Neuroepidemiological Survey For Epilepsy And Knowledge About Neurocysticiercosis At Ngqwala Location, South Africa

摘要

Objective: To determine the prevalence of epilepsy and knowledge about neurocysiticercosis (NCC) and HIV/AIDS in adult population of one South Africa rural community. Setting: Ngqwala location, at 14 km away from Umtata (Capital of the former Transkei). Design: A two-stage design study was used. The first stage involved screening of the general population on door-to-door basis by interviewing peoples living in 100 household selected randomly using an internationally validated questionnaire for detecting epilepsy and knowledge about other associated diseases. The second stage consisted of a neurological assessment of the peoples who screened positive. Results: A total of 2987 adults were screened. The prevalence of active epilepsy in these adults was 13.7/1,000. Only7.6 % of epileptic patients were under regular anti-epileptic treatment, 87% of the total population had not idea about NCC, and 57% of them did not know the cause of AIDS. Conclusion: The prevalence of epilepsy is high and poor utilization of anti-epileptic treatment is cause for concern. NCC and HIV/AIDS awareness campaign at the rural locations in the former Transkei should be made as soon as possible while other permanent solution will arrive. Introduction Neurocisticercosis (NCC) is an infection of central nervous system (CNS) caused by the larval stage (Cysticercus cellulosae) of the pig tapeworm Taenia solium. This is the most common helminthes to produce CNS infection in human being. The occurrence of acquired epilepsy or the syndrome of raised intracranial pressure in a person living in or visiting a region where taeniasis is endemic or even in one living in close contact with people who have taeniasis should suggest a diagnosis of cysticercosis; patients with NCC may remain asymptomatic for months to years, and commonly a diagnosis is made incidentally when neuroimaging is performed, many symptomatic forms can predominate. Symptoms and signs are related both to the parasite, which can show a different biological behavior from one place to another, and different inflammatory-inmunological responses on different hosts. NCC is the most common cause of acquired epilepsy worldwide and most of the patients taking phenytoin or carbamazepine for a proper control of their seizures, respond very well. 1 2 3 4 5 Other aspects related to NCC from our region are also available on line 6 7 this study was designed for Ngqwala location which is situated at the former Transkei. Transkei was one of the three administrative authorities of the so-called independent homelands (Ciskei, Transkei and the Cape Provincial Administration under different apartheid governments) it is currently region D and E of Eastern Cape Province of South Africa; Umtata is the capital for the former Transkei which is one of the poorest region countrywide, and serves as a labor reservoir for other wealthier provinces, with men leaving behind women and children whilst they seek and find employment elsewhere.8 Epilepsy is the most common chronic disorder of the central nervous system (CNS) manifested by recurrent unprovoked seizures that affect approximately 1% of the U.S. population9 During 1986-1990; approximately 1.1 million persons in United States annually reported having epilepsy and the overall prevalence of epilepsy was 4.7. The point prevalence of epilepsy is estimated at about 0.4 % to 0.8 % in some European countries,10 11 the prevalence of epilepsy is said to be about 3 to 9 per 1,000 population. As countries in Asia, the prevalence rates from published reports are: China (4.6),12 Parsi (4.7), Kashmir (2.47) rural Bengal also in India (3.05)13 Pakistan (9.0), Guam (4.9), Singapore (3.5), rural Thailand (7.2)14 and the Philippines League Against Epilepsy (2.3). The lower prevalence rate reported in the last study was most likely related to differences in the communities surveyed, because the Philippine study was conducted in a mixed urban and rural community.15 Central and South American co