Estimating the Burden of Neurocysticercosis in Mexico

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2012-10-19

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Abstract

Neurocysticercosis (NCC) is a parasitic disease caused by the larva of the zoonotic cestode Taenia solium. The objectives of this study were to evaluate the distribution of presenting clinical manifestations of NCC, to evaluate the socio-demographic characteristics of NCC patients, to compare quality of life of individuals diagnosed with NCC with an age and sex matched control population and to estimate the non-monetary burden of NCC in Mexico. In order to accomplish these objectives, a case series of NCC patients was conducted in two neurology referral hospitals in Mexico City, Mexico during 2007-2008. Information on clinical manifestations associated with NCC was obtained via medical chart reviews of NCC patients. Information on socio-demographic characteristics of NCC patients was obtained through the administration of questionnaires. In addition, a cross-sectional study was conducted to compare the quality of life of NCC patients to an age and sex matched control population using the short form 12 v2 (SF-12 v2) survey. Non-monetary burden of NCC in Mexico was estimated using disability adjusted life years (DALYs), incorporating morbidity due to both NCC-associated epilepsy and severe headache and mortality due to NCC-associated epilepsy. NCC patients presented to the neurology referral hospitals with numerous clinical manifestations, with severe headache and epilepsy being the most common. Lack of knowledge of T. solium transmission was common among NCC patients, with 25 percent of patients not knowledgeable about tapeworm infections in humans. Of those that were aware that tapeworm infections do occur, 57 percent were not aware of how the worms were transmitted to humans. The SF-12 v2 general health survey showed that individuals with NCC had a significantly lower score for all eight domains of health evaluated (physical functioning, role physical, bodily pain, vitality, general health, social functioning, role emotional and mental health) compared with the age and sex matched population from the same region (p< 0.05). The mean total number of DALYs lost due to NCC in Mexico was estimated to be 99,866 (95 percent CR: 43,187 ?189,182), with a mean of 0.95 (95 percent CR: 0.4?1.8) DALYs lost per thousand persons per year.

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