title: Reduction in rate of epilepsy from neurocysticercosis by community interventions: the Salamá, Honduras study.
abstract: OBJECTIVE
  Epilepsy is highly prevalent in developing countries like Honduras, with few studies evaluating this finding. This population-based study evaluated the impact of an 8-year public health and educational intervention program in reducing symptomatic epilepsies in rural Salamá, Honduras.
  
  
  METHODS
  We used the capture and recapture method including review of charts, previous databases, key informants from the community, and a second house-to-house survey for epilepsy. Epilepsy incidence and prevalence day after the interventions was May 5, 2005. Residents with active epilepsy with onset after May 1997 were offered neurologic evaluation, electroencephalography, and brain tomography. New data over 8 years were compared to preintervention data from the initial baseline 1997 study utilizing prevalence ratios and confidence intervals. Other calculations utilized chi square or Fisher's exact tests.
  
  
  RESULTS
  Thirty-three of 36 patients with onset of active epilepsy after 1997 accepted evaluations to determine etiology. Symptomatic etiology was found in 58.3%. Neurocysticercosis (NCC) was again the most frequent cause (13.9%), followed by perinatal insults (11.1%). Epilepsy secondary to NCC was significantly reduced from 36.9% in 1997 (p = 0.02). The incidence (35.7/100,000) and prevalence (11.8/1,000) of active epilepsy were not significantly reduced when compared to the incidence (92.7/100,000) and prevalence (15.4/1,000) of active epilepsy in 1997.
  
  
  CONCLUSIONS
  Our cohort appears to indicate that health and educational community interventions can reduce preventable epilepsy from NCC in a hyperendemic population in a low-resource, developing country. Plans are underway for the Honduran Government to institute this rural model countrywide.
authors.affiliation: Neurology Training Program, National Autonomous University of Honduras, Tegucigalpa, Honduras. marcotmedina@yahoo.com
authors.forename: Marco T
authors.initials: MT
authors.lastname: Medina
authors.forename: Rafael L
authors.initials: RL
authors.lastname: Aguilar-Estrada
authors.forename: Allan
authors.initials: A
authors.lastname: Alvarez
authors.forename: Reyna M
authors.initials: RM
authors.lastname: Durón
authors.forename: Lizandro
authors.initials: L
authors.lastname: Martínez
authors.forename: Sofia
authors.initials: S
authors.lastname: Dubón
authors.forename: Ana L
authors.initials: AL
authors.lastname: Estrada
authors.forename: Concepción
authors.initials: C
authors.lastname: Zúniga
authors.forename: Dora
authors.initials: D
authors.lastname: Cartagena
authors.forename: Arnold
authors.initials: A
authors.lastname: Thompson
authors.forename: Eunice
authors.initials: E
authors.lastname: Ramirez
authors.forename: Lenín
authors.initials: L
authors.lastname: Banegas
authors.forename: Juan R
authors.initials: JR
authors.lastname: Osorio
authors.forename: Antonio V
authors.initials: AV
authors.lastname: Delgado-Escueta
authors.forename: Julianne S
authors.initials: JS
authors.lastname: Collins
authors.forename: Kenton R
authors.initials: KR
authors.lastname: Holden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D011159:Population Surveillance / Q000379:methods; D012111:Residence Characteristics; D013552:Swine; D055815:Young Adult