Epidemiology of cerebral cysticercosis in an Andean community in Ecuador.

Taenia solium neurocysticercosis (NCC) has been documented to be an underly ing cause of epilepsy intractable headaches, hydrocephalus, dementia and ot her serious neurological conditions in many countries of Central and South America. However, methodological limitations had prevented the assessment o f the true prevalence of this condition at the community level. We conducte d a house-to-house neuroepidemiological survey of 6,118 residents of an And ean community This information was used to target neuroimaging (CT-scan) an d immunodiagnosis (enzyme-linked immunoelectrotransfer blot assay EITB) tes ts in individuals suspected of harbouring Taenia solium NCC. In the rural p opulation, NCC was confirmed in 8 out of 47 examined by CT-scan (17%) and i n 6 of 42 examined by EITB (14%). In the urban population, NCC was confirme d in 35 of 147 examined by CT-scan (23.8% and in 28 of 124 examined by EITB (22.6%). In a sample of relatives of patients with documented cerebral cys ticercosis, 20 out of 81 examined by CT-scan (25%) and 12 of 79 (15%) exami ned by EITB had NCC Finally CT scans were performed for 83 school children from urban areas, and 9 (11%) were diagnosed as harbouring NCC. In a community-based study, cysticercosis appears to be much more frequent than initially thought when CT examination is used as the "gold standard" f or diagnosis.