OU Researcher Working to Harness Epilepsy in Developing Countries
More than 50 million people around the world have epilepsy, but 80 percent of them live in developing countries.
Now, research by a University of Oklahoma Health Sciences Center epidemiologist is helping explain why the burden is so great in these areas.
“Many developing countries are endemic with neurocysticercosis, an infection caused by the tapeworm people get from eating undercooked pork meat,” said Helene Carabin, DVM, Ph.D., a researcher and professor of epidemiology with the OU College of Public Health. Neurocysticercosis is a preventable cause of epilepsy.
Carabin and colleagues studied three villages in the African nation of Burkina Faso. In the two villages where pigs and people lived in close proximity, residents had a higher prevalence of both neurocysticercosis and cysticercosis, the larval stage of the parasite in their body.
“One village was predominantly Muslim so there were hardly any pigs and there were no cases of neurocysticercosis as confirmed by brain imaging,” Carabin said. “In the other two villages, the infection in pigs was extremely high as compared to other areas of the world and almost half of the people with epilepsy had neurocysticercosis.”
Carabin said the exchange of tapeworms between pigs and humans is a terrible cycle that can only be improved with better sanitation, pig fencing and the building of latrines.
The pigs often are not penned and live near the humans, who defecate outside. The pigs are infected with the eggs of tapeworms by eating human waste and the humans are infected with the tapeworms by eating undercooked pork.
“Humans also can get infected with the eggs present in the contaminated environment. The eggs do the same as they would in a pig,” Carabin said. “They become larvae and migrate to the muscles and the brain of people. When larvae migrate to the brain, this is what we call neurocysticercosis.”
Carabin said improving sanitation and penning pigs could prevent up to half of all epilepsies in endemic villages.
Epilepsy is highly stigmatized in the villages, Carabin said, and sometimes associated with witchcraft or God’s will. Still, residents are willing to change their hygiene habits if they are provided knowledge to build latrines that will be durable and solid.
She is currently following up on the study with a randomized control trial in 60 villages in Burkina Faso. Researchers will study the impact of community education about pig management and sanitation, and the link to epilepsy.
While neurocysticercosis is not common in the U.S., it is a concern, Carabin said. The disease is linked to increased immigration from countries in Latin America where the disease is endemic.
Carabin’s research is funded by $2.4 million from the National Institutes of Health, but she said it would not be possible without the help of nonprofit and research organizations in Africa too.
It was published in the international scientific journal, Acta Neurologica Scandinavica.