High prevalence of cysticercosis in people with epilepsy in southern Rwanda.
BACKGROUND: Neurocysticercosis (NCC), the central nervous system infection by Taenia solium larvae, is a preventable and treatable cause of epilepsy. In Sub-Saharan Africa, the role of NCC in epilepsy differs geographically and, overall, is poorly defined. We aimed at contributing specific, first da...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-11-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC3828157?pdf=render |
| _version_ | 1818444029314990080 |
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| author | Ruth Rottbeck Jules Fidèle Nshimiyimana Pierrot Tugirimana Uta E Düll Janko Sattler Jean-Claudien Hategekimana Janvier Hitayezu Irmengard Bruckmaier Matthias Borchert Jean Bosco Gahutu Sebastian Dieckmann Gundel Harms Frank P Mockenhaupt Ralf Ignatius |
| author_facet | Ruth Rottbeck Jules Fidèle Nshimiyimana Pierrot Tugirimana Uta E Düll Janko Sattler Jean-Claudien Hategekimana Janvier Hitayezu Irmengard Bruckmaier Matthias Borchert Jean Bosco Gahutu Sebastian Dieckmann Gundel Harms Frank P Mockenhaupt Ralf Ignatius |
| author_sort | Ruth Rottbeck |
| collection | DOAJ |
| description | BACKGROUND: Neurocysticercosis (NCC), the central nervous system infection by Taenia solium larvae, is a preventable and treatable cause of epilepsy. In Sub-Saharan Africa, the role of NCC in epilepsy differs geographically and, overall, is poorly defined. We aimed at contributing specific, first data for Rwanda, assessing factors associated with NCC, and evaluating a real-time PCR assay to diagnose NCC in cerebrospinal fluid (CSF). METHODOLOGY/PRINCIPAL FINDINGS: At three healthcare facilities in southern Rwanda, 215 people with epilepsy (PWE) and 51 controls were clinically examined, interviewed, and tested by immunoblot for cysticerci-specific serum antibodies. Additionally, CSF samples from PWE were tested for anticysticercal antibodies by ELISA and for parasite DNA by PCR. Cranial computer tomography (CT) scans were available for 12.1% of PWE with additional symptoms suggestive of NCC. The Del Brutto criteria were applied for NCC diagnosis. Cysticerci-specific serum antibodies were found in 21.8% of PWE and 4% of controls (odds ratio (OR), 6.69; 95% confidence interval (95%CI), 1.6-58.7). Seropositivity was associated with age and lack of safe drinking water. Fifty (23.3%) PWE were considered NCC cases (definitive, based on CT scans, 7.4%; probable, mainly based on positive immunoblots, 15.8%). In CSF samples from NCC cases, anticysticercal antibodies were detected in 10% (definitive cases, 25%) and parasite DNA in 16% (definitive cases, 44%). Immunoblot-positive PWE were older (medians, 30 vs. 22 years), more frequently had late-onset epilepsy (at age >25 years; 43.5% vs. 8.5%; OR, 8.30; 95%CI, 3.5-20.0), and suffered from significantly fewer episodes of seizures in the preceding six months than immunoblot-negative PWE. CONCLUSIONS/SIGNIFICANCE: NCC is present and contributes to epilepsy in southern Rwanda. Systematic investigations into porcine and human cysticercosis as well as health education and hygiene measures for T. solium control are needed. PCR might provide an additional, highly specific tool in NCC diagnosis. |
| first_indexed | 2024-12-14T19:09:26Z |
| format | Article |
| id | doaj.art-b8e356e85fcb4dc7b0101474691e4adb |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-14T19:09:26Z |
| publishDate | 2013-11-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-b8e356e85fcb4dc7b0101474691e4adb2022-12-21T22:50:47ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352013-11-01711e255810.1371/journal.pntd.0002558High prevalence of cysticercosis in people with epilepsy in southern Rwanda.Ruth RottbeckJules Fidèle NshimiyimanaPierrot TugirimanaUta E DüllJanko SattlerJean-Claudien HategekimanaJanvier HitayezuIrmengard BruckmaierMatthias BorchertJean Bosco GahutuSebastian DieckmannGundel HarmsFrank P MockenhauptRalf IgnatiusBACKGROUND: Neurocysticercosis (NCC), the central nervous system infection by Taenia solium larvae, is a preventable and treatable cause of epilepsy. In Sub-Saharan Africa, the role of NCC in epilepsy differs geographically and, overall, is poorly defined. We aimed at contributing specific, first data for Rwanda, assessing factors associated with NCC, and evaluating a real-time PCR assay to diagnose NCC in cerebrospinal fluid (CSF). METHODOLOGY/PRINCIPAL FINDINGS: At three healthcare facilities in southern Rwanda, 215 people with epilepsy (PWE) and 51 controls were clinically examined, interviewed, and tested by immunoblot for cysticerci-specific serum antibodies. Additionally, CSF samples from PWE were tested for anticysticercal antibodies by ELISA and for parasite DNA by PCR. Cranial computer tomography (CT) scans were available for 12.1% of PWE with additional symptoms suggestive of NCC. The Del Brutto criteria were applied for NCC diagnosis. Cysticerci-specific serum antibodies were found in 21.8% of PWE and 4% of controls (odds ratio (OR), 6.69; 95% confidence interval (95%CI), 1.6-58.7). Seropositivity was associated with age and lack of safe drinking water. Fifty (23.3%) PWE were considered NCC cases (definitive, based on CT scans, 7.4%; probable, mainly based on positive immunoblots, 15.8%). In CSF samples from NCC cases, anticysticercal antibodies were detected in 10% (definitive cases, 25%) and parasite DNA in 16% (definitive cases, 44%). Immunoblot-positive PWE were older (medians, 30 vs. 22 years), more frequently had late-onset epilepsy (at age >25 years; 43.5% vs. 8.5%; OR, 8.30; 95%CI, 3.5-20.0), and suffered from significantly fewer episodes of seizures in the preceding six months than immunoblot-negative PWE. CONCLUSIONS/SIGNIFICANCE: NCC is present and contributes to epilepsy in southern Rwanda. Systematic investigations into porcine and human cysticercosis as well as health education and hygiene measures for T. solium control are needed. PCR might provide an additional, highly specific tool in NCC diagnosis.http://europepmc.org/articles/PMC3828157?pdf=render |
| spellingShingle | Ruth Rottbeck Jules Fidèle Nshimiyimana Pierrot Tugirimana Uta E Düll Janko Sattler Jean-Claudien Hategekimana Janvier Hitayezu Irmengard Bruckmaier Matthias Borchert Jean Bosco Gahutu Sebastian Dieckmann Gundel Harms Frank P Mockenhaupt Ralf Ignatius High prevalence of cysticercosis in people with epilepsy in southern Rwanda. PLoS Neglected Tropical Diseases |
| title | High prevalence of cysticercosis in people with epilepsy in southern Rwanda. |
| title_full | High prevalence of cysticercosis in people with epilepsy in southern Rwanda. |
| title_fullStr | High prevalence of cysticercosis in people with epilepsy in southern Rwanda. |
| title_full_unstemmed | High prevalence of cysticercosis in people with epilepsy in southern Rwanda. |
| title_short | High prevalence of cysticercosis in people with epilepsy in southern Rwanda. |
| title_sort | high prevalence of cysticercosis in people with epilepsy in southern rwanda |
| url | http://europepmc.org/articles/PMC3828157?pdf=render |
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