title: Neurological morbidity among human T-lymphotropic-virus-type-1-infected individuals in a rural West African population.
abstract: BACKGROUND
  Community-based neurological data about human T lymphotropic virus type 1 (HTLV-1) morbidity in sub-Saharan Africa are scarce.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. sarah.cooper@doctors.org.uk
authors.forename: S
authors.initials: S
authors.lastname: Cooper
authors.forename: M Schim
authors.initials: MS
authors.lastname: van der Loeff
authors.forename: S
authors.initials: S
authors.lastname: McConkey
authors.forename: M
authors.initials: M
authors.lastname: Cooper
authors.forename: R
authors.initials: R
authors.lastname: Sarge-Njie
authors.forename: S
authors.initials: S
authors.lastname: Kaye
authors.forename: H
authors.initials: H
authors.lastname: Whittle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D015490:HTLV-I Infections / Q000453:epidemiology*; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult