Neurocysticercosis in Bhutan; a cross-sectional study in people with epilepsy

Bhutan Epilepsy Project

Research output: Contribution to journalA1: Web of Science-article

Abstract

BACKGROUND: We sought to provide an assessment of the burden of neurocysticercosis among people with epilepsy (PWE) in Bhutan and evaluate the yield of various tests for Taenia solium.

METHODS: PWE were enrolled at the National Referral Hospital in Thimphu (2014-2015). Serum was tested for anti-Taenia solium IgG using ELISA (Ab-ELISA), enzyme-linked immunoelectrotransfer blot (EITB), and parasite antigen. Results were compared to brain MRI. Participants were categorized as definite neurocysticercosis (MRI and EITB positive), probable neurocysticercosis (MRI or EITB positive), or without neurocysticercosis. Logistic regression models were constructed to explore clinicodemographic associations.

RESULTS: There were 12/205 (6%, 95% CI 2%, 9%) definite and 40/205 (20%, 95% CI 14%, 25%) probable neurocysticercosis cases. 25/205 (12%) with positive EITB did not have neurocysticercosis on MRI, and 15/205 (7%) participants with positive MRI had negative EITB. Participants with neurocysticercosis-suggestive lesions on MRI had an average of 1.2 cysts (parenchymal 26/27; nodular/calcified stage 21/27). In a multivariable analysis, present age (OR 1.05, 95% CI 1.01,1.09, p=0.025) was positively associated with (combined probable or definite) neurocysticercosis while mesial temporal sclerosis on MRI (OR 0.294, 95% CI 0.144, 0.598, p=0.001) was negatively associated.

CONCLUSIONS: Neurocysticercosis was associated with 6-25% of epilepsy in a Bhutanese cohort. Combining EITB and MRI would aid the diagnosis of neurocysticercosis among PWE since no test identified all cases.

Original languageEnglish
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Volume110
Issue number9
Pages (from-to)517-526
Number of pages10
ISSN0035-9203
DOIs
Publication statusPublished - Sep-2016

Keywords

  • Adult
  • Animals
  • Antibodies, Helminth/blood
  • Antigens, Helminth/blood
  • Bhutan/epidemiology
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay/methods
  • Epilepsy/diagnosis
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Immunoblotting/methods
  • Magnetic Resonance Imaging
  • Male
  • Neurocysticercosis/diagnosis
  • Neuroimaging
  • Occupations
  • Sensitivity and Specificity
  • Taenia solium/isolation & purification

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