Abstracts

Rationale: The prevalence of epilepsy in Cameroon is higher than that of the industrialized world with values exceeding 30 per thousand (Kamgno et al., Epilepsia 2003;44:956). Neurocysticercosis that arises from Taenia solium infestation appears to be an important cause of epilepsy in some parts of Cameroon (Zoli et al., Trans Roy Soc Trop Med Hyg 2003;97:683), although there are some conflicting data in this regard (Dongmo et al., Bull Soc Pathol Exot 2004;97:105). The prevalence of epilepsy appears to be espcially high in the Momo Division of the Northwest Province of Cameroon. We sought to test the hypothesis that those patients in Momo who have epilepsy have a higher percentage of seropositivity to Taenia solium than a matched control population. Methods: A case control study was conducted in the Momo sub-division of Ngie which has nineteen villages. Epilepsy patients were recruited from the epilepsy clinics in Ngie and control subjects were randomly selected from members of the Ngie villages. An adapted form of a previously validated screening questionnaire (Placencia et al., Brain 1992;115:783) was applied by trained field workers to identify potential cases of epileptic seizures to be included in the study. Blood samples were taken from all consenting individuals by finger prick, stored in StabilZyme Select, and assayed for antibodies to Taenia soleum as described (Handali et al., J Immunol Meth 2007;320:164-71). Results: We accrued 249 patients with epilepsy and 245 age-matched controls. The number of patients with epilepsy who participated in this study represent about 75% of the total number of seizure patients in Ngie where the population is around 40,000 inhabitants. The mean age of control subjects was 17.5 years and that of the seizure population 18.8 years (P > 0.1). There were 53% male and 47% female in the seizure group and 57% male and 43% female in the control group (P > 0.1). Seizure onset was at 11.64 yrs. Sixty-eight percent of patients had generalized convulsive seizures with 25% having localization-related epilepsy with secondary generalized seizures. There was no significant difference between the control and seizure populations in seropositivity to Taenia soleum which was 4.9% in the control group vs. 5% in the seizure group. Conclusions: These data do not support the hypothesis that those patients in the Ngie sub-division of Momo who have epilepsy have a higher percentage of seropositivity to Taenia solium than a matched control population. The data make it highly unlikely that neurocysticercosis plays a causative role in the increased prevalence of epilepsy in the Momo Division of the Northwest Province of Cameroon. Supported in part by The Bloorview Children's Hospital Foundation