Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.

<h4>Background</h4>We reviewed studies that analyzed cysticercosis (CC), neurocysticercosis (NCC) and epilepsy across Latin America, Asia and Sub-Saharan Africa, to estimate the odds ratio and etiologic fraction of epilepsy due to CC in tropical regions.<h4>Methodology</h4>We...

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Main Authors: Gabrielle Debacq, Luz M Moyano, Héctor H Garcia, Farid Boumediene, Benoit Marin, Edgard B Ngoungou, Pierre-Marie Preux
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-03-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0005153
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author Gabrielle Debacq
Luz M Moyano
Héctor H Garcia
Farid Boumediene
Benoit Marin
Edgard B Ngoungou
Pierre-Marie Preux
author_facet Gabrielle Debacq
Luz M Moyano
Héctor H Garcia
Farid Boumediene
Benoit Marin
Edgard B Ngoungou
Pierre-Marie Preux
author_sort Gabrielle Debacq
collection DOAJ
description <h4>Background</h4>We reviewed studies that analyzed cysticercosis (CC), neurocysticercosis (NCC) and epilepsy across Latin America, Asia and Sub-Saharan Africa, to estimate the odds ratio and etiologic fraction of epilepsy due to CC in tropical regions.<h4>Methodology</h4>We conducted a systematic review of the literature on cysticercosis and epilepsy in the tropics, collecting data from case-control and cross-sectional studies. Exposure criteria for CC included one or more of the following: serum ELISA or EITB positivity, presence of subcutaneous cysts (both not verified and unverified by histology), histology consistent with calcified cysts, and brain CT scan consistent with NCC. A common odds-ratio was then estimated using meta-analysis.<h4>Principal findings</h4>37 studies from 23 countries were included (n = 24,646 subjects, 14,934 with epilepsy and 9,712 without epilepsy). Of these, 29 were case-control (14 matched). The association between CC and epilepsy was significant in 19 scientific articles. Odds ratios ranged from 0.2 to 25.4 (a posteriori power 4.5-100%) and the common odds ratio was 2.7 (95% CI 2.1-3.6, p <0.001). Three subgroup analyses performed gave odds ratios as: 2.2 (EITB-based studies), 3.2 (CT-based studies), 1.9 (neurologist-confirmed epilepsy; door-to-door survey and at least one matched control per case). Etiologic fraction was estimated to be 63% in the exposed group among the population.<h4>Significance</h4>Despite differences in findings, this meta-analysis suggests that cysticercosis is a significant contributor to late-onset epilepsy in tropical regions around the world, and its impact may vary depending on transmission intensity.
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1935-2735
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spelling doaj-art-d5475d2d35454aa694f0d20afb04e25d2025-08-20T03:29:58ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352017-03-01113e000515310.1371/journal.pntd.0005153Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.Gabrielle DebacqLuz M MoyanoHéctor H GarciaFarid BoumedieneBenoit MarinEdgard B NgoungouPierre-Marie Preux<h4>Background</h4>We reviewed studies that analyzed cysticercosis (CC), neurocysticercosis (NCC) and epilepsy across Latin America, Asia and Sub-Saharan Africa, to estimate the odds ratio and etiologic fraction of epilepsy due to CC in tropical regions.<h4>Methodology</h4>We conducted a systematic review of the literature on cysticercosis and epilepsy in the tropics, collecting data from case-control and cross-sectional studies. Exposure criteria for CC included one or more of the following: serum ELISA or EITB positivity, presence of subcutaneous cysts (both not verified and unverified by histology), histology consistent with calcified cysts, and brain CT scan consistent with NCC. A common odds-ratio was then estimated using meta-analysis.<h4>Principal findings</h4>37 studies from 23 countries were included (n = 24,646 subjects, 14,934 with epilepsy and 9,712 without epilepsy). Of these, 29 were case-control (14 matched). The association between CC and epilepsy was significant in 19 scientific articles. Odds ratios ranged from 0.2 to 25.4 (a posteriori power 4.5-100%) and the common odds ratio was 2.7 (95% CI 2.1-3.6, p <0.001). Three subgroup analyses performed gave odds ratios as: 2.2 (EITB-based studies), 3.2 (CT-based studies), 1.9 (neurologist-confirmed epilepsy; door-to-door survey and at least one matched control per case). Etiologic fraction was estimated to be 63% in the exposed group among the population.<h4>Significance</h4>Despite differences in findings, this meta-analysis suggests that cysticercosis is a significant contributor to late-onset epilepsy in tropical regions around the world, and its impact may vary depending on transmission intensity.https://doi.org/10.1371/journal.pntd.0005153
spellingShingle Gabrielle Debacq
Luz M Moyano
Héctor H Garcia
Farid Boumediene
Benoit Marin
Edgard B Ngoungou
Pierre-Marie Preux
Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
PLoS Neglected Tropical Diseases
title Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
title_full Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
title_fullStr Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
title_full_unstemmed Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
title_short Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy.
title_sort systematic review and meta analysis estimating association of cysticercosis and neurocysticercosis with epilepsy
url https://doi.org/10.1371/journal.pntd.0005153
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