Knowledge, practices and seroprevalence of Taenia species in smallholder farms in Gauteng, South Africa.

Porcine cysticercosis and associated human infections are endemic in Sub-Saharan Africa, Latin America, and Asia. Poor agricultural practices, sanitary practices, and lack of knowledge increase the burden of the diseases in susceptible populations. This study investigates the seroprevalence of Taenia spp. in township pigs in Gauteng, South Africa and describes knowledge and farming practices of pig farmers regarding T. solium infections. Blood samples were collected from 126 pigs in three Gauteng township areas, and analyzed for active Taenia spp. infection using the B158/B60 Ag-ELISA. Farmer questionnaire surveys were conducted in four township areas to investigate the level of knowledge and practices associated with porcine cysticercosis and neurocysticercosis. Logistic regression models were used to assess the relationship between predictor variables and the outcome variable, knowledge of porcine cysticercosis or knowledge of neurocysticercosis. Overall, 7% of the pigs were seropositive for active Taenia spp. infection. 46% of farmers practiced a free-ranging system, while 25% practiced a semi-intensive system. Latrines were absent on all farms; however, 95% of farmers indicated that they have access to latrines at home. Most farmers had no knowledge of porcine cysticercosis (55%) or neurocysticercosis (79%), and this was not associated with any of the factors investigated. The prevalence of active Taenia spp. infection was reasonably low in this study, yet the knowledge level was also low, thus calling for further educational and training programmes to prevent Taenia spp. transmission in these communities.

[Depressive disorders associated with neurocysticercosis: prevalence and clinical correlations]. / Transtornos depressivos associados à neurocisticercose. Prevalência e correlações clínicas.

OBJECTIVE: To determine the frequency and features of psychiatric morbidity in a cross-section of 38 outpatients with neurocysticercosis. METHODS: Diagnosis of neurocysticercosis was established by CT scan, MRI and CSF analysis. Psychiatric diagnoses were made by using the Present State Examination and the Schedule for Affective Disorders and Schizophrenia. Lifetime version; cognitive state was assessed by Mini-Mental State Examination and Strub & Black's Mental Status Examination. RESULTS: Depression was the most frequent psychiatric diagnosis (52.6%) as shown by PSE. Active disease and intracranial hypertension were associated with higher psychiatric morbidity, and previous history of mood disorders was strongly related to current depression. CONCLUSIONS: Depression syndromes are frequent in patients with neurocysticercosis. The extent to which organic mechanisms related to brain lesions may underlie the observed mental changes is yet unclear, though the similar sex distribution of patients with and without depression, as well as the above mentioned correlations, provide further evidence of the role played by organic factors in the cause of these syndromes. The results of this study are discussed in the light of the data available for other organic psychiatric disorders.

Transtornos depressivos associados à neurocisticercose: prevalência e correlaçöes clínicas / Depressive disorders associated with neurocysticercosis: prevalence and clinical correlations

Objetivo: Investigar a ocorrência e os fatores de risco para morbidade depressiva em uma amostra de 38 pacientes ambulatoriais com neurosisticercose. Métodos: O diagnóstico psiquiátrico baseou-se nos exames do estado mental atual e pregresso, respectivamente obtidos pelas entrevistas estruturadas do PSE-9 e SADS-L; as funçoes cognitivas foram avaliadas pelo MMS e pelo roteiro de Strub & Black (Mental Status Examination). Resultados: Transtornos depressivos foram o achado psiquiátrico mais frequente (63,1 por cento) entre os pacientes da amostra. Destes, 20 (52,6 por cento) mostravam-se deprimidos no momento da avaliaçao e 4 apresentaram depressao no passado. Entre os pacientes deprimidos, 16 preencheram critérios diagnósticos do DSM-III-R para transtorno orgânico do humor (k = 0,4). Antecedentes pessoais de depressao (p = 0,006), sinais de atividade da doença (p = 0,044) e ocorrência de hipertensao intracraniana (p=0,065) foram os parâmetros clínicos que se correlacionaram com a presença de depressao. Conclusoes: Tais achados, aliados à ausência de predomínio do sexo feminino entre os casos de depressao, sugerem etiologia orgânica. Os autores discutem essas observaçoes à luz da literatura sobre outros transtornos mentais orgânicos.

Psychiatric manifestations of neurocysticercosis: a study of 38 patients from a neurology clinic in Brazil.

OBJECTIVE: To determine the frequency and features of psychiatric morbidity in a cross section of 38 outpatients with neurocysticercosis. METHODS: Diagnosis of neurocysticercosis was established by CT, MRI, and CSF analysis. Psychiatric diagnoses were made by using the present state examination and the schedule for affective disorders and schizophrenia-lifetime version; cognitive state was assessed by mini mental state examination and Strub and Black's mental status examination. RESULTS: Signs of psychiatric disease and cognitive decline were found in 65.8 and 87.5% of the cases respectively. Depression was the most frequent psychiatric diagnosis (52.6%) and 14.2% of the patients were psychotic. Active disease and intracranial hypertension were associated with higher psychiatric morbidity, and previous history of mood disorders was strongly related to current depression. Other variables, such as number and type of brain lesions, severity of neuropsychological deficits, epilepsy, and use of steroids did not correlate with mental disturbances in this sample. CONCLUSIONS: Psychiatric abnormalities, particularly depression syndromes, are frequent in patients with neurocysticercosis. Although regarded as a rare cause of dementia, mild cognitive impairment may be a much more prevalent neuropsychological feature of patients with neurocysticercosis. The extent to which organic mechanisms related to brain lesions may underlie the mental changes is yet unclear, although the similar sex distribution of patients with and without depression, as well as the above mentioned correlations, provide further evidence of the part played by organic factors in the cause of these syndromes.

Neurocysticercosis in children. Clinical experience in 122 patients.

Cysticercosis is the most frequent parasitic disease of the central nervous system in the world and is endemic in such developing countries as Mexico. There is insufficient information about neurocysticercosis in children. The purpose of this study was to collect information on the main social factors associated with neurocysticercosis, the clinical picture, diagnosis and treatment, and the final outcome in 122 Mexican children. The ages of the patients ranged from 14 months to 17 years, with a mean of 8 years; 51 male (41.8%) and 71 female (51.8%) patients were seen; half of these patients (61) lived in well-urbanized areas; the parents of 77 families (57.3%) had only an elementary school grade average, and 46 (37.7%) lived in close proximity to animals. The most common features were seizures, intracranial hypertension and learning disabilities. The diagnosis of neurocysticercosis was supported by computed tomography or magnetic resonance imaging studies and cerebrospinal fluid analysis. The treatment was varied, with anti-convulsives, steroids, and albendazole, and only 8 patients underwent ventriculo-peritoneal shunts for hydrocephalus. The follow-up ranged from 6 months to 5 years; 90 patients became asymptomatic; 6 developed refractory epilepsy; 14, learning disabilities; and 10, a chronic type of the disease with repeated episodes of intracranial hypertension; 2 died because of chronic arachnoiditis.

[Effective response to risperidone treatment in manic syndrome secondary to neurocysticercosis]. / Buena respuesta a risperidona en fase maniaca secundaria a neurocisticercosis.

This study presents a clinical case about a patient suffering a manic syndrome secondary to neurocysticercosis and no responding to traditional neuroleptic treatment. We administrated the risperidone treatment, that was effective.

[Intellectual status of patents cerebral cysticercosis].

OBJECTIVE: To study the intellectual status of patients with cerebral cysticercosis with dementia evaluation scale. METHODS: The intellectual status of 112 patients with cerebral cysticercosis was studied with Hasagawa dementia evaluation scale and that of 30 patients with event related potential of P 300. RESULTS: In the patientsl, 50.9% suffered from mental dysfunction. Among them 11.6% had severe abnormality, 13.4% moderate, and 25.9% mild. Hypertension, epileptic attack and improper medication may cause intellectual dysfunction. CONCLUSIONS: Protection of mental function should be considered when chosing the treatment for better recovery of the patients. Hypertension, epileptic attack and improper medication may cause intellectual dysfunction.

Neurocysticercosis and performance on neuropsychologic tests: a family study in Ecuador.

Neurocysticercosis (NCC) is a common neurologic disorder in developing countries, where it may pose a major public health challenge. Recently, the disorder has become more commonly diagnosed in developed countries as a result of the influx of migrants from countries where the disease is endemic. The clinical syndrome associated with NCC includes neurologic, physical, and functional problems. Since the locus of the infection is mainly the central nervous system, there is a risk of neuropsychologic dysfunction. This study was conducted in Ecuador in a group of 123 subjects (49 males and 74 females, 9-62 years of age) from a community sample that was part of a larger neuroepidemiologic inquiry. A discriminant function procedure was used to select the tests that would be most sensitive at distinguishing between affected and nonaffected individuals. The results suggest that behavioral functions that include aspects of inhibitory control, motor, and visual-motor output are impaired in adolescent and adult subjects with NCC.

Alguns comentários sobre a história da cisticercose e dos seus transtornos neuropsiquiátricos / Some comments on the history of cysticercosis and its neuropsychiatric disorders

A história da aquisiçäo do conhecimento médico sobre a cisticercose (infestaçäo por formas larvárias da Taenia solium) é revista, com ênfase nos problemas psico-sociais e nos transtornos neuropsiquiátricos.

Manifestaçöes psiquiátricas da neurocisticercose / Psychiatric manifestations of neurocysticercosis

Inicialmente, tecem-se consideraçöes acerca da epidemiologia, parasitologia e fisiopatologia da neurocisticercose, atentando ainda para as referências da literatura quanto às manifestaçöes psiquiátricas da doença em breve revisäo bibliográfica. A seguir, apresenta-se um caso de forma psiquiátrica da neurocisticercose. Finalmente, discute-se a propedêutica clínica, laboratorial, radiológica e neuropsicológica da afecçäo