Proportion of neurocysticercosis among people with epilepsy in rural areas of Burkina Faso: A cross-sectional study

Objective: To estimate the proportion of neurocysticercosis (NCC) among people with epilepsy in rural Burkina Faso. Methods: Three villages were selected to represent types of pig-rearing methods: Batondo where pigs are roaming; Pabré where pigs are tethered or penned, and Nyonyogo where few pigs are raised. In Batondo and Nyonyogo, all concessions (a group of several households) were included. One-half of the concessions in Pabré were randomly selected. All households in participating concessions were included and one person per household was randomly selected for epilepsy screening. Some persons self-identified with epilepsy were also screened in Batondo and Nyonyogo. Epilepsy was defined as ever having had more than one episode of unprovoked seizures. Medically confirmed cases were offered a CT-scan of the brain. The diagnosis of NCC was made using a modification of the criteria of Del Brutto et al. Results: Forty (4.5%) of 888 randomly selected villagers and 39 self-reported cases were confirmed with epilepsy, and 76 received a brain CT. Lesions compatible with cysticercosis included cysts with scolex (8), cysts without scolex (4) calcifications (24) and ring-enhancing lesions (2). Using the criteria proposed by Del Brutto et al., eleven (14%) were diagnosed with definite and twelve (16%) with probable NCC. None of these cases were from the village with few pigs (Nyonyogo). Discussion/conclusion: Prevalence of NCC among people with epilepsy was observed only in villages where pig raising is common. Stakeholders should consider using Taenia solium infection control programmes to reduce the burden of epilepsy in cysticercosis endemic areas.