Case-control study of seropositivity for cysticercosis in Cuenca, Ecuador.

Abstract

Abstract. The prevalence of neurocysticercosis has been well documented in rural communities in Latin America using the enzyme-linked inmmunoelectrotransfer blot (EITB) assay. We studied the prevalence of neurocysticercosis in an urban, upper-middle class population in Cuenca, Ecuador. Family members of 34 index cases with parenchymal neurocysticercosis on a computed tomography (CT) scan and family members of 14 patients who had normal CT scans after a trauma or migraine were enrolled in the study. Serum was obtained from 226 individuals, 173 (72%) from the case families and 67 (28%) from the control families. Twelve percent of the case family members and 4% of the control family members were seropositive by the EITB assay. This was a statistically significant difference (P Ͻ 0.05) when age and education were held constant by logistic regression. Seropositivity was not related to age. No neurologic symptom proved predictive of serostatus and the only demographic variable that correlated with seropositivity was increased crowding. Positive serology in index cases did correlate with CT findings as follows: 86% of patients with active lesions, 67% with transitional lesions, and only 41% of patients with inactive lesions were positive by the EITB assay. Eighteen percent of family members with a positive EITB test result had parenchymal lesions on a subsequent CT scan. This study demonstrates a high rate of seropositivity of cysticercosis among urban, middle to upper-middle class individuals in a region endemic for Taenia solium. Household contacts of patients with neurocysticercosis had a three-fold higher risk of positive serology for cysticercosis, in comparison with controls.

The relationship between neurocysticercosis and epilepsy: an endless debate

“…Immunoserologic assays, such as enzyme-linked immunoelectrotransfer blot assay (EITB) or enzyme-linked immunosorbent assay (ELISA), detect antibodies against T. solium 15 . Epidemiological surveys using EITB report a seroprevalence of 8% to 12% for antibodies against T. solium in some regions of Latin America; however, most of these patients did not have symptomatic NC 15,16 . These assays are useful for identification of individuals who have had systemic contact with the parasite at some time, but their sole use in the diagnosis of NC is equivocal.…”

Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools

“…Gonzalez et al 1990, Diaz et al 1992, Garcia Noval et al 1996, Sanchez et al 1997, Goodman et al 1999, Garcia et al 2003, Cruz-Licea et al 2003, PrestesCarneiro et al 2006. Both methods attempt to measure the proportion of infected individuals, however, antigen detection is restricted to the detection of viable cysticerci, while the finding of antibodies can indicate the presence of both viable and degenerated cysticerci or past infection (Dorny et al 2004a).…”

Neurocysticercosis, familial cerebral cavernomas and intracranial calcifications: differential diagnosis for adequate management

“…Alive cysts are depicted as one or more hypodense areas, variable in size and without constrast enhancement whereas the transitional ones as cysts with contrast enhacement. Inactive lesions are depicted as rounded, hypodense, without enhancement and with areas of calcification 28 . MRI is the best test for definition of the cyst stage in their evolution in the brain on T1, T2, FLAIR sequences, including the inflammatory aspects when using enhanced images with gadolinium infusion ( Figures 3A, B and C) 29 although not as accurate in detection of calcifications.…”

“…An interesting confounding aspect is that there are few studies showing familial aggregation of NC 28,34 and, on this situation, it would be reasonable to use MRI scan to establish the differential diagnosis with FCCM. As the familial form of cavernomas is more prone to develop epilepsy 24 and also characterized by multiple brain lesions, often calcified on the CT scan, ranging from a few to uncountable ones, the different nature of the two diseases certainly raises the importance the correct diagnosis.…”