Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management

Abstract

Neurocysticercosis has been recognized as a major cause of secondary epilepsy worldwide. So far, most of the knowledge about the disease comes from Latin America and the Indian subcontinent. Unfortunately, in sub-Saharan Africa the condition was neglected for a long time, mainly owing to the lack of appropriate diagnostic tools. This review therefore focuses on the prevalence of neurocysticercosis in sub-Saharan Africa, the clinical picture with emphasis on epilepsy, as well as the diagnosis and treatment of neurocysticercosis and its related epilepsy/epileptic seizures in African resource-poor settings.

Keywords:

• Cysticercosis
• Epilepsy
• Sub-Saharan Africa

I am extremely grateful to the patients and their relatives of the Epilepsy Clinics of Haydom Lutheran Hospital (northern Tanzania) and Mahenge Hospital (southern Tanzania) for helping me gain experience with epilepsy and/or NCC within the African setting. I am especially indebted to Dr Wendy Harrison, Schistosomiasis Control Initiative, Imperial College, London, and Professor Hugo Garcia, Cysticercosis Working Group in Peru for their advice and critical review of parts of the manuscript. I am also very thankful to the German Research Foundation (DFG) and the Bill and Melinda Gates foundation for their support of further work into the subject of epilepsy and NCC.