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

Bhutan Epilepsy Project

    Research output: Contribution to journalA1: Web of Science-articlepeer-review


    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
    Issue number9
    Pages (from-to)517-526
    Number of pages10
    Publication statusPublished - Sept-2016


    • 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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