Neurological morbidity among human T-lymphotropic-virus-type-1-infected individuals in a rural West African population.
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.
Cooper
S
S
Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. sarah.cooper@doctors.org.uk
van der Loeff
M Schim
MS
McConkey
S
S
Cooper
M
M
Sarge-Njie
R
R
Kaye
S
S
Whittle
H
H
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