Abstract:
Neurocysticercosis (NCC) is a major cause of epilepsy in regions where pigs are free-ranging and hygiene is poor. Pork
production is expected to increase in the next decade in sub-Saharan Africa, hence NCC will likely become more prevalent.
In this study, people with epilepsy (PWE, n = 212) were followed up 28.6 months after diagnosis of epilepsy. CT scans were
performed, and serum and cerebrospinal fluid (CSF) of selected PWE were analysed. We compared the demographic data,
clinical characteristics, and associated risk factors of PWE with and without NCC. PWE with NCC (n = 35) were more likely to
be older at first seizure (24.3 vs. 16.3 years, p = 0.097), consumed more pork (97.1% vs. 73.6%, p = 0.001), and were more
often a member of the Iraqw tribe (94.3% vs. 67.8%, p = 0.005) than PWE without NCC (n = 177). PWE and NCC who were
compliant with anti-epileptic medications had a significantly higher reduction of seizures (98.6% vs. 89.2%, p = 0.046). Other
characteristics such as gender, seizure frequency, compliance, past medical history, close contact with pigs, use of latrines
and family history of seizures did not differ significantly between the two groups. The number of NCC lesions and active
NCC lesions were significantly associated with a positive antibody result. The electroimmunotransfer blot, developed by the
Centers for Disease Control and Prevention, was more sensitive than a commercial western blot, especially in PWE and
cerebral calcifications. This is the first study to systematically compare the clinical characteristics of PWE due to NCC or other
causes and to explore the utility of two different antibody tests for diagnosis of NCC in sub-Saharan Africa.
