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

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. This article is protected by copyright. All rights reserved.