Université de Limoges, IFR 145 GEIST, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, EA 3174 NeuroEpidémiologie Tropicale et Comparée, Limoges, France.
Epilepsia. 2010 May;51(5):830-7. doi: 10.1111/j.1528-1167.2009.02401.x. Epub 2009 Nov 16.
The association between cysticercosis and epilepsy has been widely studied in Latin America and Asia and has proven to be one of the main causes of epilepsy. Despite high prevalences of both diseases in Africa, their association remains unclear. In this article we quantified the strength of the association between epilepsy and cysticercosis in Africa and we proposed some guidelines for future studies.
We performed a systematic review of literature on cysticercosis (considered as exposure) and epilepsy (considered as the disease) and collected data from both cross-sectional and case-control studies. A common odds ratio was estimated using a random-effects meta-analysis model of aggregate published data.
Among 21 retrieved documents, 11 studies located in 8 African countries were included in the meta-analysis. Odds ratio of developing epilepsy when presenting cysticercosis (defined as Taenia solium seropositivity) ranged from 1.3-6.1. Overall, association between cysticercosis and epilepsy was found significant with a common odds ratio of 3.4 [95% confidence interval (CI) 2.7-4.3; p < 0.001].
The variability of the association found between the studies could be due to differences in study design or in pathogenesis of cysticercosis. Further studies should overcome identified problems by following some guidelines to improve epidemiologic and clinical assessment of the association. Better understanding of the relation between cysticercosis and epilepsy is a key issue in improving prevention of epilepsy in Africa.
囊尾蚴病和癫痫之间的关联已在拉丁美洲和亚洲得到广泛研究，事实证明这是癫痫的主要病因之一。尽管非洲这两种疾病的发病率都很高，但它们之间的关联仍不清楚。本文我们定量评估了非洲癫痫与囊尾蚴病之间的关联强度，并提出了一些未来研究的指导方针。
我们对囊尾蚴病（视为暴露因素）和癫痫（视为疾病）的文献进行了系统综述，并从横断面和病例对照研究中收集了数据。使用汇总发表数据的随机效应荟萃分析模型估算了共同比值比。
在 21 篇检索到的文献中，有 11 项研究来自非洲 8 个国家，纳入了荟萃分析。在存在囊尾蚴病（定义为猪带绦虫血清阳性）的情况下发生癫痫的优势比范围为 1.3-6.1。总体而言，囊尾蚴病与癫痫之间存在显著关联，共同比值比为 3.4 [95%置信区间（CI）2.7-4.3；p < 0.001]。
研究之间发现的关联的可变性可能是由于研究设计或囊尾蚴病发病机制的差异所致。进一步的研究应通过遵循一些指导方针来克服已确定的问题，从而改善对该关联的流行病学和临床评估。更好地了解囊尾蚴病和癫痫之间的关系是改善非洲癫痫预防的关键问题。
