Neurological morbidity among human T-lymphotropic-virus-type-1-infected individuals in a rural West African population. Issue 1 (31st October 2008)

• Record Type: Journal Article
• Authors: Cooper, S; Schim van der Loeff, M; McConkey, S; Cooper, M; Sarge-Njie, R; Kaye, S; Whittle, H
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 80:Issue 1(2009)
• Page Start: 66
• Page End: 68
• Publication Date: 2008-10-31
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2008.152819
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Community-based neurological data about human T lymphotropic virus type 1 (HTLV-1) morbidity in sub-Saharan Africa are scarce. Objectives: To ascertain the prevalence of neurological morbidity, in particular tropical spastic paraparesis (TSP), among HTLV-1-infected subjects and to compare TSP prevalence in HTLV-1-infected with that in non-infected subjects in a rural West African population. Methods: A cross-sectional study of HTLV-1-infected cases and controls (ratio 4:1) from a rural community (population approximately 10 000, HTLV-1 prevalence 7.7%). One neurologist masked to HTLV-1 serological status assessed all subjects. Clinical criteria were employed to diagnose TSP. Results: From 205 eligible cases and controls, 139 were recruited with a mean age of 56 years, and 113 (81%) were HTLV-1-infected. 108/139 (78%) were female, and 8/113 HTLV-1 infected cases (7.1%) had a definite or probable TSP (all females; mean age 67 years) compared with 0/26 controls. Two with TSP were co-infected with HIV-2. Complaints of back pain and leg weakness were more common in HTLV-1-infected individuals (p = 0.03, p = 0.02), but no single symptom distinguished between subjects with and without TSP. Conclusion: We report a prevalence of TSP among HTLV-1-infected persons in this rural West African setting of 7.1%. There are difficulties excluding other potential aetiologies here.