METHODS: This was part of a cross-sectional community-based study conducted in Sinda district to evaluate an antibody-detecting T. solium point-of-care (TS POC) test for taeniosis and (neuro)cysticercosis. All TS POC cysticercosis positive (CC+) participants and a subset of the TS POC cysticercosis negative (CC-) received a clinical evaluation and cerebral computed tomography (CT) examination for neurocysticercosis (NCC) diagnosis and staging.
RESULTS: Of the 1249 participants with a valid TS POC test result, 177 (14%) were TS POC CC+ . Cysticercosis sero-prevalence was estimated to be 20.1% (95% confidence intervals [CI] 14.6-27.0%). In total, 233 participants received a CT examination (151 TS POC CC+ , 82 TS POC CC-). Typical NCC lesions were present in 35/151 (23%) TS POC CC+ , and in 10/82 (12%) TS POC CC- participants. NCC prevalence was 13.5% (95% CI 8.4-21.1%) in the study population and 38.0% (95% CI 5.2-87.4%) among people reporting epileptic seizures. Participants with NCC were more likely to experience epileptic seizures (OR = 3.98, 95% CI 1.34-11.78, p = 0.01) than those without NCC, although only 7/45 (16%) people with NCC ever experienced epileptic seizures. The number of lesions did not differ by TS POC CC status (median: 3 [IQR 1-6] versus 2.5 [IQR 1-5.3], p = 0.64). Eight (23%) of the 35 TS POC CC+ participants with NCC had active stage lesions; in contrast none of the TS POC CC- participants was diagnosed with active NCC.
CONCLUSIONS: NCC is common in communities in the Eastern province of Zambia, but a large proportion of people remain asymptomatic.
方法:这是一项在信达地区进行的基于社区的横断面研究的一部分,该研究旨在评估抗体检测T.solium即时护理(TSPOC)测试的taeniosis和(神经)囊虫病。所有TSPOC囊虫病阳性(CC)参与者和TSPOC囊虫病阴性(CC-)的一部分接受了临床评估和脑计算机断层扫描(CT)检查,以进行神经囊虫病(NCC)的诊断和分期。
结果:在具有有效TSPOC测试结果的1249名参与者中,177(14%)为TSPOCCC+。囊虫病血清患病率估计为20.1%(95%置信区间[CI]14.6-27.0%)。总的来说,233名参与者接受了CT检查(151TSPOCCC+,82TSPOCCC-)。典型的NCC病变出现在35/151(23%)TSPOCCC+中,和10/82(12%)TSPOCCC参与者。研究人群的NCC患病率为13.5%(95%CI8.4-21.1%),报告癫痫发作的人群为38.0%(95%CI5.2-87.4%)。有NCC的参与者比没有NCC的参与者更有可能出现癫痫发作(OR=3.98,95%CI1.34-11.78,p=0.01)。尽管只有7/45(16%)的NCC患者经历过癫痫发作。病变数量因TSPOCCC状态而无差异(中位数:3[IQR1-6]对2.5[IQR1-5.3],p=0.64)。35名具有NCC的TSPOCCC+参与者中有8名(23%)具有活跃期病变;相比之下,TSPOCCC-参与者均未被诊断为活跃的NCC。
结论:NCC在赞比亚东部省的社区中很常见,但是很大一部分人仍然无症状。