Introduction Neurocysticercosis (NCC) is a major public health problem, especially in the developing world and also increasingly reported in the developed world either due to migration of infected population or Taenia solium carriers. Studies from developing countries and Latin America identified NCC as the major cause (26.3%–53.8%) of active epilepsy and 2% of neurological / neurosurgical admissions. We conducted a systematic study to estimate the disease burden in pig farming community of North India.
Methods Total 294 families from 30 villages were chosen based on 30 cluster sampling approach. Demographic, clinical and epidemiological data were collected from all the subjects. Individuals with active epilepsy were identified on door-to-door survey. Patients with active epilepsy and asymptomatic individuals underwent MRI of the brain.
Results Active epilepsy was identified in 5.6% populations and 48.3% of them had NCC; 15.1% healthy individuals had silent NCC. Epilepsy in the family and no separate place for pigs, intake of raw vegetable and undercooked pork, and lack of safe drinking water were identified as risks for NCC. TLR4 Asp299Gly and Thr399Ile gene polymorphisms, increased Th1 cytokines, sICAM-1 and MMP-9 levels in serum were associated with symptomatic disease.
Conclusion Our studies demonstrate that NCC burden is extremely high in pig raising community. TLR4 gene polymorphisms, elevated Th1 cytokines, sICAM-1 and MMP levels in serum appear to be the predictors for NCC related active epilepsy. Since NCC is a preventable and potentially eradicable disease, appropriate control measures are required to reduce the disease burden.
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