Dataset Information

Prevalence case-control study of epilepsy in three Burkina Faso villages.

ABSTRACT: To estimate the association between the prevalence of epilepsy and potential risk factors in three Burkina Faso villages.Three villages were selected based on local reports of high numbers of epilepsy cases and pig-rearing practices. One person aged 7 or older was selected at random from all households of selected concessions for epilepsy screening and blood sampling. Epilepsy was confirmed by a physician using the ILAE definition. The cross-sectional associations between epilepsy and selected factors and seroresponse to the antigens of Taenia solium were estimated using a Bayesian hierarchical logistic regression. Prevalence odds ratios (POR) and their 95% Bayesian Credible Intervals (95% BCI) were estimated.Of 888 individuals interviewed, 39 of 70 screened positive were confirmed to have epilepsy for a lifetime prevalence of 4.5% (95% CI: 3.3; 6.0). The prevalence of epilepsy was associated with a positive reaction to cysticercosis Ag-ELISA serology (POR = 3.1, 95% BCI = 1.0; 8.3), past pork consumption (POR = 9.7, 95% BCI = 2.5; 37.9), and being salaried or a trader compared to a farmer or housewife (POR = 2.9, 95% BCI = 1.2; 6.4).Several factors were associated with prevalent epilepsy, with Ag-ELISA suggesting the presence of neurocysticercosis. The association between epilepsy and some occupations may reflect differences in local attitudes toward epilepsy and should be further explored.

SUBMITTER: Nitiema P

PROVIDER: S-EPMC4187350 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Prevalence case-control study of epilepsy in three Burkina Faso villages.

Nitiéma P P Carabin H H Hounton S S Praet N N Cowan L D LD Ganaba R R Kompaoré C C Tarnagda Z Z Dorny P P Millogo A A Efécab

Acta neurologica Scandinavica 20120131 4

<h4>Purpose</h4>To estimate the association between the prevalence of epilepsy and potential risk factors in three Burkina Faso villages.<h4>Methods</h4>Three villages were selected based on local reports of high numbers of epilepsy cases and pig-rearing practices. One person aged 7 or older was selected at random from all households of selected concessions for epilepsy screening and blood sampling. Epilepsy was confirmed by a physician using the ILAE definition. The cross-sectional associations ...[more]

PMID: 22289127

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Project description:BackgroundTaenia solium, a zoonotic infection transmitted between humans and pigs, is considered an emerging infection in Sub-Saharan Africa, yet individual and community-level factors associated with the human infection with the larval stages (cysticercosis) are not well understood. This study aims to estimate the magnitude of association of individual-level and village-level factors with current human cysticercosis in 60 villages located in three Provinces of Burkina Faso.Methodology/principal findingsBaseline cross-sectional data collected between February 2011 and January 2012 from a large community randomized-control trial were used. A total of 3609 individuals provided serum samples to assess current infection with cysticercosis. The association between individual and village-level factors and the prevalence of current infection with cysticercosis was estimated using Bayesian hierarchical logistic models. Diffuse priors were used for all regression coefficients. The prevalence of current cysticercosis varied across provinces and villages ranging from 0% to 11.5%. The results obtained suggest that increased age, being male and consuming pork as well as a larger proportion of roaming pigs and percentage of sand in the soil measured at the village level were associated with higher prevalences of infection. Furthermore, consuming pork at another village market had the highest increased prevalence odds of current infection. Having access to a latrine, living in a household with higher wealth quintiles and a higher soil pH measured at the village level decreased the prevalence odds of cysticercosis.Conclusions/significanceThis is the first large-scale study to examine the association between variables measured at the individual-, household-, and village-level and the prevalence odds of cysticercosis in humans. Factors linked to people, pigs, and the environment were of importance, which further supports the need for a One Health approach to control cysticercosis infection.

Project description:BACKGROUND:Individuals diagnosed with neurocysticercosis often present with epilepsy and sometimes with progressively worsening severe chronic headaches (WSCH). While cross-sectional associations between seropositivity to cysticercal antigens and epilepsy have been reported, few large scale studies have been conducted in West Africa and none have measured the association between seropositivity to cysticercal antigens and headaches. This study aimed at filling these knowledge gaps by estimating the strength of the cross-sectional association between seropositivity to cysticercal antigens and the prevalence of epilepsy and WSCH in 60 villages of Burkina Faso, West Africa. METHODOLOGY/PRINCIPAL FINDINGS:Baseline data from a cluster randomized controlled trial collected from January 2011 to February 2012 in 60 villages across three provinces in Burkina Faso were used. Between 78 and 80 individuals were screened for epilepsy and WSCH in each village, and those screened positive were confirmed by a physician. Seventy-five percent of all participants were asked to provide a blood sample to test for Taenia solium cysticercus circulating antigens. Hierarchical multivariable logistic models were used to measure the association between seropositivity to cysticercal antigens and epilepsy (lifetime and active) as well as WSCH. Among 3696 individuals who provided a blood sample, 145 were found to have epilepsy only, 140 WSCH only and 19 both. There were positive associations between seropositivity to cysticercal antigens and active epilepsy (prevalence odds ratio (POR): 2.40 (95%CI: 1.15-5.00)) and WSCH (POR: 2.59 (1.34-4.99)). CONCLUSIONS/SIGNIFICANCE:Our study is the first to demonstrate a cross-sectional association between seropositivity to cysticercal antigens and WSCH in a large community-based study conducted in West Africa. The measured cross-sectional association had a strength similar to the ones previously observed between seropositivity to cysticercal antigens and lifetime or active epilepsy. As a result, preventing new cysticercosis cases in communities may reduce the prevalence of these two important neurological disorders.

Project description:BackgroundEpilepsy and progressively worsening severe chronic headaches (WSCH) are the two most common clinical manifestations of neurocysticercosis, a form of cysticercosis. Most community-based studies in sub-Saharan Africa (SSA) use a two-step approach (questionnaire and confirmation) to estimate the prevalence of these neurological disorders and neurocysticercosis. Few validate the questionnaire in the field or account for the imperfect nature of the screening questionnaire and the fact that only those who screen positive have the opportunity to be confirmed. This study aims to obtain community-based validity estimates of a screening questionnaire, and to assess the impact of verification bias and misclassification error on prevalence estimates of epilepsy and WSCH.Methodology/principal findingsBaseline screening questionnaire followed by neurological examination data from a cluster randomized controlled trial collected between February 2011 and January 2012 were used. Bayesian latent-class models were applied to obtain verification bias adjusted validity estimates for the screening questionnaire. These models were also used to compare the adjusted prevalence estimates of epilepsy and WSCH to those directly obtained from the data (i.e. unadjusted prevalence estimates). Different priors were used and their corresponding posterior inference was compared for both WSCH and epilepsy. Screening data were available for 4768 individuals. For epilepsy, posterior estimates for the sensitivity varied with the priors used but remained robust for the specificity, with the highest estimates at 66.1% (95%BCI: 56.4%;75.3%) for sensitivity and 88.9% (88.0%;89.8%) for specificity. For WSCH, the sensitivity and specificity estimates remained robust, with the highest at 59.6% (49.7%;69.1%) and 88.6% (87.6%;89.6%), respectively. The unadjusted prevalence estimates were consistently lower than the adjusted prevalence estimates for both epilepsy and WSCH.Conclusions/significanceThis study demonstrates that in some settings, the prevalence of epilepsy and WSCH can be considerably underestimated when using the two-step approach. We provide an analytic solution to obtain more valid prevalence estimates of these neurological disorders, although more community-based validity studies are needed to reduce the uncertainty of the estimates. Valid estimates of these two neurological disorders are essential to obtain accurate burden values for neglected tropical diseases such as neurocysticercosis that manifest as epilepsy or WSCH.Trial registrationClinicalTrials.gov NCT03095339.

Project description:BACKGROUND:Genetic and environment play a significant role in the etiology of essential hypertension (EH). Recently STK39 rs3754777, ATP2B1 rs2681472 and rs17249754 have been associated with BP variation and hypertension. In this study we aimed to determine firstly whether index variants were associated with the risk of developing EH in Burkina Faso and secondly to characterize cardiovascular risk markers. METHODS:We conducted a case-control study with 380 participants including 180 case subjects with EH and 200 control subjects with normal BP. We used TaqMan genotyping assays with probes from Applied Biosystems to genotype polymorphisms using the 7500 Real-Time PCR System. Biochemical parameters were measured using chemistry analyzer COBAS C311. RESULTS:T-test showed that cardiovascular risk markers such as body mass index, waist circumference, blood sugar, total cholesterol and triglycerides were significantly higher in hypertensive compared to normotensive (all p?<? 0.05). Binary logistic regression analysis revealed in decreasing order that overweight, family history of hypertension, central obesity and alcohol intake increased the risk of developing EH (all OR?>?3.8; all p?<? 0.001). In genetic level we observed that individuals carrying the AA+AG genotype of ATP2B1 rs17249754 had a low risk of developing EH than those carrying the GG genotype (OR?=?0.48 [95% CI: 0.31-0.75] p?=?0.001) and the A allele frequency in the cases was significantly lower than that of the controls (OR?=?0.56 [95% CI: 0.38-0.82] p?=?0.003). We also observed that ATP2B1 rs17249754 was significantly associated with higher SBP and DPB in case and control groups (GG versus AG?+?AA; p?<? 0.05), ATP2B1 rs2681472 was significantly associated with higher SBP only in case and control group (AA versus AG?+?GG; p?<? 0.05), STK39 rs3754777 was not significantly associated with any of the BP traits (CC versus CT?+?TT; p?>?0.05). CONCLUSION:Our results confirmed the significant association of ATP2B1 rs17249754 with the risk of developing EH in Burkinabe and showed an increase of cardiovascular risk markers levels in subjects with EH.

Dataset Information

Prevalence case-control study of epilepsy in three Burkina Faso villages.

Publications

Prevalence case-control study of epilepsy in three Burkina Faso villages.

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