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Castillo G, Fustamante L, Delgado-Kamiche AD, Camen-Orozco RP, Clark T, Bernal E, Morales-Alvarez J, Ferrufino M, Mamani-Palomino J, Bustos JA, Garcia HH, Gavidia CM, Gilman RH, Verastegui M. Understanding the pathogenic mechanisms and therapeutic effects in neurocysticercosis. Brain Pathol 2024; 34:e13237. [PMID: 38212958 PMCID: PMC11328352 DOI: 10.1111/bpa.13237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024] Open
Abstract
Despite being a leading cause of acquired seizures in endemic regions, the pathological mechanisms of neurocysticercosis are still poorly understood. This study aims to investigate the impact of anthelmintic treatment on neuropathological features in a rat model of neurocysticercosis. Rats were intracranially infected with Taenia solium oncospheres and treated with albendazole + praziquantel (ABZ), oxfendazole + praziquantel (OXF), or untreated placebo (UT) for 7 days. Following the last dose of treatment, brain tissues were evaluated at 24 h and 2 months. We performed neuropathological assessment for cyst damage, perilesional brain inflammation, presence of axonal spheroids, and spongy changes. Both treatments showed comparable efficacy in cyst damage and inflammation. The presence of spongy change correlated with spheroids counts and were not affected by anthelmintic treatment. Compared to white matter, gray matter showed greater spongy change (91.7% vs. 21.4%, p < 0.0001), higher spheroids count (45.2 vs. 0.2, p = 0.0001), and increased inflammation (72.0% vs. 21.4%, p = 0.003). In this rat model, anthelmintic treatment destroyed brain parasitic cysts at the cost of local inflammation similar to what is described in human neurocysticercosis. Axonal spheroids and spongy changes as markers of damage were topographically correlated, and not affected by anthelmintic treatment.
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Affiliation(s)
- Gino Castillo
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lizbeth Fustamante
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ana D Delgado-Kamiche
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Rogger P Camen-Orozco
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Taryn Clark
- The Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Emergency Medicine, SUNY Downstate Medical Center, Kings County Hospital Medical Center, Brooklyn, New York, New York, United States
| | - Edson Bernal
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jemima Morales-Alvarez
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Ferrufino
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Javier Mamani-Palomino
- Facultad de Medicina Veterinaria y Salud animal, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A Bustos
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Cesar M Gavidia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- The Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Manuela Verastegui
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Asociación Benéfica Prisma, Lima, Peru
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Ribeiro LGS, Marcusso HC, Abud LG. Reactivation of neurocysticercosis: calcified nodular lesion and perilesional edema. Rev Soc Bras Med Trop 2022; 55:e0560. [PMID: 35239913 PMCID: PMC8909441 DOI: 10.1590/0037-8682-0560-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022] Open
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Mejia Maza A, Carmen-Orozco RP, Carter ES, Dávila-Villacorta DG, Castillo G, Morales JD, Mamani J, Gavídia CM, Alroy J, Sterling CR, Gonzalez AE, García HH, Woltjer RL, Verástegui MR, Gilman RH. Axonal swellings and spheroids: a new insight into the pathology of neurocysticercosis. Brain Pathol 2018; 29:425-436. [PMID: 30368965 DOI: 10.1111/bpa.12669] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/21/2018] [Indexed: 12/13/2022] Open
Abstract
Neurocysticercosis is a parasitic brain disease caused by the larval form (Cysticercus cellulosae) of Taenia solium and is the leading cause of preventable epilepsy worldwide. However, the pathophysiology and relation to the wide range of clinical features remains poorly understood. Axonal swelling is emerging as an important early pathological finding in multiple neurodegenerative diseases and as a cause of brain injury, but has not been well described in neurocysticercosis. Histological analysis was performed on human, rat and porcine NCC brain specimens to identify axonal pathology. Rat infection was successfully carried out via two routes of inoculation: direct intracranial injection and oral feeding. Extensive axonal swellings, in the form of spheroids, were observed in both humans and rats and to a lesser extent in pigs with NCC. Spheroids demonstrated increased immunoreactivity to amyloid precursor protein and neurofilament indicating probable impairment of axonal transport. These novel findings demonstrate that spheroids are present in NCC which is conserved across species. Not only is this an important contribution toward understanding the pathogenesis of NCC, but it also provides a model to analyze the association of spheroids with specific clinical features and to investigate the reversibility of spheroid formation with antihelminthic treatment.
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Affiliation(s)
- Alan Mejia Maza
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Rogger P Carmen-Orozco
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Emma S Carter
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Danitza G Dávila-Villacorta
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Gino Castillo
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Jemina D Morales
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Javier Mamani
- Faculty of Veterinary Medicine and Animal Husbandry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar M Gavídia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Joseph Alroy
- Department of Pathology, Tufts University School of Medicine and Tufts-New England Medical Center, Boston, MA
| | - Charles R Sterling
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ
| | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Héctor H García
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Randy L Woltjer
- Department of Pathology, Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR
| | - Manuela R Verástegui
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Robert H Gilman
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú.,The Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD.,Asociación Benéfica PRISMA, Lima, Perú
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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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Abdaljaleel M, Mazumder R, Patel CB, Im K, Pope W, Liau LM, Vinters HV, Yong WH. Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis? Neuropathology 2016; 37:233-240. [DOI: 10.1111/neup.12349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Maram Abdaljaleel
- Department of Pathology, Jordan University Hospital; University of Jordan; Amman Jordan
- Department of Pathology and Laboratory Medicine (Neuropathology); University of California at Los Angeles; Los Angeles CA USA
| | - Rajarshi Mazumder
- Department of Neurology; University of California at Los Angeles; Los Angeles CA USA
| | - Chirag B. Patel
- Department of Neurology; University of California at Los Angeles; Los Angeles CA USA
| | - Kyuseok Im
- Department of Pathology and Laboratory Medicine (Neuropathology); University of California at Los Angeles; Los Angeles CA USA
| | - Whitney Pope
- Department of Radiological Sciences (Neuroradiology); University of California at Los Angeles; Los Angeles CA USA
| | - Linda M. Liau
- Department of Neurosurgery, David Geffen School of Medicine; University of California at Los Angeles; Los Angeles CA USA
| | - Harry V. Vinters
- Department of Pathology and Laboratory Medicine (Neuropathology); University of California at Los Angeles; Los Angeles CA USA
- Department of Neurology; University of California at Los Angeles; Los Angeles CA USA
| | - William H. Yong
- Department of Pathology and Laboratory Medicine (Neuropathology); University of California at Los Angeles; Los Angeles CA USA
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Verastegui MR, Mejia A, Clark T, Gavidia CM, Mamani J, Ccopa F, Angulo N, Chile N, Carmen R, Medina R, García HH, Rodriguez S, Ortega Y, Gilman RH. Novel rat model for neurocysticercosis using Taenia solium. THE AMERICAN JOURNAL OF PATHOLOGY 2016. [PMID: 26216286 DOI: 10.1016/j.ajpath.2015.04.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Neurocysticercosis is caused by Taenia solium infecting the central nervous system and is the leading cause of acquired epilepsy and convulsive conditions worldwide. Research into the pathophysiology of the disease and appropriate treatment is hindered by lack of cost-effective and physiologically similar animal models. We generated a novel rat neurocysticercosis model using intracranial infection with activated T. solium oncospheres. Holtzman rats were infected in two separate groups: the first group was inoculated extraparenchymally and the second intraparenchymally, with different doses of activated oncospheres. The groups were evaluated at three different ages. Histologic examination of the tissue surrounding T. solium cysticerci was performed. Results indicate that generally infected rats developed cysticerci in the brain tissue after 4 months, and the cysticerci were observed in the parenchymal, ventricle, or submeningeal brain tissue. The route of infection did not have a statistically significant effect on the proportion of rats that developed cysticerci, and there was no dependence on infection dose. However, rat age was crucial to the success of the infection. Epilepsy was observed in 9% of rats with neurocysticercosis. In histologic examination, a layer of collagen tissue, inflammatory infiltrate cells, perivascular infiltrate, angiogenesis, spongy change, and mass effect were observed in the tissue surrounding the cysts. This study presents a suitable animal model for the study of human neurocysticercosis.
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Affiliation(s)
- Manuela R Verastegui
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Alan Mejia
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Taryn Clark
- Cysticercosis Working Group in Peru, Lima, Peru; Weill Cornell Medical College, New York, New York
| | - Cesar M Gavidia
- Cysticercosis Working Group in Peru, Lima, Peru; Public Health Section, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Javier Mamani
- Cysticercosis Working Group in Peru, Lima, Peru; Faculty of Veterinary Medicine and Animal Husbandry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fredy Ccopa
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Noelia Angulo
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nancy Chile
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rogger Carmen
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Roxana Medina
- Cysticercosis Working Group in Peru, Lima, Peru; Department of Biology Science, Universidad Nacional del Altiplano, Puno, Peru
| | - Hector H García
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru
| | - Silvia Rodriguez
- Cysticercosis Working Group in Peru, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru
| | - Ynes Ortega
- Cysticercosis Working Group in Peru, Lima, Peru; Department of Food Science & Technology, The University of Georgia, Athens, Georgia
| | - Robert H Gilman
- Cysticercosis Working Group in Peru, Lima, Peru; Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland; Asociación Benéfica PRISMA, San Miguel, Lima, Peru
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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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Coeli GNM, Tiengo RR, Silva ACD, Fernandes JOM, Silva GCD, Silva LUMAD. Neurocisticercose nodular calcificada com sinais de reativação. Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000500012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A neurocisticercose é uma doença caracterizada pelo envolvimento do sistema nervoso central pelo estágio larval intermediário do parasita Taenia solium. O processo de degeneração da larva e a reação inflamatória do organismo causam os sintomas clínicos. Relatamos a reativação clínica e radiológica de uma forma nodular calcificada e assintomática há mais de 20 anos. O tratamento antiparasitário mostrou boa resposta.
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de Almeida SM, Torres LFB. Neurocysticercosis--retrospective study of autopsy reports, a 17-year experience. J Community Health 2011; 36:698-702. [PMID: 21416341 DOI: 10.1007/s10900-011-9389-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neurocysticercosis (NCC) is a common central nervous system (CNS) infection caused by Taenia solium metacestodes. The objective of this study is to describe the incidence of cysticercosis diagnosed at autopsies and describe the epidemiological and clinical characteristics of NCC. Retrospective study analyzing 6,500 reports of autopsies between 1977 and 1994 from a school hospital in Curitiba, PR, southern of Brazil. The following data was obtained, age, gender, site of cysticercosis, NCC as cause of death. The diagnosis of cysticercosis was established in 52 (0.8%) autopsies. From 1977 to 1987 (0.7%) and from 1988 to 1994 (1.1%). In the autopsies with cysticercosis 75% were male; age (mean ± SD) was 43 ± 20. NCC was present in 96% of cases, and seizures was the most frequent clinical manifestation. Asymptomatic cases in 54%. These data classify our area as hiperendemic, according with OMS criteria. The present study reinforces the necessity to develop adequate control programs.
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Affiliation(s)
- Sérgio Monteiro de Almeida
- Setor Análises Clínicas, Laboratório de Virologia, Ambulatório de Neuroinfecção do Hospital de Clínicas UFPR, Rua Padre Camargo, 280, Curitiba, PR, 80060-240, Brazil.
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Carvalho Junior RMD, Costa DL, Soares SC, Costa CHN. Evaluation of an enzyme immunoassay for clinical diagnosis of neurocysticercosis in symptomatic patients. Rev Soc Bras Med Trop 2011; 43:647-50. [PMID: 21181016 DOI: 10.1590/s0037-86822010000600009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Accepted: 09/01/2010] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Neurocysticercosis is an infection of the human central nervous system caused by the metacestode larvae of Taenia solium. Neurocysticercosis is the most common parasitic disease in developing countries. Epilepsy is the most common clinical manifestation. Difficulties in confirming the diagnosis motivated the evaluation of the enzyme-linked immunosorbent assay on cerebral spinal fluid (CSF). METHODS Twenty-two patients with NCC and 44 control patients were studied. CSF was analyzed using a commercial ELISA kit developed for NCC. Sensitivity and specificity were measured and a multivariate logistic regression was performed. RESULTS Sensitivity and specificity of ELISA were 31.8% and 100%, respectively, with accuracy of 77.3%. Only the size of the lesions proved to be important for performance of the test. CONCLUSIONS The results showed that ELISA contributes to the diagnosis of neurocysticercosis if the result is negative or if the patient has a lesion of 2 cm or more.
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de Souza A, Nalini A, Kovoor JME, Yeshraj G, Siddalingaiah HS, Thennarasu K. Perilesional gliosis around solitary cerebral parenchymal cysticerci and long-term seizure outcome: A prospective study using serial magnetization transfer imaging. Epilepsia 2011; 52:1918-27. [DOI: 10.1111/j.1528-1167.2011.03189.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, Qian YJ, Rainwater E, Dickey M, Reynolds S, Stoner JA. A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis 2010; 4:e870. [PMID: 21072231 PMCID: PMC2970544 DOI: 10.1371/journal.pntd.0000870] [Citation(s) in RCA: 284] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 10/04/2010] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The objective of this study is to conduct a systematic review of studies reporting the frequency of neurocysticercosis (NCC) worldwide. METHODS/PRINCIPAL FINDINGS PubMed, Commonwealth Agricultural Bureau (CAB) abstracts and 23 international databases were systematically searched for articles published from January 1, 1990 to June 1, 2008. Articles were evaluated for inclusion by at least two researchers focusing on study design and methods. Data were extracted independently using standardized forms. A random-effects binomial model was used to estimate the proportion of NCC among people with epilepsy (PWE). Overall, 565 articles were retrieved and 290 (51%) selected for further analysis. After a second analytic phase, only 4.5% of articles, all of which used neuroimaging for the diagnosis of NCC, were reviewed. Only two studies, both from the US, estimated an incidence rate of NCC using hospital discharge data. The prevalence of NCC in a random sample of village residents was reported from one study where 9.1% of the population harboured brain lesions of NCC. The proportion of NCC among different study populations varied widely. However, the proportion of NCC in PWE was a lot more consistent. The pooled estimate for this population was 29.0% (95%CI: 22.9%-35.5%). These results were not sensitive to the inclusion or exclusion of any particular study. CONCLUSION/SIGNIFICANCE Only one study has estimated the prevalence of NCC in a random sample of all residents. Hence, the prevalence of NCC worldwide remains unknown. However, the pooled estimate for the proportion of NCC among PWE was very robust and could be used, in conjunction with estimates of the prevalence and incidence of epilepsy, to estimate this component of the burden of NCC in endemic areas. The previously recommended guidelines for the diagnostic process and for declaring NCC an international reportable disease would improve the knowledge on the global frequency of NCC.
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Affiliation(s)
- Patrick C. Ndimubanzi
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Hélène Carabin
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Christine M. Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, United States of America
| | - Hai Nguyen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Ying-Jun Qian
- National Institute of Parasitic Diseases, Shangai, People's Republic of China
| | - Elizabeth Rainwater
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Mary Dickey
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Stephanie Reynolds
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Julie A. Stoner
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
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