Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy

Background: we reviewed studies that analyzed cysticercosis (cc),neurocysticercosis (ncc) and epilepsy across latin america,asia and sub-saharan africa,to estimate the odds ratio and etiologic fraction of epilepsy due to cc in tropical regions. methodology: we conducted a systematic review of the literature on cysticercosis and epilepsy in the tropics,collecting data from case-control and cross-sectional studies. exposure criteria for cc included one or more of the following: serum elisa or eitb positivity,presence of subcutaneous cysts (both not verified and unverified by histology),histology consistent with calcified cysts,and brain ct scan consistent with ncc. a common odds-ratio was then estimated using meta-analysis. principal findings: 37 studies from 23 countries were included (n = 24,646 subjects,14,934 with epilepsy and 9,712 without epilepsy). of these,29 were case-control (14 matched). the association between cc and epilepsy was significant in 19 scientific articles. odds ratios ranged from 0.2 to 25.4 (a posteriori power 4.5–100%) and the common odds ratio was 2.7 (95% ci 2.1–3.6,p <0.001). three subgroup analyses performed gave odds ratios as: 2.2 (eitb-based studies),3.2 (ct-based studies),1.9 (neurologist-confirmed epilepsy; door-to-door survey and at least one matched control per case). etiologic fraction was estimated to be 63% in the exposed group among the population. significance: despite differences in findings,this meta-analysis suggests that cysticercosis is a significant contributor to late-onset epilepsy in tropical regions around the world,and its impact may vary depending on transmission intensity. © 2017 debacq et al.