207943 Lesions identified by cranial computerized tomography of people with epilepsy in rural areas of Burkina Faso: A cross-sectional study

Tuesday, November 10, 2009

Pascal Nitiema, MD, MPH , Biostatistics and Epidemiology, University of Oklahoma Health Center, Oklahoma City, OK
Athanase Millogo, MD , Centre Universitaire Souro Sanou, Bobo Dioulasso, Burkina Faso
Helene Carabin, DVM, PhD , Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma Ctiy, OK
Sennen Hounton , Centre MURAZ, IMMPACT Project, Bobo Dioulasso 01, Burkina Faso
Rasmané Ganaba , Centre MURAZ, IMMPACT Project, Bobo Dioulasso 01, Burkina Faso
Rabiou Cisse, MD , Centre Hospitalier Universitaire Yalgado Ouedraogo de Ouagadougou, Ouagadougou, Burkina Faso
Linda D. Cowan, PhD , Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Marie-Paul Boncoeur-Martel, MD , Centre Hospitalier Universitaire de Limoges, Limoges, France
Pierre-Marie Preux, MD , Institut d'Epidémiologie neurologique et de Neurologie Tropicale, Faculté de Médecine, Limoges, France
Background: Computerized tomography (CT) is a helpful tool for identifying possible causes of epilepsy. We describe the different lesions identified in the CT scans of people with epilepsy from three villages in Burkina Faso.

Methods:

Three villages were selected to represent types of pig-rearing methods: 1) Batondo where pigs are left to roam; 2) Pabré where pigs are mostly tethered or penned, and 3) Nyonyogo where the majority are Muslim and few pigs are raised. In Batondo and Nyonyogo, all concessions (a group of several households) were included. Half of the concessions in Pabré were randomly chosen. All households of selected concessions were included; one person per household was randomly selected for epilepsy screening. Epilepsy was defined as ever having more than one asymptomatic, central nervous system (CNS) seizure. Medically confirmed cases had a brain CT-scan.

Results:

Forty participants were diagnosed with epilepsy and 36 had a cranial CT. Twenty-two of those had a normal CT (61%), while seven (19%) presented one or more lesions compatible with neurocysticercosis (NCC). The diagnosis of NCC was uncertain in two subjects (6%) and five people (14%) showed other types of CNS lesions. None of the definite or uncertain NCC cases was from the village with few pigs (Nyonyogo). The lesions suggestive of NCC included calcifications (found in each of the seven definite cases) and cystic and ring-enhancing lesions.

Discussion:

These data suggest a high prevalence of NCC among people with epilepsy in Burkina Faso living in villages where pig raising is common.

Learning Objectives:
Describe the different lesions identified in the CT scans of people with epilepsy from three villages in Burkina Faso.

Keywords: Developing Countries, Disease Data

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the medical investigator on the field and participated in the data analysis during my MPH program. I am currently a doctoral student in epidemiology at the Health Sciences Center of the University of Oklahoma (OUHSC).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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