Clinical criteria were employed to diagnose TSP. RESULTS: From 205 eligible cases and controls, 139 were recruited with a mean age of 56 years, and 113 (81%) were HTLV-1-infected. 108/139 (78%) were female, and 8/113 HTLV-1 infected cases (7.1%) had a definite or probable TSP (all females; mean age 67 years) compared with 0/26 controls. Two with TSP were co-infected with HIV-2. Complaints of back pain and leg weakness were more common in HTLV-1-infected individuals (p = 0.03, p = 0.02), but no single symptom distinguished between subjects with and without TSP. CONCLUSION: We report a prevalence of TSP among HTLV-1-infected persons in this rural West African setting of 7.1%. There are difficulties excluding other potential aetiologies here.
BACKGROUND: Community-based neurological data about human T lymphotropic virus type 1 (HTLV-1) morbidity in sub-Saharan Africa are scarce. OBJECTIVES: To ascertain the prevalence of neurological morbidity, in particular tropical spastic paraparesis (TSP), among HTLV-1-infected subjects and to compare TSP prevalence in HTLV-1-infected with that in non-infected subjects in a rural West African population. METHODS: A cross-sectional study of HTLV-1-infected cases and controls (ratio 4:1) from a rural community (population approximately 10 000, HTLV-1 prevalence 7.7%). One neurologist masked to HTLV-1 serological status assessed all subjects. Clinical criteria were employed to diagnose TSP. RESULTS: From 205 eligible cases and controls, 139 were recruited with a mean age of 56 years, and 113 (81%) were HTLV-1-infected. 108/139 (78%) were female, and 8/113 HTLV-1 infected cases (7.1%) had a definite or probable TSP (all females; mean age 67 years) compared with 0/26 controls. Two with TSP were co-infected with HIV-2. Complaints of back pain and leg weakness were more common in HTLV-1-infected individuals (p = 0.03, p = 0.02), but no single symptom distinguished between subjects with and without TSP. CONCLUSION: We report a prevalence of TSP among HTLV-1-infectedpersons in this rural West African setting of 7.1%. There are difficulties excluding other potential aetiologies here.
Authors: Carla van Tienen; Maarten F Schim van der Loeff; Ingrid Peterson; Matthew Cotten; Birgitta Holmgren; Sören Andersson; Tim Vincent; Ramu Sarge-Njie; Sarah Rowland-Jones; Assan Jaye; Peter Aaby; Hilton Whittle Journal: Retrovirology Date: 2010-06-04 Impact factor: 4.602
Authors: Carla van Tienen; Maarten Schim van der Loeff; Ingrid Peterson; Matthew Cotten; Sören Andersson; Birgitta Holmgren; Tim Vincent; Thushan de Silva; Sarah Rowland-Jones; Peter Aaby; Hilton Whittle Journal: PLoS One Date: 2011-12-14 Impact factor: 3.240
Authors: Carla van Tienen; Thushan I de Silva; Luiz Carlos Junior Alcantara; Clayton O Onyango; Sheikh Jarju; Nato Gonçalves; Tim Vincent; Peter Aaby; Hilton Whittle; Maarten Schim van der Loeff; Matthew Cotten Journal: PLoS Negl Trop Dis Date: 2012-06-12