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Prevalence of neurocysticercosis in people with epilepsy in the Eastern Province of Zambia

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Abstract
Zambia is endemic for Taenia solium taeniosis and cysticercosis. In this single-centered, cross-sectional, community-based study, the role of neurocysticercosis (NCC) as a cause of epilepsy was examined. People with epilepsy (PWE, n = 56) were identified in an endemic area using a screening questionnaire followed by in-depth interviews and neurological examination. Computed tomography (CT) was performed on 49 people with active epilepsy (PWAE) and their sera (specific antibody and antigen detection, n = 56) and stools (copro-antigen detection, n = 54) were analyzed. The CT scan findings were compared to a group of 40 CT scan controls. Of the PWE, 39.3% and 23.2% were positive for cysticercal antibodies and antigens, respectively, and 14.8% for coproantigens (taeniosis). Lesions highly suggestive of NCC were detected in 24.5% and definite NCC lesions in 4.1% of CT scans of PWAE. This compares to 2.5% and 0%, respectively, in the control CT scans. Using the Del Brutto diagnostic criteria, 51.8% of the PWAE were diagnosed with probable or definitive NCC and this rose to 57.1% when the adapted criteria, as proposed by Gabriel et al. (adding the sero-antigen ELISA test as a major criterion), were used. There was no statistically significant relationship between NCC, current age, age at first seizure and gender. This study suggests that NCC is the single most important cause of epilepsy in the study area. Additional large-scale studies, combining a community based prevalence study for epilepsy with neuroimaging and serological analysis in different areas are needed to estimate the true impact of neurocysticercosis in endemic regions and efforts should be instituted to the control of T. solium.
Keywords
MANAGEMENT, EPIDEMIOLOGY, COUNTRIES, COMMUNITY, SOUTHERN PROVINCES, DIAGNOSTIC-CRITERIA, CLINICAL CHARACTERISTICS, PORCINE CYSTICERCOSIS, TAENIA-SOLIUM, SUB-SAHARAN AFRICA

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Chicago
Mwape, Kabemba E, Joachim Blocher, Jasmin Wiefek, Kathie Schmidt, Pierre Dorny, Nicolas Praet, Clarance Chiluba, et al. 2015. “Prevalence of Neurocysticercosis in People with Epilepsy in the Eastern Province of Zambia.” Plos Neglected Tropical Diseases 9 (8).
APA
Mwape, K. E., Blocher, J., Wiefek, J., Schmidt, K., Dorny, P., Praet, N., Chiluba, C., et al. (2015). Prevalence of neurocysticercosis in people with epilepsy in the Eastern Province of Zambia. PLOS NEGLECTED TROPICAL DISEASES, 9(8).
Vancouver
1.
Mwape KE, Blocher J, Wiefek J, Schmidt K, Dorny P, Praet N, et al. Prevalence of neurocysticercosis in people with epilepsy in the Eastern Province of Zambia. PLOS NEGLECTED TROPICAL DISEASES. 2015;9(8).
MLA
Mwape, Kabemba E, Joachim Blocher, Jasmin Wiefek, et al. “Prevalence of Neurocysticercosis in People with Epilepsy in the Eastern Province of Zambia.” PLOS NEGLECTED TROPICAL DISEASES 9.8 (2015): n. pag. Print.
@article{7093317,
  abstract     = {Zambia is endemic for Taenia solium taeniosis and cysticercosis. In this single-centered, cross-sectional, community-based study, the role of neurocysticercosis (NCC) as a cause of epilepsy was examined. People with epilepsy (PWE, n = 56) were identified in an endemic area using a screening questionnaire followed by in-depth interviews and neurological examination. Computed tomography (CT) was performed on 49 people with active epilepsy (PWAE) and their sera (specific antibody and antigen detection, n = 56) and stools (copro-antigen detection, n = 54) were analyzed. The CT scan findings were compared to a group of 40 CT scan controls. Of the PWE, 39.3\% and 23.2\% were positive for cysticercal antibodies and antigens, respectively, and 14.8\% for coproantigens (taeniosis). Lesions highly suggestive of NCC were detected in 24.5\% and definite NCC lesions in 4.1\% of CT scans of PWAE. This compares to 2.5\% and 0\%, respectively, in the control CT scans. Using the Del Brutto diagnostic criteria, 51.8\% of the PWAE were diagnosed with probable or definitive NCC and this rose to 57.1\% when the adapted criteria, as proposed by Gabriel et al. (adding the sero-antigen ELISA test as a major criterion), were used. There was no statistically significant relationship between NCC, current age, age at first seizure and gender. This study suggests that NCC is the single most important cause of epilepsy in the study area. Additional large-scale studies, combining a community based prevalence study for epilepsy with neuroimaging and serological analysis in different areas are needed to estimate the true impact of neurocysticercosis in endemic regions and efforts should be instituted to the control of T. solium.},
  articleno    = {e0003972},
  author       = {Mwape, Kabemba E and Blocher, Joachim and Wiefek, Jasmin and Schmidt, Kathie and Dorny, Pierre and Praet, Nicolas and Chiluba, Clarance and Schmidt, Holger and Phiri, Isaac K and Winkler, Andrea S and Gabri{\"e}l, Sarah},
  issn         = {1935-2735},
  journal      = {PLOS NEGLECTED TROPICAL DISEASES},
  keyword      = {MANAGEMENT,EPIDEMIOLOGY,COUNTRIES,COMMUNITY,SOUTHERN PROVINCES,DIAGNOSTIC-CRITERIA,CLINICAL CHARACTERISTICS,PORCINE CYSTICERCOSIS,TAENIA-SOLIUM,SUB-SAHARAN AFRICA},
  language     = {eng},
  number       = {8},
  pages        = {15},
  title        = {Prevalence of neurocysticercosis in people with epilepsy in the Eastern Province of Zambia},
  url          = {http://dx.doi.org/10.1371/journal.pntd.0003972},
  volume       = {9},
  year         = {2015},
}

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