Hunter Ewan, Burton Kathryn, Iqbal Ahmed, Birchall Daniel, Jackson Margaret, Rogathe Jane, Jusabani Ahmed, Gray William, Aris Eric, Kamuyu Gathoni, Wilkins Patricia P, Newton Charles R, Walker Richard
Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Trop Med Int Health. 2015 Sep;20(9):1171-1179. doi: 10.1111/tmi.12529. Epub 2015 May 26.
To assess the contribution of neurocysticercosis (NCC) to the burden of epilepsy in a rural Tanzanian population.
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.
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.
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.
评估神经囊尾蚴病（NCC）对坦桑尼亚农村人口癫痫负担的影响。
在一个既定的人口监测点进行挨家挨户的研究，以确定成年癫痫患者（PWE）。对PWE和社区对照者进行了针对NCC病原体猪带绦虫的抗体检测，并为所有PWE提供了头部计算机断层扫描（CT）。从PWE和对照者那里收集了关于家庭居住情况和卫生设施、养猪和猪肉消费的数据，并使用卡方检验或费舍尔精确检验评估了与癫痫的关联。
218名PWE中有6人对猪带绦虫有抗体（2.8%；95%可信区间0.6 - 4.9），而174名对照者中无人有抗体（费舍尔精确检验，P = 0.04）。在200次CT扫描中有8次发现了与NCC相符的病变（4.0%；95%可信区间1.3 - 6.7）。共有176名PWE接受了两项检查，其中两人血清学呈阳性且CT上有与NCC相符的病变（1.1%；95%可信区间0.3 - 4.0）。未发现癫痫与任何NCC危险因素之间存在关联。
该人群中存在神经囊尾蚴病，但患病率低于坦桑尼亚其他地区和撒哈拉以南非洲。来自低患病率地区的见解可能为旨在减轻可预防癫痫负担的公共卫生干预措施提供参考。
