Neurocysticercosis control for primary epilepsy prevention: a systematic review

Pathog Glob Health. 2022 Jul;116(5):282-296. doi: 10.1080/20477724.2021.2015869. Epub 2021 Dec 20.

Abstract

Neurocysticercosis (NCC) is a leading cause of preventable epilepsy in lower- and upper- middle-income countries (LMICs/UMICs). NCC is a human-to-human transmitted disease caused by ingestion of Taenia solium eggs from a Taenia carrier. T. solium infection control is the key to reduce NCC incidence. This systematic review aims to identify T. solium control programs that can provide frameworks for endemic areas to prevent NCC-related epilepsy. A systematic search was conducted in PubMed/Medline, Embase, Web of Science, and Cochrane Library databases in March 2021. After title and abstract review, full texts were screened for qualitative analysis. Additional articles were identified via citation search. Of 1322 total results, 34 unique studies were included. Six major intervention types were identified: national policy (8.8%), community sanitation improvement (8.8%), health education (8.8%), mass drug administration (29.4%), pig vaccination and treatment (32.4%), and combined human and pig treatment (11.8%). Overall, 28 (82.4%) studies reported decreased cysticercosis prevalence following the intervention. Only health education and combined human and pig treatment were effective in all selected studies. NCC causes preventable epilepsy in LMICs/UMICs and its incidence can be reduced through T. solium control. Most interventions that disrupt the T. solium transmission cycle are effective. Long-term sustained results require comprehensive programs, ongoing surveillance, and collaborative effort among multisectoral agencies.

Keywords: Neurocysticercosis; epilepsy; global health; global neurosurgery; infectious disease.

Publication types

  • Systematic Review

MeSH terms

  • Animals
  • Cysticercosis* / complications
  • Cysticercosis* / epidemiology
  • Epilepsy* / epidemiology
  • Epilepsy* / etiology
  • Epilepsy* / prevention & control
  • Incidence
  • Neurocysticercosis* / complications
  • Neurocysticercosis* / epidemiology
  • Neurocysticercosis* / prevention & control
  • Prevalence
  • Swine
  • Taenia solium*