title: Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study.
abstract: OBJECTIVE
  To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town.
  
  
  METHODS
  Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot.
  
  
  RESULTS
  Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P < 0.05). A similarly increasing pattern of higher seroprevalence was observed among migrants by age at migration. In rural villagers, there was strong evidence of an association between positive serology and having seizures (P = 0.011) but such an association was not observed in long-term migrants or in urban residents. In the entire study population, compared with seronegative participants, those with strong antibody reactions (≥ 4 antibody bands) were more likely to have epilepsy (P < 0.001).
  
  
  CONCLUSIONS
  It is not only international migration that affects cysticercosis endemicity; internal migration can also affect patterns of endemicity within an endemic country. The neurological consequences of cysticercosis infection likely outlast the antibody response for years after rural-to-urban migration.
authors.affiliation: Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.
authors.forename: Isidro
authors.initials: I
authors.lastname: Gonzales
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodriguez
authors.forename: Victor
authors.initials: V
authors.lastname: Vargas
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cjuno
authors.forename: Liam
authors.initials: L
authors.lastname: Smeeth
authors.forename: Armando E
authors.initials: AE
authors.lastname: Gonzalez
authors.forename: Victor C W
authors.initials: VC
authors.lastname: Tsang
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Hector H
authors.initials: HH
authors.lastname: Garcia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000906:Antibodies / Q000097:blood; D003551:Cysticercosis / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D004827:Epilepsy / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D011157:Population Dynamics; D015995:Prevalence; D012424:Rural Population; D012640:Seizures / Q000150:complications / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D041201:Taenia solium / Q000276:immunology; D014171:Transients and Migrants; D014505:Urban Population; D055815:Young Adult
chemical_list: D000906:Antibodies
keywords: Cisticercosis; Peru; Perú; Pérou; Taenia solium; convulsiones; crise d’épilepsie; cysticercose; cysticercosis; migración; migration; neurocisticercosis; neurocysticercose; neurocysticercosis; seizures