Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study
Author(s)
Type
Journal Article
Abstract
OBJECTIVES: To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. METHODS: Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. RESULTS: Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P < 0.05). A similarly increasing pattern of higher seroprevalence was observed among migrants by age at migration. In rural villagers, there was strong evidence of an association between positive serology and having seizures (P = 0.011) but such an association was not observed in long-term migrants or in urban residents. In the entire study population, compared with seronegative participants, those with strong antibody reactions (≥ 4 antibody bands) were more likely to have epilepsy (P < 0.001). CONCLUSIONS: It is not only international migration that affects cysticercosis endemicity; internal migration can also affect patterns of endemicity within an endemic country. The neurological consequences of cysticercosis infection likely outlast the antibody response for years after rural-to-urban migration.
Date Issued
2015-03-05
Date Acceptance
2015-01-08
Citation
Tropical Medicine & International Health, 2015, 20 (4), pp.546-552
ISSN
1365-3156
Publisher
Wiley
Start Page
546
End Page
552
Journal / Book Title
Tropical Medicine & International Health
Volume
20
Issue
4
Copyright Statement
© 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Sponsor
Wellcome Trust
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/25581851
Grant Number
097816/Z/11/A
Subjects
Cisticercosis
Peru
Perú
Pérou
Taenia solium
convulsiones
crise d’épilepsie
cysticercose
cysticercosis
migración
migration
neurocisticercosis
neurocysticercose
neurocysticercosis
seizures
Adult
Aged
Aged, 80 and over
Animals
Antibodies
Cysticercosis
Epilepsy
Female
Humans
Male
Middle Aged
Population Dynamics
Prevalence
Rural Population
Seizures
Seroepidemiologic Studies
Transients and Migrants
Urban Population
Young Adult
Cysticercosis Working Group in Peru
Tropical Medicine
1117 Public Health And Health Services
Publication Status
Published
Coverage Spatial
England