Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management

Abstract

Neurocysticercosis has been recognized as a major cause of secondary epilepsy worldwide. So far, most of the knowledge about the disease comes from Latin America and the Indian subcontinent. Unfortunately, in sub-Saharan Africa the condition was neglected for a long time, mainly owing to the lack of appropriate diagnostic tools. This review therefore focuses on the prevalence of neurocysticercosis in sub-Saharan Africa, the clinical picture with emphasis on epilepsy, as well as the diagnosis and treatment of neurocysticercosis and its related epilepsy/epileptic seizures in African resource-poor settings.

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

“…Patients mainly present with partial onset seizure with or without generalisation and have a high risk of seizure recurrence. Contrary to India, multiple lesions mainly of the intraparenchymal type seem to prevail in people with NCC from Latin America, sub-Saharan Africa and other Asian countries although scientific publications on NCC-related neuroimaging from sub-Saharan Africa and Asian countries other than India are rare [67,92,93].…”

“…Such studies are desperately needed to evaluate the risk of symptomatic NCC with potentially ensuing death in many hundreds of thousands of people in sub-Saharan Africa. For more details on the calculation of how many people in sub-Saharan Africa would potentially be at risk of developing neurological side effects after mass drug administration of praziquantel and albendazole refer to Winkler [67].…”

“…They are transported via the bloodstream and cysticerci form within a few weeks/months, mainly in subcutaneous tissue (painless, palpable, cystic lesions), skeletal muscle (lesion may not be palpable), the eye and the central nervous system, particularly in the brain but also in the spinal cord ( [90]; Figure 2). Differences in phenotype of cysticercosis between various regions of the world have been described, indicating that the subcutaneous form of cysticercosis is most frequent in Asia, least prevalent in Latin America and that reports of its occurrence are conflicting in sub-Saharan Africa [67]. Especially cysticercosis of the eye and central nervous system are of clinical importance, where cysticerci can cause inflammation and/or space-occupying lesions with a mass effect and/or obstruction with resulting hydrocephalus.…”

Habit of cooking pork on hot stones as main risk of cysticercosis

“…Neurocysticercosis has been reported as the cause of around 20-50 % of secondary epilepsy in several countries in the world. (4) The incidence of taeniasis/cysticercosis is highest in Africa, Southeast Asia, Central and South America, and Europe. (3,5) In the Southeast Asian region research has been conducted on the prevalence of taeniasis and cysticercosis, e.g.…”

Simple Identification of Human Taenia Species by Multiplex Loop-Mediated Isothermal Amplification in Combination with Dot Enzyme-Linked Immunosorbent Assay

“…[1][2][3][4] Neurocysticercosis, an infection of the central nervous system, has been increasingly recognized as a lethal helminthic disease in both developing 1,5,6 and developed countries. [7][8][9] Among the Taeniae of humans, including T. solium, Taenia saginata, and Taenia asiatica, which cause taeniasis, [10][11][12][13] only T. solium causes cysticercosis in humans.…”