Cysticercosis and epilepsy in rural Tanzania: a community-based case-control and imaging study

Ewan Hunter, Kathryn Burton, Ahmed Iqbal, Daniel Birchall, Margaret Jackson, Jane Rogathe, Ahmed Jusabani, William Gray, Eric Aris, Gathoni Kamuyu, Patricia P. Wilkins, Charles R. Newton and Richard Walker
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To assess the contribution of NCC to the burden of epilepsy in a rural Tanzanian population.


We identified adult people with epilepsy (PWE) in a door-to-door study in an established demographic surveillance site. PWE and community controls were tested for antibodies to Taenia solium, the causative agent of NCC, and all PWE were offered a computerised tomography (CT) head scan. Data on household occupancy and sanitation, pig-keeping and pork consumption were collected from PWE and controls and associations with epilepsy were assessed using Chi-square or Fisher's Exact tests.


Six of 218 PWE had antibodies to T. Solium (2.8%; 95% CI 0.6 to 4.9), compared to none of 174 controls (Fisher's exact test, p=0.04). Lesions compatible with NCC were seen in eight of 200 CT scans (4.0%; 95% CI 1.3 to 6.7). 176 PWE had both investigations, of whom two had positive serology along with NCC-compatible lesions on CT (1.1%; 95% 0.3 to 4.0). No associations between epilepsy and any categorical risk factors for NCC were identified.


NCC is present in this population, but at a lower prevalence than elsewhere in Tanzania and SSA. Insights from low-prevalence areas may inform public health interventions designed to reduce the burden of preventable epilepsy.