University of Rochester School of Medicine, Rochester, New York.
Department of Psychology, University of Zambia, Lusaka, Zambia.
Pediatr Neurol. 2020 Jan;102:36-43. doi: 10.1016/j.pediatrneurol.2019.07.017. Epub 2019 Aug 6.
Neurocysticercosis is the most common parasitic infection of the brain and a leading cause of epilepsy in resource-limited settings. Although neurocysticercosis and human immunodeficiency virus coinfections have commonly been reported, there are few data on how they interact. As part of an observational study of human immunodeficiency virus and cognition in Lusaka, Zambia, we identified a cluster of subjects with neurocysticercosis. We hypothesized that the neighborhood of residence may be an important factor driving clustering of neurocysticercosis and used a geographic information systems approach to investigate this association.
A total of 34 subjects with human immunodeficiency virus and 13 subjects without human immunodeficiency virus (aged eight to 17 years) enrolled in the HIV-Associated Neurocognitive Disorders in Zambia study, had magnetic resonance imaging of the brain performed, and were evaluated for neurocysticercosis. Quantitative geographic information systems was utilized to investigate the relationship between neighborhood of residence, HIV, and neurocysticercosis.
Three of 34 subjects with human immunodeficiency virus (8.82%) and one of 13 controls were found to have neurocysticercosis. Geographic cluster analysis demonstrated that all subjects with neurocysticercosis were clustered in two adjacent neighborhoods (Chawama and Kanyama) with lower rates of piped water (Chawama: 22.8%, Kanyama: 26.7%) and flush toilets (Chawama: 14.0%, Kanyama: 14.0%) than the surrounding neighborhoods.
We describe a cluster of patients with both neurocysticercosis and human immunodeficiency virus in Lusaka. Cases of neurocysticercosis clustered in neighborhoods with low rates of piped water and limited access to flush toilets. Geographic information systems may be a useful approach for studying the relationship between human immunodeficiency virus and neurocysticercosis. Larger studies are necessary to further investigate this association.
脑囊虫病是最常见的脑部寄生虫感染，也是资源有限环境中癫痫的主要原因。尽管脑囊虫病与人类免疫缺陷病毒合并感染已被广泛报道，但关于它们相互作用的信息却很少。作为赞比亚卢萨卡人类免疫缺陷病毒与认知研究的一部分，我们发现了一组脑囊虫病患者。我们假设居住的社区可能是导致脑囊虫病聚集的一个重要因素，并利用地理信息系统方法来研究这种关联。
共有 34 名人类免疫缺陷病毒感染者和 13 名未感染人类免疫缺陷病毒的对照者（年龄 8 至 17 岁）参加了赞比亚人类免疫缺陷病毒相关神经认知障碍研究，进行了脑部磁共振成像检查，并接受了脑囊虫病评估。定量地理信息系统被用于研究居住社区、HIV 和脑囊虫病之间的关系。
在 34 名人类免疫缺陷病毒感染者中，有 3 名（8.82%）和 13 名对照者中的 1 名（7.70%）被发现患有脑囊虫病。地理聚类分析表明，所有患有脑囊虫病的患者都集中在两个相邻的社区（Chawama 和 Kanyama），这两个社区的自来水供应率较低（Chawama：22.8%，Kanyama：26.7%），冲水厕所的普及率也较低（Chawama：14.0%，Kanyama：14.0%）。
我们描述了一组在卢萨卡同时患有脑囊虫病和人类免疫缺陷病毒的患者。脑囊虫病病例集中在自来水供应率低且冲水厕所使用受限的社区。地理信息系统可能是研究人类免疫缺陷病毒与脑囊虫病之间关系的有用方法。需要更大规模的研究来进一步探讨这种关联。
