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

PLoS Negl Trop Dis. 2016 Dec 19;10(12):e0005130. doi: 10.1371/journal.pntd.0005130. eCollection 2016 Dec.

Abstract

Background: Neurocysticercosis 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.

Methodology: We 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 findings: Of 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Antibodies, Helminth / blood
  • Asymptomatic Infections / epidemiology*
  • Brain / parasitology
  • Brain / pathology
  • Child
  • Child, Preschool
  • Endemic Diseases*
  • Female
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Neurocysticercosis / blood
  • Neurocysticercosis / diagnostic imaging
  • Neurocysticercosis / epidemiology*
  • Neurocysticercosis / immunology
  • Peru / epidemiology
  • Prevalence
  • Rural Health
  • Seizures / epidemiology
  • Seizures / etiology
  • Seizures / parasitology
  • Taenia solium / immunology
  • Taenia solium / isolation & purification
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Antibodies, Helminth