Epidemiology and Burden of Neurocysticercosis in Bukina Faso

说明(申请人提供)：该项目的长期目标是通过干预一种可预防的原因--猪带绦虫囊虫病，减轻布基纳法索、西非所有年龄段的人的神经系统疾病(主要是癫痫)的负担。脑囊虫病(NCC)是一种可预防的，最终可根除的原因，可引起癫痫和其他重要的神经系统并发症，包括痴呆，发生在整个年龄段。这一发展阶段的主要目标是估计囊虫病在人和猪中的患病率和癫痫的患病率以及可归因于NCC的比例，并估计布基纳法索囊虫病的短期和长期神经、经济和农业负担。还将探索消除囊虫病的机会。这些目标将通过俄克拉荷马大学健康科学中心、阿波米-卡拉维大学、帕拉库大学、圣地公共研究所、热带神经病流行病学研究所和皇家兽医农业大学之间的研究和培训合作来实现。探索阶段将确定相关的现有数据、对更多数据和专门知识的需求以及建设满足这些需求的能力的机制。将进行可行性研究，以制定可接受的办法来评估未来干预措施的效力。在6个月内，博士学位候选人将被确定，人类和猪囊虫病诊断培训将开始。9个月后，将确定两个主要城市地区附近的3个地区，进行囊虫病和NCC流行情况的试点研究。在接下来的9个月里，将对4个医疗和兽医从业者团队进行试点研究程序方面的培训。这些小组将收集人和猪的血液样本，对村民进行癫痫发作和癫痫筛查，以及是否存在表明囊虫病的皮肤结节。在过去5年内有一次或多次癫痫发作的人将接受CT扫描，以确定可能的NCC病例。将以CT作为“金标准”，评估用于识别NCC(例如，血清学或结节)的替代方法的有效性。我们将评估使用日记来衡量可归因于NCC和猪囊虫病的金钱损失的可行性。

DESCRIPTION (provided by applicant): The long-term goal of this project is to reduce the burden of neurological diseases (primarily epilepsy) in persons of all ages in Burkina Faso, West Africa through intervention on a preventable cause - Taenia solium cysticercosis. Neurocysticercosis (NCC), caused by the migration of T. solium cestodes to the brain, is a preventable, eventually eradicable, cause of epilepsy and other significant neurological complications, including dementia, that occur across the age span. The primary objectives of this developmental phase are to estimate the prevalence of cysticercosis in humans and pigs and the prevalence of epilepsy and the proportion attributable to NCC, and to estimate the short and long-term neurological, economical and agricultural burden of cysticercosis in Burkina. Opportunities for the elimination of cysticercosis will also be explored. These goals will be achieved through a research and training collaboration between the University of Oklahoma Health Sciences Center, Universite d'Abomey-Calavi, Universite de Parakou, Institut Regional de Sante Publique, Institut d'Epidemiologie Neurologique et de Neurologie Tropicale and Royal Veterinary & Agricultural University. The exploratory phase will identify relevant existing data, needs for additional data and expertise, and mechanisms to build capacities to address these needs. Feasibility studies will be conducted to develop acceptable approaches to estimating the effectiveness of future interventions. Within 6 months, doctoral degree candidates will be identified, and training in the diagnosis of human and pig cysticercosis will begin. After 9 months, 3 regions proximal to 2 major urban areas will be identified for a pilot study of the prevalence of cysticercosis and NCC. Over the next 9 months, 4 teams of medical and veterinary practitioners will be trained in the procedures for the pilot study. The teams will collect human and pig blood samples, screen villagers for seizures and epilepsy and the presence of skin nodules indicative of cysticercosis. Persons who have had one or more seizures within the previous 5 years will have a CT scan to identify possible cases of NCC. Using CT as the "gold standard", the validity of alternative methods for identifying NCC (e.g., serology or nodules) will be evaluated. We will assess the feasibility of using a diary for measuring the monetary losses attributable to NCC and pig cysticercosis.