Magnitude of the disease burden from neurocysticercosis in a developing country

Abstract

Cysticercosis contributes to higher epilepsy rates in developing countries than in industrialized ones, yet no estimate exists for the associated burden of disease. We used epidemiological data on neurocysticercosis in Peru to calculate the burden of disease and applied our model to the other countries of Latin America where neurocysticercosis is endemic to determine a regional estimate. Analysis of 12 population-based community studies demonstrated that neurocysticercosis was endemic in highland areas and high jungles, with seroprevalences from 6% to 24%. In one community, the adult seizure disorder rate was 9.1% among seropositive persons versus 4. 6% among seronegative persons; we used this difference for estimates. On the basis of average prevalence rates in areas of endemicity of 6%-10%, we estimated that there are 23,512-39,186 symptomatic neurocysticercosis cases in Peru. In Latin America, an estimated 75 million persons live in areas where cysticercosis is endemic, and approximately 400,000 have symptomatic disease. Cysticercosis contributes substantially to neurological disease in Peru and in all of Latin America.

Figure 1

Diagram of relationship between cysticercosis disease or infection and diagnostic test results (+, positive; −, negative). Lower part of triangle represents persons with asymptomatic cysticercosis infection, whereas upper part represents those who have symptomatic neurocysticercosis disease. Some infections and some symptomatic cases involve positive electroimmunotransfer blot serology (EITB) only or positive computerized tomography (CT) of the brain; some involve both or neither. Our disease burden estimate corresponds to shaded area, representing only EITB-positive symptomatic cases (see text for full explanation).