Epidemiology and Burden of Neurocysticercosis in Bukina Faso

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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.