TY - JOUR
T1 - Epilepsy and Neurocysticercosis in Latin America
T2 - A Systematic Review and Meta-analysis
AU - Bruno, Elisa
AU - Bartoloni, Alessandro
AU - Zammarchi, Lorenzo
AU - Strohmeyer, Marianne
AU - Bartalesi, Filippo
AU - Bustos, Javier A.
AU - Santivañez, Saul
AU - García, Héctor H.
AU - Nicoletti, Alessandra
AU - Bonati, Maurizio
AU - Severino, Francesca
AU - Confalonieri, Valeria
AU - Pandolfini, Chiara
AU - Bisoffi, Zeno
AU - Buonfrate, Dora
AU - Angheben, Andrea
AU - Albonico, Marco
AU - Muñoz, Jose
AU - Pool, Robert
AU - Requena-Mendez, Ana
AU - Roura, Maria
AU - Hardon, Anita
AU - Pell, Christopher
AU - Chiodini, Peter
AU - Moreira, Juan
AU - Sempértegui, Roberto
AU - Anselmi, Mariella
AU - Gotuzzo, Eduardo
AU - Mena, Maria Alejandra
AU - Torrico, Faustino
AU - Lozano, Daniel
AU - Rojas, Guido Chumiray
AU - Cabrera, Teresa Hinojosa
AU - Morón, Javier Ochoa
AU - Cuellar, Ignacio Abapori
AU - Suarez, Jaime Amorós
AU - Tognoni, Gianni
AU - Caro, Carola Liendo
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Background:The difference in epilepsy burden existing among populations in tropical regions has been attributed to many factors, including the distribution of infectious diseases with neurologic sequels. To define the burden of epilepsy in Latin American Countries (LAC) and to investigate the strength of association with neurocysticercosis (NCC), considered one of the leading causes of epilepsy, we performed a systematic review and meta-analysis of the literature.Methodology:Studies published until 2012 were selected applying predefined inclusion criteria. Lifetime epilepsy (LTE) prevalence, active epilepsy (AE) prevalence, incidence, mortality, treatment gap (TG) and NCC proportion among people with epilepsy (PWE) were extracted. Median values were obtained for each estimate using random effects meta-analysis. The impact of NCC prevalence on epilepsy estimates was determined using meta-regression models. To assess the association between NCC and epilepsy, a further meta-analysis was performed on case-control studies.Principal findings:The median LTE prevalence was 15.8/1,000 (95% CI 13.5-18.3), the median AE prevalence was 10.7/1,000 (95% CI 8.4-13.2), the median incidence was 138.2/100,000 (95% CI 83.6-206.4), the overall standardized mortality ratio was 1.4 (95% CI 0.01-6.1) and the overall estimated TG was 60.6% (95% CI 45.3-74.9). The median NCC proportion among PWE was 32.3% (95% CI 26.0-39.0). Higher TG and NCC estimates were associated with higher epilepsy prevalence. The association between NCC and epilepsy was significant (p<0.001) with a common odds ratio of 2.8 (95% CI 1.9-4.0).Significance:A high burden of epilepsy and of NCC in LAC and a consistent association between these two diseases were pointed out. Furthermore, NCC prevalence and TG were identified as important factors influencing epilepsy prevalence to be considered in prevention and intervention strategies.
AB - Background:The difference in epilepsy burden existing among populations in tropical regions has been attributed to many factors, including the distribution of infectious diseases with neurologic sequels. To define the burden of epilepsy in Latin American Countries (LAC) and to investigate the strength of association with neurocysticercosis (NCC), considered one of the leading causes of epilepsy, we performed a systematic review and meta-analysis of the literature.Methodology:Studies published until 2012 were selected applying predefined inclusion criteria. Lifetime epilepsy (LTE) prevalence, active epilepsy (AE) prevalence, incidence, mortality, treatment gap (TG) and NCC proportion among people with epilepsy (PWE) were extracted. Median values were obtained for each estimate using random effects meta-analysis. The impact of NCC prevalence on epilepsy estimates was determined using meta-regression models. To assess the association between NCC and epilepsy, a further meta-analysis was performed on case-control studies.Principal findings:The median LTE prevalence was 15.8/1,000 (95% CI 13.5-18.3), the median AE prevalence was 10.7/1,000 (95% CI 8.4-13.2), the median incidence was 138.2/100,000 (95% CI 83.6-206.4), the overall standardized mortality ratio was 1.4 (95% CI 0.01-6.1) and the overall estimated TG was 60.6% (95% CI 45.3-74.9). The median NCC proportion among PWE was 32.3% (95% CI 26.0-39.0). Higher TG and NCC estimates were associated with higher epilepsy prevalence. The association between NCC and epilepsy was significant (p<0.001) with a common odds ratio of 2.8 (95% CI 1.9-4.0).Significance:A high burden of epilepsy and of NCC in LAC and a consistent association between these two diseases were pointed out. Furthermore, NCC prevalence and TG were identified as important factors influencing epilepsy prevalence to be considered in prevention and intervention strategies.
UR - http://www.scopus.com/inward/record.url?scp=84887275949&partnerID=8YFLogxK
U2 - 10.1371/journal.pntd.0002480
DO - 10.1371/journal.pntd.0002480
M3 - Original Article
C2 - 24205415
AN - SCOPUS:84887275949
SN - 1935-2727
VL - 7
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 10
M1 - e2480
ER -