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Pray IW, Pizzitutti F, Bonnet G, Gonzales-Gustavson E, Wakeland W, Pan WK, Lambert WE, Gonzalez AE, Garcia HH, O’Neal SE. Validation of a spatial agent-based model for Taenia solium transmission ("CystiAgent") against a large prospective trial of control strategies in northern Peru. PLoS Negl Trop Dis 2021; 15:e0009885. [PMID: 34705827 PMCID: PMC8575314 DOI: 10.1371/journal.pntd.0009885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 11/08/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pork tapeworm (Taenia solium) is a parasitic helminth that imposes a major health and economic burden on poor rural populations around the world. As recognized by the World Health Organization, a key barrier for achieving control of T. solium is the lack of an accurate and validated simulation model with which to study transmission and evaluate available control and elimination strategies. CystiAgent is a spatially-explicit agent based model for T. solium that is unique among T. solium models in its ability to represent key spatial and environmental features of transmission and simulate spatially targeted interventions, such as ring strategy. METHODS/PRINCIPAL FINDINGS We validated CystiAgent against results from the Ring Strategy Trial (RST)-a large cluster-randomized trial conducted in northern Peru that evaluated six unique interventions for T. solium control in 23 villages. For the validation, each intervention strategy was replicated in CystiAgent, and the simulated prevalences of human taeniasis, porcine cysticercosis, and porcine seroincidence were compared against prevalence estimates from the trial. Results showed that CystiAgent produced declines in transmission in response to each of the six intervention strategies, but overestimated the effect of interventions in the majority of villages; simulated prevalences for human taenasis and porcine cysticercosis at the end of the trial were a median of 0.53 and 5.0 percentages points less than prevalence observed at the end of the trial, respectively. CONCLUSIONS/SIGNIFICANCE The validation of CystiAgent represented an important step towards developing an accurate and reliable T. solium transmission model that can be deployed to fill critical gaps in our understanding of T. solium transmission and control. To improve model accuracy, future versions would benefit from improved data on pig immunity and resistance, field effectiveness of anti-helminthic treatment, and factors driving spatial clustering of T. solium infections including dispersion and contact with T. solium eggs in the environment.
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Affiliation(s)
- Ian W. Pray
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Francesco Pizzitutti
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Gabrielle Bonnet
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Eloy Gonzales-Gustavson
- Tropical and Highlands Veterinary Research Institute, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, EL Mantaro, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Wayne Wakeland
- Systems Science Program, Portland State University, Portland, Oregon, United States of America
| | - William K. Pan
- Duke Global Health Institute & Nicholas School of Environment, Duke University, Durham, North Carolina, United States of America
| | - William E. Lambert
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Armando E. Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H. Garcia
- School of Sciences, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
| | - Seth E. O’Neal
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
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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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Alva-Díaz C, Navarro-Flores A, Rivera-Torrejon O, Huerta-Rosario A, Molina RA, Velásquez-Rimachi V, Morán-Mariños C, Farroñay C, Pacheco-Mendoza J, Metcalf T, Burneo JG, Pacheco-Barrios K. Prevalence and incidence of epilepsy in Latin America and the Caribbean: A systematic review and meta-analysis of population-based studies. Epilepsia 2021; 62:984-996. [PMID: 33651439 DOI: 10.1111/epi.16850] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study was undertaken to perform an updated systematic review and meta-analysis to estimate the pooled prevalence and incidence of epilepsy in Latin America and the Caribbean (LAC), describing trends over time, and exploring potential clinical and epidemiological factors explaining the heterogeneity in the region. METHODS Observational studies assessing the incidence or prevalence of epilepsy in LAC countries up to March 2020 were systematically reviewed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses and cumulative analyses were performed using random-effects models. We assessed between-study heterogeneity with sensitivity, subgroup, and meta-regression analyses. Moreover, the quality of the included studies and the certainty of evidence were evaluated using the GRADE (grading of recommendation, assessment, development, and evaluation) approach. RESULTS Overall, 40 studies (from 42 records) were included, 37 for prevalence analyses and six for incidence (312 387 inhabitants; 410 178 person-years). The lifetime prevalence was 14.09 per 1000 inhabitants (95% confidence interval [CI] = 11.72-16.67), for active epilepsy prevalence was 9.06 per 1000 individuals (95% CI = 6.94-11.44), and the incidence rate was 1.11 per 1000 person-years (95% CI = .65-1.70). These high estimates have been constant in the region since 1990. However, substantial statistical heterogeneity between studies and publication bias were found. The overall certainty of evidence was low. Methodological aspects (sample size) and countries' epidemiological characteristics such as access to sanitation services and child and adult mortality rates explained the high heterogeneity. Finally, the prevalence of epilepsy associated with neurocysticercosis (NCC) in the general population was high, and the proportion of NCC diagnosis among people living with epilepsy was 17.37%. SIGNIFICANCE The epilepsy prevalence and incidence in LAC are higher than worldwide estimates, being constant since 1990 and strongly influenced by NCC. We identified high between-study heterogeneity and significant methodological limitations (e.g., heterogeneous definitions, lack of longitudinal studies). The region needs upgraded research using standardized definitions and diagnostic methods, and urgent action against preventable causes.
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Affiliation(s)
- Carlos Alva-Díaz
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru
| | - Alba Navarro-Flores
- Clinical and Health Efficacy Network, REDECS, Lima, Peru.,School of Medicine, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Oscar Rivera-Torrejon
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru.,Clinical and Health Efficacy Network, REDECS, Lima, Peru
| | - Andrely Huerta-Rosario
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru.,Clinical and Health Efficacy Network, REDECS, Lima, Peru.,School of Medicine, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Roberto A Molina
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru.,Clinical and Health Efficacy Network, REDECS, Lima, Peru.,School of Medicine, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Victor Velásquez-Rimachi
- Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru.,Clinical and Health Efficacy Network, REDECS, Lima, Peru
| | - Cristian Morán-Mariños
- Clinical and Health Efficacy Network, REDECS, Lima, Peru.,San Ignacio de Loyola University, Lima, Peru
| | | | | | - Tatiana Metcalf
- Neurology Department, Department of Medicine and Office for Teaching Support and Research, Daniel Alcides Carrion Hospital, Callao, Peru
| | - Jorge G Burneo
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine, Western University, London, Canada
| | - Kevin Pacheco-Barrios
- Research Unit for the Generation and Synthesis of Evidence in Health, San Ignacio de Loyola University, Lima, Peru.,SYNAPSIS Mental Health and Neurology, Lima, Peru.,Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Herrick JA, Bustos JA, Clapham P, Garcia HH, Loeb JA, For The Cysticercosis Working Group In Peru. Unique Characteristics of Epilepsy Development in Neurocysticercosis. Am J Trop Med Hyg 2020; 103:639-645. [PMID: 32431269 PMCID: PMC7410468 DOI: 10.4269/ajtmh.19-0485] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The parasitic helminth infection neurocysticercosis (NCC) is the most common cause of adult-acquired epilepsy in the world. Despite the serious consequences of epilepsy due to this infection, an in-depth review of the distinct characteristics of epilepsy due to neurocysticercosis has never been conducted. In this review, we evaluate the relationship between NCC and epilepsy and the unique characteristics of epilepsy caused by NCC. We also discuss recent advances in our understanding of NCC-related epilepsy, including the importance of anti-inflammatory therapies, the association between NCC and temporal lobe epilepsy, and the recent discovery of biomarkers of severe epilepsy development in individuals with NCC and seizures.
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Affiliation(s)
- Jesica A Herrick
- Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Javier A Bustos
- Center for Global Health, Instituto Nacional de Ciencias Neurológicas, Universidad Peruana Cayetano Heredia, and Cysticercosis Unit, Lima, Perú
| | - Philip Clapham
- Division of Infectious Diseases, Immunology, and International Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Hector H Garcia
- Center for Global Health, Instituto Nacional de Ciencias Neurológicas, Universidad Peruana Cayetano Heredia, and Cysticercosis Unit, Lima, Perú
| | - Jeffrey A Loeb
- Department of Neurology and Rehabilitation Medicine, University of Illinois at Chicago, Chicago, Illinois
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Carrasco-Escobar G, Schwarz L, Miranda JJ, Benmarhnia T. Revealing the air pollution burden associated with internal Migration in Peru. Sci Rep 2020; 10:7147. [PMID: 32346063 PMCID: PMC7188878 DOI: 10.1038/s41598-020-64043-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/05/2020] [Indexed: 11/09/2022] Open
Abstract
This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between "current" (2016-2017) and "origin" (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran's I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 137.1 (95%CI: 93.2, 179.4) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths.
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Affiliation(s)
- Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, CA, USA.
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
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Del Brutto OH. Twenty-five years of evolution of standard diagnostic criteria for neurocysticercosis. How have they impacted diagnosis and patient outcomes? Expert Rev Neurother 2019; 20:147-155. [DOI: 10.1080/14737175.2020.1707667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Oscar H. Del Brutto
- School of Medicine, Universidad Espíritu Santo – Ecuador, Samborondón, Ecuador
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7
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Arroyo G, Rodriguez S, Lescano AG, Alroy KA, Bustos JA, Santivañez S, Gonzales I, Saavedra H, Pretell EJ, Gonzalez AE, Gilman RH, Tsang VCW, Garcia HH. Antibody Banding Patterns of the Enzyme-Linked Immunoelectrotransfer Blot and Brain Imaging Findings in Patients With Neurocysticercosis. Clin Infect Dis 2019; 66:282-288. [PMID: 29020381 DOI: 10.1093/cid/cix774] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/29/2017] [Indexed: 11/12/2022] Open
Abstract
Background The enzyme-linked immunoelectrotransfer blot (EITB) assay is the reference serological test for neurocysticercosis (NCC). A positive result on EITB does not always correlate with the presence of active infections in the central nervous system (CNS), and patients with a single viable brain cyst may be EITB negative. Nonetheless, EITB antibody banding patterns appears to be related with the expression of 3 protein families of Taenia solium, and in turn with the characteristics of NCC in the CNS (type, stage, and burden of viable cysts). Methods We evaluated EITB antibody banding patterns and brain imaging findings of 548 NCC cases. Similar banding patterns were grouped into homogeneous classes using latent class analysis. The association between classes and brain imaging findings was assessed. Results Four classes were identified. Class 1 (patients negative or only positive to the GP50 band, related to the protein family of the same name) was associated with nonviable or single viable parenchymal cysticerci; class 2 (patients positive to bands GP42-39 and GP24, related to the T24-42 protein family, with or without anti-GP50 antibodies) was associated with intraparenchymal viable and nonviable infections; classes 3 and 4 (positive to GP50, GP42-39, and GP24 but also responding to low molecular weight bands GP21, GP18, GP14, and GP13, related to the 8 kDa protein family) were associated with extraparenchymal and intraparenchymal multiple viable cysticerci. Conclusions EITB antibody banding patterns correlate with brain imaging findings and complement imaging information for the diagnosis of NCC and for staging NCC patients.
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Affiliation(s)
- Gianfranco Arroyo
- School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia Rodriguez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Andres G Lescano
- School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karen A Alroy
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Javier A Bustos
- School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Saul Santivañez
- Instituto Peruano de Parasitología Clínica y Experimental, Lima
| | - Isidro Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Herbert Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Hector H Garcia
- School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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8
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Dermauw V, Carabin H, Ganaba R, Cissé A, Tarnagda Z, Gabriël S, Dorny P, Millogo A. Factors Associated with the 18-Month Cumulative Incidence of Seroconversion of Active Infection with Taenia solium Cysticercosis: A Cohort Study among Residents of 60 Villages in Burkina Faso. Am J Trop Med Hyg 2019; 99:1018-1027. [PMID: 30182917 PMCID: PMC6159582 DOI: 10.4269/ajtmh.18-0294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Taeniasis/cysticercosis (CC) is an important disease complex with significant burden. This large-scale cohort study aimed at estimating and exploring individual- and village-level factors associated with the cumulative incidences of seroconversion (SC) and seroreversion (SR) of active human CC in three provinces of Burkina Faso. In 60 villages, blood samples were collected and interviews regarding sociodemographic variables and knowledge, attitude, and practices toward the disease complex were conducted at baseline and 18-month follow-up (N = 2,211), with the presence of active CC being determined using the B158/B60 antigen enzyme-linked immunosorbent assay (Ag-ELISA). The 18-month Ag SC and SR were estimated at 3.3% (95% confidence interval [CI]: 2.6; 4.2%) and 35.8% (95% CI: 24.5; 48.5%), respectively. Marked provincial differences were found for the 18-month Ag SC (Boulkiemde: cumulative incidence ratio [CIR]: 2.41 (95% CI: 1.21; 4.78) and Nayala: CIR: 3.28 (95% CI: 1.37; 7.84), compared with Sanguie), while not being significantly associated with other sociodemographic factors. A continued refraining from pork consumption was associated with a lower 18-month Ag SC (CIR: 0.55 [95% CI: 0.28; 1.07]), whereas at the village level, the percentage of households owning pigs was associated with a higher 18-month Ag SC (CIR: 1.03 [95% CI: 1.01; 1.05]). In conclusion, this is one of few cohort studies and the first to have enough power to assess possible causal links between individual- and village-level variables and CC in humans. Variables linked to province, pig raising, and pork consumption behaviors were found to cause Ag SC in humans. The latter results further support the importance of adopting a One Health approach to the control of CC.
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Affiliation(s)
- Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hélène Carabin
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rasmané Ganaba
- Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), Bobo Dioulasso, Burkina Faso
| | - Assana Cissé
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | - Zékiba Tarnagda
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pierre Dorny
- Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Athanase Millogo
- Centre Hospitalier Universitaire Souro Sanou, Bobo Dioulasso, Burkina Faso
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Millogo A, Kongnyu Njamnshi A, Kabwa-PierreLuabeya M. Neurocysticercosis and epilepsy in sub-Saharan Africa. Brain Res Bull 2019; 145:30-38. [DOI: 10.1016/j.brainresbull.2018.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/20/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
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Martins-Melo FR, Ramos AN, Cavalcanti MG, Alencar CH, Heukelbach J. Reprint of "Neurocysticercosis-related mortality in Brazil, 2000-2011: Epidemiology of a neglected neurologic cause of death". Acta Trop 2017; 165:170-178. [PMID: 27887696 DOI: 10.1016/j.actatropica.2016.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/23/2015] [Accepted: 10/16/2015] [Indexed: 11/30/2022]
Abstract
Neurocysticercosis (NCC) is an important cause of severe neurological disease mainly in low- and middle-income countries, but data on NCC mortality from endemic areas are scarce. Here we analysed the epidemiological patterns of NCC-related mortality in Brazil. We included all deaths recorded in Brazil between 2000 and 2011, in which NCC was mentioned on death certificates, either as underlying or as associated cause of death. NCC was identified in 1829/12,491,280 deaths (0.015%), 1130 (61.8%) as underlying cause, and 699 (38.2%) as associated cause. Overall age-adjusted mortality rate for the period was 0.97 deaths/1,000,000 inhabitants (95% confidence interval [CI]: 0.83-1.12). The highest NCC-related mortality rates were found in males, elderly, white race/colour and residents in endemic states/regions. Age-adjusted mortality rates at national level decreased significantly over time (annual percent change [APC]: -4.7; 95% CI: -6.0 to -3.3), with a decrease in the Southeast, South and Central-West regions, and a non-significant increasing trend in the North and Northeast regions. We identified spatial and spatiotemporal high-risk mortality clusters located mainly in NCC-endemic areas. Conditions related to the nervous system were the most commonly associated causes of death when NCC was mentioned as an underlying cause, and HIV/AIDS was the main underlying cause when NCC was an associated cause. NCC is a neglected and preventable cause of severe neurologic disease and death with high public health impact in Brazil. There is a clear need to strengthen nationwide epidemiological surveillance and control for the taeniasis/cysticercosis complex.
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Affiliation(s)
- Francisco Rogerlândio Martins-Melo
- Department of Community Health, School of Medicine, Federal University of Ceará, Rua Professor Costa Mendes, 1608, Rodolfo Teófilo, 60430-140 Fortaleza, CE, Brazil; Federal Institute of Education, Science and Technology of Ceará, Rua Engenheiro João Alfredo, s/n, Pabussu, 61600-000 Caucaia, CE, Brazil.
| | - Alberto Novaes Ramos
- Department of Community Health, School of Medicine, Federal University of Ceará, Rua Professor Costa Mendes, 1608, Rodolfo Teófilo, 60430-140 Fortaleza, CE, Brazil
| | - Marta Guimarães Cavalcanti
- Infectious and Parasitic Diseases Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, 21941-913 Rio de Janeiro, RJ, Brazil
| | - Carlos Henrique Alencar
- Department of Community Health, School of Medicine, Federal University of Ceará, Rua Professor Costa Mendes, 1608, Rodolfo Teófilo, 60430-140 Fortaleza, CE, Brazil
| | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of Ceará, Rua Professor Costa Mendes, 1608, Rodolfo Teófilo, 60430-140 Fortaleza, CE, Brazil; Anton Breinl Centre for Public Health and College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia.
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11
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Del Brutto OH, Nash TE, White AC, Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 2016; 372:202-210. [PMID: 28017213 DOI: 10.1016/j.jns.2016.11.045] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/29/2016] [Accepted: 11/20/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND A unified set of criteria for neurocysticercosis (NCC) has helped to standardize its diagnosis in different settings. METHODS Cysticercosis experts were convened to update current diagnostic criteria for NCC according to two principles: neuroimaging studies are essential for diagnosis, and all other information provides indirect evidence favoring the diagnosis. Recent diagnostic advances were incorporated to this revised set. RESULTS This revised set is structured in absolute, neuroimaging and clinical/exposure criteria. Absolute criteria include: histological confirmation of parasites, evidence of subretinal cysts, and demonstration of the scolex within a cyst. Neuroimaging criteria are categorized as major (cystic lesions without scolex, enhancing lesions, multilobulated cysts, and calcifications), confirmative (resolution of cysts after cysticidal drug therapy, spontaneous resolution of single enhancing lesions, and migrating ventricular cysts on sequential neuroimaging studies) and minor (hydrocephalus and leptomeningeal enhancement). Clinical/exposure criteria include: detection of anticysticercal antibodies or cysticercal antigens by well-standardized tests, systemic cysticercosis, evidence of a household Taenia carrier, suggestive clinical manifestations, and residency in endemic areas. Besides patients having absolute criteria, definitive diagnosis can be made in those having two major neuroimaging criteria (or one major plus one confirmative criteria) plus exposure. For patients presenting with one major and one minor neuroimaging criteria plus exposure, definitive diagnosis of NCC requires the exclusion of confounding pathologies. Probable diagnosis is reserved for individuals presenting with one neuroimaging criteria plus strong evidence of exposure. CONCLUSIONS This revised set of diagnostic criteria provides simpler definitions and may facilitate its more uniform and widespread applicability in different scenarios.
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Affiliation(s)
- O H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador
| | - T E Nash
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States
| | - A C White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - V Rajshekhar
- Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India
| | - P P Wilkins
- Parasitology Services, Marathon, FL, United States
| | - G Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India
| | - C M Vasquez
- Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - P Salgado
- Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico
| | - R H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - H H Garcia
- Center for Global Health, Tumbes, Peru; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
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Abstract
Neurocysticercosis is an important cause of seizures worldwide and is endemic in most of Latin America, Sub-Saharan Africa, Southeast Asia, India, and China. Neurocysticercosis has profoundly different disease manifestations varying from asymptomatic presentation to life-threatening hydrocephalus. Clinical manifestations, pathogenesis, diagnostic methods, and optimal treatment vary with the location, number of lesions, and host response. Diagnosis is based on a combination of clinical presentation, neuroimaging findings, history of exposure, and serologic testing. Initial therapy should be focused on symptom management including seizure control and management of increased intracranial pressure. Emerging data are demonstrating that the optimal management approach varies with stage. Single enhancing or cystic lesions should be treated with albendazole and steroids. Patients with more than two cystic lesions should be treated with combination therapy with albendazole and praziquantel, whereas patients with hydrocephalus benefit from surgical management, especially with minimally invasive approaches.
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Affiliation(s)
- Camille M Webb
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, 301 University Boulevard, Rt 0435, Galveston, TX, 77555-0435, USA
| | - A Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, 301 University Boulevard, Rt 0435, Galveston, TX, 77555-0435, USA.
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Martins-Melo FR, Ramos AN, Cavalcanti MG, Alencar CH, Heukelbach J. Neurocysticercosis-related mortality in Brazil, 2000-2011: Epidemiology of a neglected neurologic cause of death. Acta Trop 2016; 153:128-36. [PMID: 26505283 DOI: 10.1016/j.actatropica.2015.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/23/2015] [Accepted: 10/16/2015] [Indexed: 11/29/2022]
Abstract
Neurocysticercosis (NCC) is an important cause of severe neurological disease mainly in low- and middle-income countries, but data on NCC mortality from endemic areas are scarce. Here we analysed the epidemiological patterns of NCC-related mortality in Brazil. We included all deaths recorded in Brazil between 2000 and 2011, in which NCC was mentioned on death certificates, either as underlying or as associated cause of death. NCC was identified in 1829/12,491,280 deaths (0.015%), 1130 (61.8%) as underlying cause, and 699 (38.2%) as associated cause. Overall age-adjusted mortality rate for the period was 0.97 deaths/1,000,000 inhabitants (95% confidence interval [CI]: 0.83-1.12). The highest NCC-related mortality rates were found in males, elderly, white race/colour and residents in endemic states/regions. Age-adjusted mortality rates at national level decreased significantly over time (annual percent change [APC]: -4.7; 95% CI: -6.0 to -3.3), with a decrease in the Southeast, South and Central-West regions, and a non-significant increasing trend in the North and Northeast regions. We identified spatial and spatiotemporal high-risk mortality clusters located mainly in NCC-endemic areas. Conditions related to the nervous system were the most commonly associated causes of death when NCC was mentioned as an underlying cause, and HIV/AIDS was the main underlying cause when NCC was an associated cause. NCC is a neglected and preventable cause of severe neurologic disease and death with high public health impact in Brazil. There is a clear need to strengthen nationwide epidemiological surveillance and control for the taeniasis/cysticercosis complex.
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