Cysticercosis and neurocysticercosis in Eastern Zambia: A cross-sectional, community-based study

Zulu G, Mwape KE, Welte TM, Stelzle D, Simuunza M, Prucker P, Hachangu A, Mutale W, Masuku M, Ruether C, Sikasunge CS, Phiri IK, Winkler AS (2026)

Publication Type: Journal article

Publication year: 2026

Book Volume: 21

Article Number: 101018

DOI: 10.1016/j.ijregi.2026.101018

Abstract

Objective This study aimed to estimate the seroprevalence of cysticercosis and the prevalence of neurocysticercosis (NCC) among cysticercosis-positive participants, and to describe their clinical and radiological manifestations in rural Zambia. Methods A cross-sectional study was conducted between June 2019 and December 2022 in the Eastern Province of Zambia. The serum antigen enzyme-linked immunosorbent assay (Ag-ELISA) and Cysticercosis immunoglobulin G (IgG) Western blot were used to detect cysticercosis. All cysticercosis (CC)-positive participants received further clinical work-up and cerebral computed tomography (CT) examination. Results Out of 2876 serum samples examined, 70 (2.4%) [95% confidence interval (CI) = 1.9-3.1%] tested positive only on Ag-ELISA, 149 (5.2%) [95% CI = 4.4-6.1%] tested positive only on the Western blot and 35 (1.2%) [95% CI = 0.9-1.7%] were positive on both the antigen and antibody tests, yielding a total of 254 (8.8%) [95% CI = 7.8-9.9%] positive on at least one serological test. More males than females were CC-positive (10.6% versus 7.6%, P = 0.005); seropositivity increased with age ( P = 0.046) and differed between villages ( P = 0.001). Among the CC-positive participants, 236/254 (93%) had a clinical work-up and cerebral CT examination, of whom 80/236 (34%) [95% CI = 28-40%] had NCC. Overall, neurological deficits were rare, the most common being cranial nerve abnormalities (23/236, 10%). However, headache and epileptic seizures were more frequently reported among participants with NCC than among those without NCC [37/80 (46%) versus 52/156 (33%) for headache ( P = 0.05) and 13/80 (16%) versus 12/156 (8%) for epileptic seizures ( P = 0.04)]. Regarding NCC lesions in people with epileptic seizures, 53% (52/99) and 96% (95/99) of all lesions were in the brain parenchyma and inactive (calcified), respectively. For people with headache, 68% (139/205) and 83% (170/205) of all lesions were in the parenchyma and inactive, respectively. Conclusion Our findings demonstrate that cysticercosis and NCC are prevalent in this rural community in the Eastern Province of Zambia. Most of the patients with NCC had calcified lesions, and people with NCC more often had epileptic seizures and headache than those without NCC; only a few people had neurological deficits.

Involved external institutions

Klinikum rechts der Isar DE Germany (DE) University of Zambia (UNZA) ZM Zambia (ZM) Ministry of Health ZM Zambia (ZM) Technische Universität München (TUM) DE Germany (DE)

How to cite

APA:

Zulu, G., Mwape, K.E., Welte, T.M., Stelzle, D., Simuunza, M., Prucker, P.,... Winkler, A.S. (2026). Cysticercosis and neurocysticercosis in Eastern Zambia: A cross-sectional, community-based study. , 21. https://doi.org/10.1016/j.ijregi.2026.101018

MLA:

Zulu, Gideon, et al. "Cysticercosis and neurocysticercosis in Eastern Zambia: A cross-sectional, community-based study." 21 (2026).

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