Multiantigen print immunoassay (MAPIA) for the diagnosis of neurocysticercosis: a single-center diagnostic optimization and accuracy study in Lima, Peru.

Neurocysticercosis (NCC) is the most common helminthic infection of the human central nervous system. The antibody detection assay of choice is the enzyme-linked immunoelectrotransfer blot assay using lentil-lectin purified parasite antigens (LLGP-EITB, Western blot), an immunoassay with exceptional performance in clinical samples. However, its use is mainly restricted to a few research laboratories because the assay is labor-intensive and requires sophisticated equipment, expertise, and large amounts of parasite material for preparation of reagents. We report a new immunoprint assay (MAPIA) that overcomes most of these barriers. We initially compared the performance of five different antigen combinations in a subset of defined samples in the MAPIA format. After selecting the best-performing assay format (a combination of rGP50 + rT24H + sTs14 antigens), 148 archived serum samples were tested, including 40 from individuals with parenchymal NCC, 40 with subarachnoid NCC, and 68 healthy controls with no evidence of neurologic disease. MAPIA using three antigens (rGP50 + rT24H + sTs14) was highly sensitive and specific for detecting antibodies in NCC. It detected 39 out of 40 (97.5%) parenchymal NCC cases and 40/40 (100%) subarachnoid cases and was negative in 67 out of 68 (98.53%) negative samples. MAPIA using three recombinant and synthetic antigens is a simple and economical tool with a performance equivalent to the LLGP-EITB assay for the detection of specific antibodies to NCC. The MAPIA overcomes existing barriers to adoption of the EITG LLGP and is a candidate for worldwide use.

Neurocysticercosis. A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world.

Neurocysticercosis is endemic in most of the world and in endemic areas it accounts for approximately 30% of cases of epilepsy. Appropriate diagnosis and management of neurocysticercosis requires understanding the diverse presentations of the disease since these will vary in regards to clinical manifestation, sensitivity of diagnostic tests, and most importantly, therapeutic approach. This review attempts to familiarize tropical neurology practitioners with the diverse types of neurocysticercosis and the more appropriate management approaches for each.

A survey report--July 1993: cysticercosis in the Grand Dani Valley, Jayawijaya District, Irian Jaya Province, Indonesia.

A community survey was conducted in Gran Dani Valley, Jayawijaya District, Irian Jaya Province, Indonesia. A total of 537 adults were asked whether they experienced epilepsy, and were physically examined for cysticercosis cysts. Forty-eight percent experienced at least one attack of epilepsy. Men had attacks 2.5 times more often than woman. Cysticercosis cysts were found in 26.5% men having 4.6 times more cysts than women. The cysts were mostly found in the pectoral region. The survey showed a raise cysticercosis in the Highlands of Irian Jaya and is considered a public health problem. Treatment was not available, but improvement of personal and environmental hygiene would be important. Mass de-worming activity should be a part of routine public health service in the district.