The burden of T. solium cysticercosis and selected neuropsychiatric disorders in Mocuba district, Zambézia province, Mozambique

Abstract

Background Taenia solium (neuro-)cysticercosis is a neglected tropical disease often associated with epileptic seizures and reportedly with other neuropsychiatric (= neurological and psychiatric) disorders. This study aimed to evaluate the association of the disease with selected neuropsychiatric disorders and/or symptoms (chronic headache, epileptic seizures/epilepsy and psychosis) in Mocuba district, Mozambique. Methodology Between March and May 2018, a cross-sectional study was conducted among 1,086 participants aged 2 years or above in Mocuba district, Zambézia province, central Mozambique to assess the seroprevalence of human cysticercosis and risk factors for infection, as well as to explore its relation to selected neuropsychiatric disorders. Socio-demographic and clinical data were collected from each participant using a modified questionnaire designed by the Cysticercosis Working Group for Eastern and Southern Africa. Additionally, neuropsychiatric disorders, such as chronic headache, epileptic seizures/epilepsy and psychosis were assessed using four vignettes. T. solium antigen and cysticercosis IgG in serum were detected using both T. solium antigen B158/B60 enzyme linked immunosorbent assay (ELISA) and LDBIO Cysticercosis Western Blot, respectively. Principal findings Overall, 112/1,086 participants (10.3%) were sero-positive for T. solium antigen or antibodies. Prevalence of antibodies (6.6%; n = 72) was higher than of antigens (4.9%; n = 54). In the questionnaires, 530 (49.5%) of participants reported chronic headache, 293 (27%) had generalized epileptic seizures, 188 (18%) focal seizures and 183 (18.3%) psychosis. We found a statistically significant association between seropositivity for T. solium and chronic headache (p = 0.013). Additionally, increasing age (p = 0.03) was associated with Ag-ELISA seropositivity. Conclusions Our study revealed that in Mocuba, T. solium cysticercosis is prevalent and associated with self-reported chronic headache. Additionally, in the study setting, the seroprevalence of cysticercosis increased with age. However, it is not associated with other neuropsychiatric disorders such epileptic seizures/epilepsy and psychosis. Future studies are needed to confirm the burden of neuropsychiatric disorders and their possible etiology, including neurocysticercosis, with additional serological, molecular biological and radiological diagnostic tools, as well as in-depth clinical examinations.

Microbiological assessment reveals that Salmonella, Shigella and Campylobacter infections are widespread in HIV infected and uninfected patients with diarrhea in Mozambique

“…The study’s findings are relevant to the local context of Maputo, where the study was conducted, and highlight the importance of addressing the issue of bacterial infections among patients with diarrhea, particularly in peri-urban and suburban areas where basic infrastructure and access to clean water and sanitation may be lacking. In point of fact, only 48.7% of the inhabitants in Mozambique have access to safe drinking water and 54.2% do not have latrines in their homes [ 22 , 30 ], which increases the risk of diarrheal diseases caused by enteric pathogens.…”

A systematic review and meta-analysis of the epidemiology of Leptospirosis in HIV uninfected and in people living with HIV from the Southern African Development Community

“…In general, paucity of studies, lack of diagnostic resources, lack of an active surveillance system and awareness of health professionals and authorities about the disease is also valid for other African countries outside SADC [ 82 ]. In addition, excessive attention paid to diseases such as HIV, malaria and tuberculosis has lead to underestimation and perpetuation of the neglected status of this and other neglected tropical diseases which are also predominant in this region [ 5 , 13 , 83 , 84 ]. In view of this, a One Health approach studies that includes the study of Leptospira species, serogroups and serovars, should be carried on, in combination with studies on the epidemiology of the bacteria in humans and animals identifying host range involved in transmission cycles and factors associated with infections [ 2 ].…”

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

“…36,42,43 More recent studies seem to show a decrease in its importance, although more information is needed to confirm these results. 44,45 Epilepsy seems well controlled by antiepileptic drugs (AE), although studies focusing on this point and precise estimations are lacking. It is important to remember that since endemic countries are poor countries, the treatment gap (lack or irregularity of treatment, insufficient dosage) due to economic factors is high.…”

“… 36 , 42 , 43 More recent studies seem to show a decrease in its importance, although more information is needed to confirm these results. 44 , 45 …”