Ewan Hunter1, Kathryn Burton2, Ahmed Iqbal3, Daniel Birchall4, Margaret Jackson4, Jane Rogathe5, Ahmed Jusabani5, William Gray6, Eric Aris7, Gathoni Kamuyu8, Patricia P Wilkins9, Charles R Newton8,10,11, Richard Walker6,12. 1. Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. 2. Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 3. Institute of Neurosciences, Southern General Hospital, Glasgow, UK. 4. Newcastle Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK. 5. Kilimanjaro Christian Medical Centre, Moshi, Tanzania. 6. Northumbria Healthcare NHS Foundation Trust, North Shields, UK. 7. Muhimbili National Hospital, Dar es Salaam, Tanzania. 8. Centre for Geographical Medicine (Coast), Kilifi, Kenya. 9. Centers for Disease Control & Prevention, Atlanta, GA, USA. 10. Muhimbili-Wellcome Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania. 11. Department of Psychiatry, University of Oxford, Oxford, UK. 12. Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK.
Abstract
OBJECTIVE: To assess the contribution of neurocysticercosis (NCC) to the burden of epilepsy in a rural Tanzanian population. METHODS: We identified adult people with epilepsy (PWE) in a door-to-door study in an established demographic surveillance site. PWE and community controls were tested for antibodies to Taenia solium, the causative agent of NCC, and all PWE were offered a computed tomography (CT) head scan. Data on household occupancy and sanitation, pig-keeping and pork consumption were collected from PWE and controls and associations with epilepsy were assessed using chi-square or Fisher's exact tests. RESULTS: Six of 218 PWE had antibodies to T. solium (2.8%; 95% CI 0.6-4.9), compared to none of 174 controls (Fisher's exact test, P = 0.04). Lesions compatible with NCC were seen in eight of 200 CT scans (4.0%; 95% CI 1.3-6.7). A total of 176 PWE had both investigations of whom two had positive serology along with NCC-compatible lesions on CT (1.1%; 95% 0.3-4.0). No associations between epilepsy and any risk factors for NCC were identified. CONCLUSIONS: Neurocysticercosis is present in this population but at a lower prevalence than elsewhere in Tanzania and sub-Saharan Africa. Insights from low-prevalence areas may inform public health interventions designed to reduce the burden of preventable epilepsy.
OBJECTIVE: To assess the contribution of neurocysticercosis (NCC) to the burden of epilepsy in a rural Tanzanian population. METHODS: We identified adult people with epilepsy (PWE) in a door-to-door study in an established demographic surveillance site. PWE and community controls were tested for antibodies to Taenia solium, the causative agent of NCC, and all PWE were offered a computed tomography (CT) head scan. Data on household occupancy and sanitation, pig-keeping and pork consumption were collected from PWE and controls and associations with epilepsy were assessed using chi-square or Fisher's exact tests. RESULTS: Six of 218 PWE had antibodies to T. solium (2.8%; 95% CI 0.6-4.9), compared to none of 174 controls (Fisher's exact test, P = 0.04). Lesions compatible with NCC were seen in eight of 200 CT scans (4.0%; 95% CI 1.3-6.7). A total of 176 PWE had both investigations of whom two had positive serology along with NCC-compatible lesions on CT (1.1%; 95% 0.3-4.0). No associations between epilepsy and any risk factors for NCC were identified. CONCLUSIONS:Neurocysticercosis is present in this population but at a lower prevalence than elsewhere in Tanzania and sub-Saharan Africa. Insights from low-prevalence areas may inform public health interventions designed to reduce the burden of preventable epilepsy.
Authors: Hector H Garcia; Silvia Rodriguez; Robert H Gilman; Armando E Gonzalez; Victor C W Tsang Journal: Trop Med Int Health Date: 2012-07-19 Impact factor: 2.622
Authors: H R Martinez; R Rangel-Guerra; G Elizondo; J Gonzalez; L E Todd; J Ancer; S S Prakash Journal: AJNR Am J Neuroradiol Date: 1989 Sep-Oct Impact factor: 3.825
Authors: E Newell; F Vyungimana; S Geerts; I Van Kerckhoven; V C Tsang; D Engels Journal: Trans R Soc Trop Med Hyg Date: 1997 Jul-Aug Impact factor: 2.184
Authors: Sukwan Handali; Molly Klarman; Amanda N Gaspard; John Noh; Yeuk-Mui Lee; Silvia Rodriguez; Armando E Gonzalez; Hector H Garcia; Robert H Gilman; Victor C W Tsang; Patricia P Wilkins Journal: Clin Vaccine Immunol Date: 2009-11-11
Authors: Andrea Sylvia Winkler; Joachim Blocher; Herbert Auer; Thaddaeus Gotwald; William Matuja; Erich Schmutzhard Journal: Epilepsia Date: 2008-11-19 Impact factor: 5.864
Authors: Ewan Hunter; Jane Rogathi; Simukai Chigudu; Ahmed Jusabani; Margaret Jackson; Richard McNally; William Gray; Roger G Whittaker; Ahmed Iqbal; Daniel Birchall; Eric Aris; Richard Walker Journal: Seizure Date: 2012-08-09 Impact factor: 3.184
Authors: Akira Ito; Hiroshi Yamasaki; Minoru Nakao; Yasuhito Sako; Munehiro Okamoto; Marcello O Sato; Kazuhiro Nakaya; Sri S Margono; Takashi Ikejima; Ayub A Kassuku; Sonia M S Afonso; Washington Benitez Ortiz; Agustin Plancarte; Andre Zoli; Stanny Geerts; Philip S Craig Journal: Acta Trop Date: 2003-06 Impact factor: 3.112
Authors: Chacha Nyangi; Dominik Stelzle; Ernatus M Mkupasi; Helena A Ngowi; Ayubu J Churi; Veronika Schmidt; Christopher Mahonge; Andrea S Winkler Journal: BMC Infect Dis Date: 2022-06-13 Impact factor: 3.667
Authors: Gabrielle Bonnet; Francesco Pizzitutti; Eloy A Gonzales-Gustavson; Sarah Gabriël; William K Pan; Hector H Garcia; Javier A Bustos; Percy Vilchez; Seth E O'Neal Journal: PLoS Comput Biol Date: 2022-05-19 Impact factor: 4.779
Authors: Oscar H Del Brutto; Gianfranco Arroyo; Victor J Del Brutto; Mauricio Zambrano; Héctor H García Journal: Epilepsia Date: 2017-08-29 Impact factor: 5.864
Authors: Helena Aminiel Ngowi; Andrea Sylvia Winkler; Uffe Christian Braae; Robinson Hammerthon Mdegela; Ernatus Martin Mkupasi; Mwemezi Lutakyawa Kabululu; Faustin Peter Lekule; Maria Vang Johansen Journal: PLoS One Date: 2019-06-05 Impact factor: 3.240
Authors: Veronika Schmidt; Marie-Claire O'Hara; Bernard Ngowi; Karl-Heinz Herbinger; John Noh; Patricia Procell Wilkins; Vivien Richter; Christian Kositz; William Matuja; Andrea Sylvia Winkler Journal: PLoS Negl Trop Dis Date: 2019-12-06