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Seizures, cysticercosis and rural‐to‐urban migration: the PERU MIGRANT study
Author(s) -
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.
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12456
Subject(s) - cysticercosis , rural population , helminthiasis , geography , rural area , socioeconomics , medicine , environmental health , population , immunology , pathology , sociology
Objectives 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. Methods Three Peruvian populations ( n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region ( n = 200), long‐term rural‐to‐urban migrants ( n = 589) and individuals living in the same urban setting ( n = 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. Results 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% ( P < 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 ( P = 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 ( P < 0.001). Conclusions 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.