Neurocysticercosis in Bhutan: a cross-sectional study in people with epilepsy

Deki, Sonam; Bruno, Veronica; Mateen, Farrah J.; Tshokey, Tshokey; Bhutan Epilepsy Project; Nirola, Damber K.; Nidup, Dechen; Hugo Garcia, Hector; Tshering, Lhab; Diamond, Megan B.; Brizzi, Kate; Klein, Joshua P.; Pelden, Sonam; Dorny, Pierre

dc.contributor.author	Brizzi, Kate
dc.contributor.author	Pelden, Sonam
dc.contributor.author	Tshokey, Tshokey
dc.contributor.author	Nirola, Damber K.
dc.contributor.author	Diamond, Megan B.
dc.contributor.author	Klein, Joshua P.
dc.contributor.author	Tshering, Lhab
dc.contributor.author	Deki, Sonam
dc.contributor.author	Nidup, Dechen
dc.contributor.author	Bruno, Veronica
dc.contributor.author	Dorny, Pierre
dc.contributor.author	Hugo Garcia, Hector
dc.contributor.author	Mateen, Farrah J.
dc.contributor.author	Bhutan Epilepsy Project
dc.date.accessioned	2019-02-22T14:54:02Z
dc.date.available	2019-02-22T14:54:02Z
dc.date.issued	2016
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5603
dc.description.abstract	Background: We sought to provide an assessment of the burden of neurocysticercosis among people with epilepsy (PWE) in Bhutan and evaluate the yield of various tests for Taenia solium. Methods: PWE were enrolled at the National Referral Hospital in Thimphu (2014-2015). Serum was tested for anti-Taenia solium IgG using ELISA (Ab-ELISA), enzyme-linked immunoelectrotransfer blot (EITB), and parasite antigen. Results were compared to brain MRI. Participants were categorized as definite neurocysticercosis (MRI and EITB positive), probable neurocysticercosis (MRI or EITB positive), or without neurocysticercosis. Logistic regression models were constructed to explore clinicodemographic associations. Results: There were 12/205 (6%, 95% CI 2%, 9%) definite and 40/205 (20%, 95% CI 14%, 25%) probable neurocysticercosis cases. 25/205 (12%) with positive EITB did not have neurocysticercosis on MRI, and 15/205 (7%) participants with positive MRI had negative EITB. Participants with neurocysticercosis-suggestive lesions on MRI had an average of 1.2 cysts (parenchymal 26/27; nodular/calcified stage 21/27). In a multivariable analysis, present age (OR 1.05, 95% CI 1.01,1.09, p=0.025) was positively associated with (combined probable or definite) neurocysticercosis while mesial temporal sclerosis on MRI (OR 0.294, 95% CI 0.144, 0.598, p=0.001) was negatively associated. Conclusions: Neurocysticercosis was associated with 6-25% of epilepsy in a Bhutanese cohort. Combining EITB and MRI would aid the diagnosis of neurocysticercosis among PWE since no test identified all cases.	en_US
dc.language.iso	eng
dc.publisher	Oxford University Press
dc.relation.ispartofseries	Transactions of the Royal Society of Tropical Medicine and Hygiene
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	Neurocysticercosis	en_US
dc.subject	Epilepsy	en_US
dc.subject	Seizure	en_US
dc.subject	Bhutan	en_US
dc.subject	Enzyme-linked immunoelectrotransfer blot	en_US
dc.subject	Magnetic resonance imaging	en_US
dc.title	Neurocysticercosis in Bhutan: a cross-sectional study in people with epilepsy	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1093/trstmh/trw066
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1878-3503