Neurocysticercosis and cognitive impairment among people with epilepsy in Taenia solium endemic regions of rural southern Tanzania: A hospital-based cross-sectional study in mental health clinics of selected sites in Tanzania.
Journal: Epilepsy & behavior : E&B
Volume: 159
Issue:
Year of Publication:
Affiliated Institutions:
National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania. Electronic address: charles.makassi@nimr.or.tz.
Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania. Electronic address: b_ngowi@yahoo.co.uk.
Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany. Electronic address: tamara.welte@tum.de.
Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany. Electronic address: dominik.stelzle@tum.de.
Haydom Global Health Research Centre, Haydom Lutheran Hospital, Mbulu, Tanzania.
Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany. Electronic address: veronika.schmidt@tum.de.
Department of Neuroradiology, Faculty of Medicine, Technical University of Munich, Munich, Germany. Electronic address: charlotte.ruether@tum.de.
National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania.
Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany. Electronic address: fabien.prodjinotho@tum.de.
National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania. Electronic address: kilale@yahoo.com.
Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany; German Center for Infection and Research (DZIF), Munich, Germany. Electronic address: clarissa.dacosta@tum.de.
Kilimanjaro Christian Medical University College, Moshi, Tanzania; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany; Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: andrea.winkler@tum.de.
Abstract summary
Epilepsy poses a significant public health problem in many parts of the world. The majority of people with epilepsy (PWE) are from low-income and middle-income countries (LMICs). Taenia solium neurocysticercosis (NCC) is estimated to cause 30% of preventable epilepsy in PWE in areas of T. solium endemicity. This study was conducted to assess the prevalence of NCC in PWE, evaluate the presence of cognitive impairment in PWE, and assess potential contributing factors.PWE were recruited within a mental health clinic-based cross-sectional study in rural Southern Tanzania. PWE underwent a detailed neurological examination, and a blood sample was collected for T. solium cysticercosis (CC) serology testing. Patients who were serologically positive for CC and those detected to have prominent neurological deficits apart from epilepsy were invited to receive a cerebral computed tomography (CT) examination.Out of the 223 people with epilepsy (PWE) recruited, 221 underwent clinical examination. Among these, 26 (11.8 %) had cognitive impairment, and 2 had additional neurological signs or symptoms. Twenty-five of the 223 PWE (11.2 %) tested positive for CC. A total of 36 participants underwent CT scans, with 18 testing positives for CC and 18 negatives. Of the 36 who had CT scans, 8 (22.2 %) were diagnosed with NCC; 7 were CC positive, and 1 was CC negative. Multivariate logistic regression confirmed that cognitive impairment in PWE was 8.62 times higher for Kongwa participants compared to Chunya, with a statistically significant association (95 % CI: 1.75-156; P<0.037). Additionally, having an education was associated with a 91 % reduction in the odds of NCC (OR=0.09) compared to no education, which was also statistically significant (95 % CI: 0.01 to 0.33; P<0.002).Our study found a 22.2% prevalence of neurocysticercosis (NCC) among PWE. Cognitive impairment was present in 11.8% of PWE but was not significantly associated with NCC. Socioeconomic and educational factors may play a larger role in cognitive impairment among PWE.
Authors & Co-authors:
Makasi Charles E CE
Ngowi Bernard B
Mahande Michael J MJ
Welte Tamara M TM
Stelzle Dominik D
Guga Godfrey G
Schmidt Veronika V
Rüther Charlotte C
Lema Yakobo Y
Fabien Prodjinotho Ulrich U
Kilale Andrew A
Prazeres da Costa Clarissa C
Mmbaga Blandina T BT
Winkler Andrea S AS
Study Outcome
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