Medical professionals are advocating for deeper investigation into the prevalence of neurological diseases, like epilepsy, in Southern Rwanda, where such have for long been attributed to cysticercosis, a condition caused by tapeworm larvae originating from contaminated environments and food. Cysticercosis is a parasitic disease prevalent in regions such as Africa, Asia, and Latin America, posing significant health risks that demand immediate attention. There is currently limited research on its prevalence, but neurology specialists in Rwanda, along with general practitioners, have often reported encountering numerous epilepsy cases among patients from Southern Rwanda. ALSO READ: Combating neglected tropical diseases with awareness and action Previously, it was commonly believed that epilepsy in the area stemmed from ingesting worm-contaminated food, leading to untreated infestations eventually affecting the brain. However, Rwandan medical experts now say there may be multiple underlying factors. These may include genetic factors. A 2020 medical report published in the Rwanda Medical Journal documented the case of a 46-year-old patient from Southern Rwanda who presented with headaches, difficulty walking, fevers, and painless subcutaneous nodules, indicative of Taenia solium infection affecting her nervous system. The report urged clinicians in cysticercosis-endemic regions, like Rwanda, to consider cysticercosis in their differential diagnosis when patients exhibit atypical clinical presentations. ALSO READ: Neurocysticercosis Dr Menelas Nkeshimana, co-author of the report, highlighted the potential of cysticercosis to infiltrate various bodily tissues, including the brain, leading to neurocysticercosis. He underscored the need for further research, particularly by neurology PhD students, to explore alternative causes and determine prevalence rates of neurological diseases in Rwanda. Cysticercosis transmission occurs primarily through the faecal-oral route, often due to ingesting eggs from Taenia solium carriers. When the central nervous system is affected, it is termed “neurocysticercosis”, with poor hygiene practices and consumption of undercooked pork meat exacerbating disease transmission. Symptoms of cysticercosis vary widely, ranging from neurological manifestations such as seizures to skin abnormalities like subcutaneous nodules. In Rwanda, where both porcine and human cysticercosis prevail, intensified efforts to control the disease are imperative, especially in areas with pig farming. Dr Arlene Ndayisenga, a consultant neurologist at King Faisal Hospital, assured the availability of treatment for cysticercosis and epilepsy, emphasising their non-contagious nature. She noted varying treatment durations, with children typically undergoing a two-year regimen and adults requiring 3-5 years. However, certain factors such as pre-existing brain damage may affect treatment efficacy, potentially leading to permanent brain damage or scarring. Despite challenges, Ndayisenga indicated that approximately 70 per cent of patients can effectively manage the condition with medication, enabling them to lead normal lives. She emphasised the importance of clean water access and improved hygiene practices to mitigate reinfection risks, particularly among tapeworm carriers, including food handlers.
