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Zhu HX, Li YC, Yang XP, Chu YH, Guo W, Chen RX, Guo DD, Cheng LJ, Li Y. Demographics and Clinical Characteristics of Patients with Neurocysticercosis: A Retrospective Study from Dali, China. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:283-291. [PMID: 37970452 PMCID: PMC10634465 DOI: 10.4103/sjmms.sjmms_298_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/19/2023] [Accepted: 08/28/2023] [Indexed: 11/17/2023]
Abstract
Background Neurocysticercosis (NCC), a predominant parasitic disease that affects the central nervous system and presents with diverse clinical manifestations, is a major contributor to acquired epilepsy worldwide, particularly in low-, middle-, and upper middle-income nations, such as China. In China, the Yunnan Province bears a significant burden of this disease. Objective To describe the demographic, clinical, and radiological features as well as serum and cerebrospinal fluid antibodies to cysticercus in patients with NCC from Dali, Yunnan Province, China. Materials and Methods This retrospective study included patients who were diagnosed with NCC at The First Affiliated Hospital of Dali University between January 2018 and May 2023 and were residing in Dali, Yunnan Province, China. Results A total of 552 patients with NCC were included, of which 33.3% belonged to Bai ethnicity. The clinical presentation of NCC exhibited variability that was influenced by factors such as the number, location, and stage of the parasites. Epilepsy/seizure (49.9%) was the most prevalent symptom, with higher occurrence in the degenerative stage of cysts (P < 0.001). Compared with other locations, cysticerci located in the brain parenchyma are more likely to lead to seizures/epilepsy (OR = 17.45, 95% CI: 7.96-38.25) and headaches (OR = 3.02, 95% CI: 1.23-7.41). Seizures/epilepsy are more likely in patients with cysts in the vesicular (OR = 2.71, 95% CI: 1.12-6.61) and degenerative (OR = 102.38, 95% CI: 28.36-369.60) stages than those in the calcified stage. Seizures was not dependent on the number of lesions. All NCC patients underwent anthelminthic therapy, with the majority receiving albendazole (79.7%). Conclusion This study provides valuable clinical insights into NCC patients in Dali and underscores the significance of NCC as a leading preventable cause of epilepsy.
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Affiliation(s)
- Han-Xiao Zhu
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Yang-Chao Li
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Xue-Ping Yang
- Clinical Medical College, Dali University, Dali, Yunnan, China
| | - Yu-Hao Chu
- Clinical Medical College, Dali University, Dali, Yunnan, China
| | - Wang Guo
- Clinical Medical College, Dali University, Dali, Yunnan, China
| | - Ruo-Xia Chen
- Clinical Medical College, Dali University, Dali, Yunnan, China
| | - Dan-Dan Guo
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Li-Jing Cheng
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Yun Li
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
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Mosley IA, Li T, Zhao X, Huang L, Chen X, Liu Y, Chen Z, Duan M, Budke CM. Monetary burden of neurocysticercosis on a hospitalized population in Muli County, China. Acta Trop 2023; 246:106984. [PMID: 37453578 DOI: 10.1016/j.actatropica.2023.106984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Neurocysticercosis (NCC) is a potentially life-threatening condition caused by the zoonotic cestode, Taenia solium. Pigs are the typical intermediate hosts for T. solium but humans can become infected and develop NCC upon ingesting parasite eggs that are shed in the feces of an infected person. The objective of this study was to estimate the monetary burden of neurocysticercosis (NCC) on hospitalized patients from Muli County, China. Muli is an agricultural county in Liangshan Prefecture, Sichuan Province, China where pigs are raised and the zoonotic cestode, Taenia solium, is endemic. Demographic and treatment data were collected from the Muli County Health Insurance Department on hospitalized individuals with an NCC diagnosis between 2014 and 2021. These patients represent residents of Muli County that purchased health insurance and received treatment in a public hospital in Sichuan Province. Hospital costs were converted from Chinese renminbi (RMB) to United States dollars (US$) for month and year of hospitalization and adjusted for inflation. Individuals with missing hospital information were excluded from analysis. For indirect costs, annual average salary for Liangshan Prefecture working-age adults was obtained to calculate productivity losses based on number of hospitalization days and travel days to and from the hospital. Transportation costs were evaluated based on estimated bus fare to and from the hospital. Out of 70 patients identified from 2014 to 2021, 68 had complete records, of which 47.1% were male (n = 33) and the median age at first hospitalization was 34 years. Total estimated cost for these patients was US$228,341.98. Direct costs contributed 62.5% (US$142,785.25) and indirect costs were 37.5% (US$85,556.73) of the total cost. The estimated median cost per case was US$2,078.69. Individuals with a single hospitalization (n = 41) cost a median of US$1,572.03 and those with multiple hospitalizations (n = 27) cost a median of US$4,169.95. The median total cost per NCC case was 18.6% of the average wage for a Liangshan Prefecture resident in 2021. While the study was limited to those with insurance coverage, monetary burden on the local population is likely substantial. Public health policies aimed at reducing transmission should be implemented to decrease the economic burden of NCC on this region.
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Affiliation(s)
- Ilana A Mosley
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - Tiaoying Li
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Xingping Zhao
- Muli County Center for Disease Control and Prevention, Muli, Liangshan Prefecture, China
| | - Lin Huang
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Xingwang Chen
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yang Liu
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Zhihua Chen
- Muli County Center for Disease Control and Prevention, Muli, Liangshan Prefecture, China
| | - Mianchuan Duan
- Muli County Center for Disease Control and Prevention, Muli, Liangshan Prefecture, China
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Ta R, Blond BN. The prevalence of and contributors to neurocysticercosis in endemic regions. J Neurol Sci 2022; 441:120393. [PMID: 36054944 DOI: 10.1016/j.jns.2022.120393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neurocysticercosis is one of the most common causes of acquired epilepsy worldwide. Caused by Taenia solium, the infection uses pigs as an intermediate host and thus is often associated with proximity to and consumption of pigs. OBJECTIVE This review explores the epidemiology of neurocysticercosis in endemic regions across Africa, Asia, and Latin America and examines common risk factors in these areas. METHODS A literature review was conducted using pubmed to search for articles with key words including neurocysticercosis, Taenia, solium, epidemiology, and the names of countries and continents in the regions of interest. FINDINGS Multiple risk factors for neurocysticercosis were identified, including inadequate regulation of pig farms and food safety, poor sanitation, and water contamination. In addition, additional barriers to appropriate diagnosis and management were found, including resource limitations and poor health literacy. CONCLUSION Despite its global prevalence, effective limitation of neurocysticercosis is still achievable through projects which address common risk factors.
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Affiliation(s)
- Ryan Ta
- Stony Brook University Renaissance School of Medicine, USA
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A Large Case Series of Neurocysticercosis in Kuwait, a Nonendemic Arabian Gulf Country in the Middle East Region. Microorganisms 2021; 9:microorganisms9061221. [PMID: 34199952 PMCID: PMC8226849 DOI: 10.3390/microorganisms9061221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 12/31/2022] Open
Abstract
Neurocysticercosis (NCC), a leading global cause of severe progressive headache and epilepsy, in developed or affluent countries is mostly diagnosed among immigrants from poor or developing Taenia solium taeniasis-endemic countries. Taeniasis carriers in Kuwait are routinely screened by insensitive stool microscopy. In this study, enzyme-linked immunoelectrotransfer blot (EITB) was used as a confirmatory test for NCC. Screening was performed on 970 patients referred for suspected NCC on the basis of relevant history and/or ring-enhancing lesions on computed tomography and/or magnetic resonance imaging during a 14-year period in Kuwait. Demographic data and clinical details were retrieved from laboratory or hospital records. EITB was positive in 150 subjects (15.5%), including 98 expatriates mostly originating from taeniasis-endemic countries and, surprisingly, 52 Kuwaiti nationals. The clinical details of 48 of 50 NCC cases diagnosed during 2014–2019 were available. Most common symptoms included seizures, persistent headache with/without fever, and fits or loss of consciousness. Cysticercal lesions were located at various brain regions in 39 of 48 patients. Multiple members of 3 families with NCC were identified; infection was linked to domestic workers from taeniasis-endemic countries and confirmed in at least 1 family. Our data show that NCC is predominantly imported in Kuwait by expatriates originating from taeniasis-endemic countries who transmit the infection to Kuwaiti citizens.
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Hamamoto Filho PT, Singh G, Winkler AS, Carpio A, Fleury A. Could Differences in Infection Pressure Be Involved in Cysticercosis Heterogeneity? Trends Parasitol 2020; 36:826-834. [DOI: 10.1016/j.pt.2020.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 12/13/2022]
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Romo ML, Hernández M, Astudillo OG, Diego G, de-la-Rosa-Arana JL, Meza-Lucas A, García-Rodea R, Toledo A, Parkhouse RME, Garate T, Sciutto E, Fleury A. Diagnostic value of glycoprotein band patterns of three serologic enzyme-linked immunoelectrotransfer blot assays for neurocysticercosis. Parasitol Res 2020; 119:2521-2529. [PMID: 32591864 DOI: 10.1007/s00436-020-06750-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Abstract
The enzyme-linked immunoelectrotransfer blot (EITB) assay to detect antibodies in serum is a complementary tool for the diagnosis of neurocysticercosis (NCC). Presence of at least one glycoprotein band corresponding to a Taenia solium (T. solium) antigen indicates a positive result; however, EITB assays have multiple glycoprotein bands, and previous work has suggested that band patterns may have additional diagnostic value. We included 58 participants with a definitive diagnosis of NCC who received care at the Instituto Nacional de Neurología y Neurocirugía in Mexico City. Three different EITB tests were applied to participants' serum samples (LDBio, France; US Centers for Disease Control and Prevention [CDC]; and Instituto de Diagnóstico y Referencia Epidemiológicos [InDRE]). There was substantial variability in specific glycoprotein band patterns among the three assays. However, in age- and sex-adjusted logistic regression models, the number of glycoprotein bands was positively associated with the presence of vesicular extraparenchymal cysts (InDRE adjusted odds ratio [aOR] 1.60 p < 0.001; CDC aOR 6.31 p < 0.001; LDBio aOR 2.45 p < 0.001) and negatively associated with the presence of calcified parenchymal cysts (InDRE aOR 0.63 p < 0.001; CDC aOR 0.25 p < 0.001; LDBio aOR 0.44 p < 0.001). In a sensitivity analysis also adjusting for cyst count, results were similar. In all three EITB serum antibody tests, the number of glycoprotein bands consistently predicted cyst stage and location, although magnitude of effect differed.
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Affiliation(s)
- Matthew L Romo
- CUNY Graduate School of Public Health and Health Policy and Institute for Implementation Science in Population Health, City University of New York, New York, NY, 10027, USA.
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.
| | - Marisela Hernández
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Osvaldo-Germán Astudillo
- Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. Carlos Malbrán", Buenos Aires, Argentina
| | - Gustavo Diego
- Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. Carlos Malbrán", Buenos Aires, Argentina
| | | | - Antonio Meza-Lucas
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Secretaria de Salud, Mexico City, Mexico
| | - Ricardo García-Rodea
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Secretaria de Salud, Mexico City, Mexico
| | - Andrea Toledo
- Unidad de Neuroinflamación, Instituto de Investigaciones Biomédicas-Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía/Facultad de Medicina-Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Teresa Garate
- Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Edda Sciutto
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Agnès Fleury
- Unidad de Neuroinflamación, Instituto de Investigaciones Biomédicas-Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía/Facultad de Medicina-Universidad Nacional Autónoma de México, Mexico City, Mexico.
- Neurocysticercosis Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.
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