The Burden of Cysticercosis

Abstract

Taenia solium cysticercosis is a major public health and agricultural problem in many developing countries. It is predominantly found and considered endemic in Latin American, Asian, and African countries where pigs are raised using traditional methods, veterinary meat inspection is insufficient, and sanitation is poor [1-3]. However, it is now increasingly being diagnosed in other regions such as the United States, Western Europe, and Canada due to an increasing flow of immigrants from endemic areas who may have taeniasis or cysticercosis [4-7]. The parasite not only impacts human health, but also pig farmers and their communities. In humans, the larvae of the parasite (metacestodes) may migrate to the brain resulting in neurocysticercosis (NCC). The natural history of NCC infection remains poorly understood, and the proportion of cases with lesions in their brains that will manifest at some point during the course of the infection remains unknown. According to a recent systematic review of the literature, among diagnosed NCC patients who sought care in clinics where imaging was available, epileptic seizures were by far the most common presenting symptom, followed by headaches, focal deficits, and cranial hypertension/hydrocephalus [8]. Depression has been reported to be very common among NCC patients, but it has not been determined if this is due to the presence of epilepsy or NCC itself [9]. Other manifestations of NCC include stroke and dementia, but those aspects have been very poorly described [10, 11]. The social consequences of NCC possibly include stigmatization, incapacitation, and decreased work productivity. Epilepsy has been shown, in several countries, to lead to social discrimination, and NCC-associated epilepsy is no different. In many endemic countries, the stigma associated with epilepsy may have a greater impact on patients’ lives and families than the disease itself [12]. In addition, due to the reduction in quality of life and the psychological effects of the condition, work productivity might be further decreased.