Neurocysticercosis : a possible cause of epileptiform seizures in people residing in villages served by the Bethanie clinic in the North West Province of South Africa

Abstract

A study to detect human taeniasis and cysticercosis was conducted in 4 village communities served by the Bethanie clinic in the North West Province, based on reports of people being diagnosed there with epileptiform episodes. Many home owners in the villages rear pigs in small numbers for both meat availability and an immediate income from live pig or pig meat sales. The primary aim of the work was to conduct in the study area a census of all small scale pig producers and a survey of rural village consumers, both by means of a structured questionnaire. The former reviewed pig husbandry practices, slaughter and marketing of pigs and the latter provided information on pork consumption, sanitation as well as people's basic knowledge of Taenia solium. Stool samples from consenting participants were screened by a contracted approved laboratory for T. solium. A descriptive analysis of retrospective data was conducted at the Bethanie clinic to determine the proportional morbidity of neurocysticercosis from the medical records of patients diagnosed with seizures in an attempt to establish possible sources of infection and routes of transmission. In addition, the total pig population in the study area was determined more accurately and the prevalence of cysticercosis investigated in pigs subjected to meat inspection at an approved abattoir. The questionnaires revealed a poor understanding of the disease, poor sanitation and hygiene, poor methods of pig husbandry and poor meat inspection and control in rural smallholder communities. There was no significant statistical difference in the proportion of households reporting evidence of epilepsy and owning pigs and those that did not. There is a strong evidence of a tendency towards an association between epilepsy, consumption habits and some identified epidemiological risk factors.