High Prevalence of Asymptomatic Neurocysticercosis in an Endemic Rural Community in Peru.

Luz M Moyano,Seth E O’Neal,Guillermo Gonzalvez,Victor C W Tsang,Viterbo Ayvar,Hector H Garcia,Armando E Gonzalez,Ricardo Gamboa,Silvia Rodriguez,Robert H Gilman,Joe Reistetter,Percy Vilchez,Agnes Fleury

doi:10.1371/journal.pntd.0005130

Abstract

BackgroundNeurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level.MethodologyWe conducted a population-based study of resident’s ≥2 years old in a highly endemic village in Peru (pop. 454). We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB). We invited all residents ≥18 years old to have non-contrast computerized tomography (CT) of the head.Principal findingsOf the 385 residents who provided serum samples, 142 (36.9%) were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8%) had brain calcifications consistent with NCC; 8/48 (17.0%) reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic.ConclusionThis study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future.

Highlights

Neurocysticercosis (NCC) is a common helminthic infection of the central nervous system and the cause of late-onset epilepsy in many lower and middle-income countries [1, 2]
This study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future
We found that the infection was very common in this community, where nearly one in five adults had calcified lesions in the brain

Summary

Introduction

Neurocysticercosis (NCC) is a common helminthic infection of the central nervous system and the cause of late-onset epilepsy in many lower and middle-income countries [1, 2]. This chronic neurological condition is the most serious health consequence of the lifecycle of Taenia solium, the parasite which causes the disease. Once ingested the eggs release oncospheres that penetrate the intestinal wall and disseminate to form cysts throughout the body including the brain As these cysts degenerate they can provoke an inflammatory process that may produce seizures [3]. Few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level

Methods

Results

Conclusion