Active epilepsy as an index of burden of neurocysticercosis in Vellore district, India

To determine the contribution of neurocysticercosis (NCC) to the causation of active epilepsy (AE) in a south Indian community. We conducted a door-to-door survey of 50,617 people between the ages of 2 and 60 years in a rural (38,105 people) and urban setting (12,512 people) in the Vellore district...

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Bibliographic Details
Published in:	Neurology Vol. 67; no. 12; pp. 2135 - 2139
Main Authors:	RAJSHEKHAR, V, VENKAT RAGHAVA, M, PRABHAKARAN, V, OOMMEN, A, MULIYIL, J
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 26-12-2006
Subjects:	Adolescent Adult Biological and medical sciences Causality Child Child, Preschool Comorbidity Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Epilepsy - epidemiology Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Health Status Indicators Health Surveys Humans India - epidemiology Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurocysticercosis - epidemiology Neurology Prevalence Risk Assessment - methods Risk Factors Rural Population - statistics & numerical data Statistics as Topic Taenia Urban Population - statistics & numerical data Asia India Infection Nervous system diseases Cysticercosis Epilepsy Central nervous system disease Central nervous system Parasitosis Helminthiasis Cestode disease Cerebral disorder
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Summary:	To determine the contribution of neurocysticercosis (NCC) to the causation of active epilepsy (AE) in a south Indian community. We conducted a door-to-door survey of 50,617 people between the ages of 2 and 60 years in a rural (38,105 people) and urban setting (12,512 people) in the Vellore district of the south Indian state of Tamil Nadu to identify patients with AE. Patients with AE were investigated with a contrast-enhanced CT scan and serologic study using enzyme-linked immunotransfer blot (EITB) for cysticercal antibodies. We identified 194 patients with AE. The prevalence of AE was 3.83 per 1,000 people, with the prevalence in the urban clusters more than twice that in the rural clusters (6.23 vs 3.04 per 1,000) (p < 0.0001). A diagnosis of NCC was made in 46 (28.4%) of the 162 patients undergoing a CT scan, and EITB was positive in 21 (13%) patients. Overall, 55 (34%) patients were diagnosed with NCC (11 definitive NCC and 44 probable NCC). There was no significant difference in the prevalence of NCC causing AE in the urban (1.28 per 1,000) and rural (1.02 per 1,000) communities. NCC is the cause of nearly one-third of all cases of AE in both the urban and rural regions. Extrapolating our results to the country as a whole leads to an estimated disease burden of 1 million patients in India with AE attributable to NCC.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0028-3878 1526-632X
DOI:	10.1212/01.wnl.0000249113.11824.64