Active epilepsy as an index of burden of neurocysticercosis in Vellore district, India.
OBJECTIVE
To determine the contribution of neurocysticercosis (NCC) to the causation of active epilepsy (AE) in a south Indian community.


METHODS
We conducted a door-to-door survey of 50,617 people between the ages of 2 and 60 years in a rural (38,105 people) and urban setting (12,512 people) in the Vellore district of the south Indian state of Tamil Nadu to identify patients with AE. Patients with AE were investigated with a contrast-enhanced CT scan and serologic study using enzyme-linked immunotransfer blot (EITB) for cysticercal antibodies.


RESULTS
We identified 194 patients with AE. The prevalence of AE was 3.83 per 1,000 people, with the prevalence in the urban clusters more than twice that in the rural clusters (6.23 vs 3.04 per 1,000) (p < 0.0001). A diagnosis of NCC was made in 46 (28.4%) of the 162 patients undergoing a CT scan, and EITB was positive in 21 (13%) patients. Overall, 55 (34%) patients were diagnosed with NCC (11 definitive NCC and 44 probable NCC). There was no significant difference in the prevalence of NCC causing AE in the urban (1.28 per 1,000) and rural (1.02 per 1,000) communities.


CONCLUSIONS
NCC is the cause of nearly one-third of all cases of AE in both the urban and rural regions. Extrapolating our results to the country as a whole leads to an estimated disease burden of 1 million patients in India with AE attributable to NCC.
Rajshekhar
V
V
Department of Neurological Sciences, Christian Medical College, Vellore 632 004, India. rajshekhar@cmcvellore.ac.in
Raghava
M Venkat
MV
Prabhakaran
V
V
Oommen
A
A
Muliyil
J
J
D000293:Adolescent; D000328:Adult; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D014505:Urban Population / Q000706:statistics & numerical data*