title: Taenia solium cysticercosis hotspots surrounding tapeworm carriers: clustering on human seroprevalence but not on seizures.
abstract: BACKGROUND
  Neurocysticercosis accounts for 30%-50% of all late-onset epilepsy in endemic countries. We assessed the clustering patterns of Taenia solium human cysticercosis seropositivity and seizures around tapeworm carriers in seven rural communities in Peru.
  
  
  METHODS
  The presence of T. solium-specific antibodies was defined as one or more positive bands in the enzyme-linked immunoelectrotransfer blot (EITB). Neurocysticercosis-related seizures cases were diagnosed clinically and had positive neuroimaging or EITB.
  
  
  RESULTS
  Eleven tapeworm carriers were identified by stool microscopy. The seroprevalence of human cysticercosis was 24% (196/803). Seroprevalence was 21% >50 m from a carrier and increased to 32% at 1-50 m (p = 0.047), and from that distance seroprevalence had another significant increase to 64% at the homes of carriers (p = 0.004). Seizure prevalence was 3.0% (25/837) but there were no differences between any pair of distance ranges (p = 0.629, Wald test 2 degrees of freedom).
  
  
  CONCLUSIONS
  We observed a significant human cysticercosis seroprevalence gradient surrounding current tapeworm carriers, although cysticercosis-related seizures did not cluster around carriers. Due to differences in the timing of the two outcomes, seroprevalence may reflect recent T. solium exposure more accurately than seizure frequency.
authors.affiliation: United States Naval Medical Research Center Detachment, Public Health Training Program (AGL) and Virology Program (SMM), Lima, Perú.
authors.forename: Andres G
authors.initials: AG
authors.lastname: Lescano
authors.forename: Hector H
authors.initials: HH
authors.lastname: Garcia
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Cesar M
authors.initials: CM
authors.lastname: Gavidia
authors.forename: Victor C W
authors.initials: VC
authors.lastname: Tsang
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodriguez
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Moulton
authors.forename: Manuel V
authors.initials: MV
authors.lastname: Villaran
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Montano
authors.forename: Armando E
authors.initials: AE
authors.lastname: Gonzalez
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D002353:Carrier State / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003551:Cysticercosis / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D012640:Seizures / Q000453:epidemiology* / Q000469:parasitology; D016036:Seroepidemiologic Studies; D041201:Taenia solium / Q000276:immunology*
chemical_list: D000909:Antibodies, Helminth