Microbiology Department, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Mozambique Institute of Health Education and Research (MIHER), Maputo, Mozambique.
PLoS Negl Trop Dis. 2022 Jul 14;16(7):e0010606. doi: 10.1371/journal.pntd.0010606. eCollection 2022 Jul.
Taenia solium (neuro-)cysticercosis, a neglected tropical disease, can be associated with epileptic seizures and other neuropsychiatric (= neurological and psychiatric) disorders. This study aimed to evaluate the association of T. solium cysticercosis with selected neuropsychiatric disorders and/or symptoms (chronic headache, epileptic seizures/epilepsy and psychosis) in Mocuba district, Mozambique.
Between March and May 2018, a cross-sectional study was conducted among 1,086 participants aged 2 years or above in Mocuba district, Zambézia province, central Mozambique, to assess the seroprevalence of human cysticercosis and risk factors for infection, as well as to explore its relation to selected neuropsychiatric disorders. Socio-demographic and clinical data were collected from each participant using a modified questionnaire designed by the Cysticercosis Working Group for Eastern and Southern Africa. Additionally, neuropsychiatric disorders, such as chronic headache, epileptic seizures/epilepsy and psychosis were assessed using four vignettes. T. solium antigen and cysticercosis IgG in serum were detected using both T. solium antigen B158/B60 enzyme linked immunosorbent assay (ELISA) and LDBIO Cysticercosis Western Blot, respectively.
Overall, 112/1,086 participants (10.3%) were sero-positive for T. solium antigen or antibodies. Prevalence of antibodies (6.6%; n = 72) was higher than of antigens (4.9%; n = 54). In the questionnaires, 530 (49.5%) of participants reported chronic headache, 293 (27%) had generalized epileptic seizures, 188 (18%) focal seizures and 183 (18.3%) psychosis. We found a statistically significant association between seropositivity for T. solium and chronic headache (p = 0.013). Additionally, increasing age (p = 0.03) was associated with Ag-ELISA seropositivity.
Our study revealed that in Mocuba, T. solium cysticercosis is prevalent and associated with self-reported chronic headache. Additionally, in the study setting, the seroprevalence of cysticercosis increased with age. However, it is not associated with other neuropsychiatric disorders such epileptic seizures/epilepsy and psychosis. Future studies are needed to confirm the high burden of neuropsychiatric disorders and their possible etiology, including neurocysticercosis, using additional serological, molecular biological and radiological diagnostic tools, as well as in-depth clinical examinations.
猪带绦虫（神经型）囊尾蚴病是一种被忽视的热带病，可与癫痫发作和其他神经精神（=神经和精神）障碍相关。本研究旨在评估莫库巴区（莫桑比克赞比西亚省）猪带绦虫囊尾蚴病与选定的神经精神障碍和/或症状（慢性头痛、癫痫发作/癫痫和精神病）之间的关联。
2018 年 3 月至 5 月期间，在莫库巴区（莫桑比克赞比西亚省）进行了一项横断面研究，纳入了 1086 名 2 岁及以上的参与者，以评估人类囊尾蚴病的血清流行率和感染的危险因素，并探索其与选定的神经精神障碍的关系。使用由东非和南非囊尾蚴病工作组设计的改良问卷从每位参与者收集社会人口统计学和临床数据。此外，还使用四个病例描述评估了慢性头痛、癫痫发作/癫痫和精神病等神经精神障碍。使用猪带绦虫抗原 B158/B60 酶联免疫吸附试验（ELISA）和 LDBIO 囊尾蚴病 Western Blot 分别检测血清中的猪带绦虫抗原和囊尾蚴病 IgG。
总体而言，1086 名参与者中有 112 名（10.3%）血清呈猪带绦虫抗原或抗体阳性。抗体的流行率（6.6%；n=72）高于抗原（4.9%；n=54）。在问卷调查中，530 名（49.5%）参与者报告有慢性头痛，293 名（27%）有全身性癫痫发作，188 名（18%）有局灶性癫痫发作，183 名（18.3%）有精神病。我们发现猪带绦虫血清阳性与慢性头痛之间存在统计学显著关联（p=0.013）。此外，年龄增长（p=0.03）与 Ag-ELISA 血清阳性相关。
我们的研究表明，在莫库巴，猪带绦虫囊尾蚴病很普遍，与自我报告的慢性头痛有关。此外，在研究环境中，囊尾蚴病的血清流行率随年龄增长而增加。然而，它与其他神经精神障碍（如癫痫发作/癫痫和精神病）无关。需要进一步的研究来确认神经精神障碍的高负担及其可能的病因，包括神经囊尾蚴病，使用额外的血清学、分子生物学和放射学诊断工具以及深入的临床检查。
