Cysticercosis and epilepsy in rural Tanzania: a community-based case-control and imaging study.
OBJECTIVE
To assess the contribution of neurocysticercosis (NCC) to the burden of epilepsy in a rural Tanzanian population.


METHODS
We identified adult people with epilepsy (PWE) in a door-to-door study in an established demographic surveillance site. PWE and community controls were tested for antibodies to Taenia solium, the causative agent of NCC, and all PWE were offered a computed tomography (CT) head scan. Data on household occupancy and sanitation, pig-keeping and pork consumption were collected from PWE and controls and associations with epilepsy were assessed using chi-square or Fisher's exact tests.


RESULTS
Six of 218 PWE had antibodies to T. solium (2.8%; 95% CI 0.6-4.9), compared to none of 174 controls (Fisher's exact test, P = 0.04). Lesions compatible with NCC were seen in eight of 200 CT scans (4.0%; 95% CI 1.3-6.7). A total of 176 PWE had both investigations of whom two had positive serology along with NCC-compatible lesions on CT (1.1%; 95% 0.3-4.0). No associations between epilepsy and any risk factors for NCC were identified.


CONCLUSIONS
Neurocysticercosis is present in this population but at a lower prevalence than elsewhere in Tanzania and sub-Saharan Africa. Insights from low-prevalence areas may inform public health interventions designed to reduce the burden of preventable epilepsy.
Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Ewan
E
Hunter
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Kathryn
K
Burton
Institute of Neurosciences, Southern General Hospital, Glasgow, UK.
Ahmed
A
Iqbal
Newcastle Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK.
Daniel
D
Birchall
Newcastle Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK.
Margaret
M
Jackson
Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Jane
J
Rogathe
Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Ahmed
A
Jusabani
Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
William
W
Gray
Muhimbili National Hospital, Dar es Salaam, Tanzania.
Eric
E
Aris
Centre for Geographical Medicine (Coast), Kilifi, Kenya.
Gathoni
G
Kamuyu
Centers for Disease Control & Prevention, Atlanta, GA, USA.
Patricia P
PP
Wilkins
Centre for Geographical Medicine (Coast), Kilifi, Kenya.|Muhimbili-Wellcome Programme, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.|Department of Psychiatry, University of Oxford, Oxford, UK.
Charles R
CR
Newton
Northumbria Healthcare NHS Foundation Trust, North Shields, UK.|Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK.
Richard
R
Walker
Afrique subsahararienne; Tanzania; Tanzanie; cisticercosis; cysticercose; cysticercosis; epilepsia; epilepsy; imagerie neurologique; neuroimagen; neuroimaging; serology; serología; sub-Saharan Africa; sérologie; África subsahariana; épilepsie