Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries

Abstract

Background Neurocysticercosis (NC) is one of the major parasitic diseases affecting the central nervous system and is endemic in much of Asia, sub-Saharan Africa, and Latin America. Its epidemiology is difficult to assess, although official registries are available in Brazil, Colombia, Ecuador, and Mexico. Methodology/Principal findings Using official statistics, we assessed trends in NC hospitalization rates during 1998–2019 in Brazil and Ecuador, during 2004–2019 in Mexico, and during 2009–2019 in Colombia. We also assessed the trend in NC mortality in Brazil (1998–2019), the trend in hospitalizations for NC in a Mexican tertiary-level hospital (Instituto Nacional de Neurología y Neurocirugía [INNN]; 1995–2019), and in Mexican primary care ambulatory clinics (1995–2019). Associations between NC hospitalization rates and the human development index (HDI) were also examined. In Brazil, Ecuador, and Mexico, statistically significant decreases in NC hospitalization rates were observed. In Mexico, a significant increase in the age of patients at INNN was observed. Conversely, a significant increase in NC hospitalization rate was observed in Colombia. HDI was not significantly associated with NC hospitalization rates when adjusting for time. Conclusions The downward trends in NC cases in Brazil, Ecuador, and Mexico are encouraging, especially in the context of the PAHO/WHO plan of action to eliminate neglected tropical diseases from the region. On the other hand, in Colombia, the increased NC hospitalization rate is concerning and needs further evaluation so that the authorities can take specific measures. These results should encourage health authorities in other endemic countries to establish a system of official registries to identify where the need for a control program is most urgent. However, it is also important to remember that NC persists, although less frequently in some Latin American countries, and efforts to achieve its control must continue.

Neurocysticercosis: The duration of its preclinical phase relies on the parasite location

“…Another result of this study is the clear decrease of risk factor exposure in included patients. This is in no doubt related with the change in NC incidence in Mexico which has shown a significant decrease since the end of the twentieth century [6]. It is important to note that the decrease of free roaming pigs and consumption of infected meat was not significant, and should prompt authorities to perform informative campaign to improve this situation.…”

“…Therefore, this is an endemic disease in most pork-eating developing countries, affecting also high-income countries due to immigration [3][4][5]. In Mexico as in other Latin American countries, an epidemiological transition is currently underway with a decrease in the incidence of neurocysticercosis [6].…”

Epilepsy Care in Latin America and the Caribbean: Overcoming Challenges and Embracing Opportunities

“…4,20 However, a recent analysis of hospitalization rates indicates a declining incidence of NCC in several LAC countries, including Brazil, Ecuador, and Mexico. 21 Over the past two decades, the epilepsy burden in LAC countries has decreased by 20%, primarily driven by years of life lost. However, despite this reduction, the region still accounts for 9.51% of the global epilepsy disease burden, equivalent to 175.9 disability-adjusted life years per 1,000,000 population.…”

“…4 20 However, a recent analysis of hospitalization rates indicates a declining incidence of NCC in several LAC countries, including Brazil, Ecuador, and Mexico. 21…”

Neurocysticercosis: A Review into Treatment Options, Indications, and Their Efficacy

“…In some countries, recent data shows a clear decrease in its incidence, although, in others, the activity of infection seems to be still very present. [4][5][6][7][8]…”