Seizures, cysticercosis and rural‐to‐urban migration: the PERU MIGRANT study. Issue 4 (3rd February 2015)

• Record Type: Journal Article
• Authors: Gonzales, Isidro; Miranda, J. Jaime; Rodriguez, Silvia; Vargas, Victor; Cjuno, Alfredo; Smeeth, Liam; Gonzalez, Armando E.; Tsang, Victor C. W.; Gilman, Robert H.; Garcia, Hector H.; The Cysticercosis Working Group in Peru
• Is Part Of: Tropical medicine & international health. Volume 20:Issue 4(2015:Apr.)
• Page Start: 546
• Page End: 552
• Publication Date: 2015-02-03
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12456
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12456-abs-0001"> <title>Abstract</title> <sec id="tmi12456-sec-0001" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="tmi12456-sec-0002" sec-type="section"> <title>Methods</title> <p>Three Peruvian populations (<italic>n</italic> = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (<italic>n</italic> = 200), long‐term rural‐to‐urban migrants (<italic>n</italic> = 589) and individuals living in the same urban setting (<italic>n</italic> = 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.</p> </sec> <sec id="tmi12456-sec-0003" sec-type="section"> <title>Results</title> <p>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% (<italic>P</italic> < 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 (<italic>P</italic> = 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 (<italic>P</italic> < 0.001).</p> </sec> <sec id="tmi12456-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>