Abstract Details

Title Neurocysticercosis and HIV Among Zambian Youth: A Geographic Approach

Topic Global Health and Neuroepidemiology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-038

Objective To investigate the relationship between HIV and neurocysticercosis using geographic analysis.

Background Neurocysticercosis is the most common parasitic infection of the brain and a leading cause of epilepsy in the developing world. While neurocysticercosis and HIV co-infections have been reported, there is little data on whether co-infection modifies pathophysiology. As part of the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) study, we detected a potential cluster of neurocysticercosis cases among children in Lusaka, the capital of Zambia, and utilized geographic information systems to investigate the association.

Design/Methods 33 study participants ages 8-17 had Magnetic Resonance Imaging (MRI) of the brain performed and evaluated. Standardized interviews were conducted to identify potential risk factors. Participants homes were approximated using satellite images from Google Maps and OpenStreetMaps using geographic information provided. Latitude and longitude coordinates were plotted into QGIS, an open-source geographic information system software. Maps were generated to visualize where participants live and to assess metrics on the basis of geography.

Results Four of 33 subjects with HIV (12%) were found to have neurocysticercosis, specifically the vesicular phase of cysticercosis. Geographic analysis demonstrated that the four neurocysticercosis subjects resided in two adjacent constituencies (Chawama + Kanyama); other participants were distributed roughly equally over the remaining constituencies that were represented in the study. Geographic analysis demonstrated low rates of piped water (Chawama 21.1%, Kanyama 23.2%) and flush toilets (Chawama 11.5%, Kanyama 14.5%).

Conclusions These results may suggest a geographic trend in neurocysticercosis in Lusaka among constituencies with low rates of piped water and limited access to flush toilets. These features may increase the risk of neurocysticercosis infection. Data on this parasitic infection are largely lacking especially in regard to its interaction with HIV. This study has identified the need for further research on neurocysticercosis and HIV co-infection, and demonstrated the utility of geographic analysis in identifying potential associations.

Authors/Disclosures
Alexandra Buda PRESENTER	Ms. Buda has nothing to disclose.
Owen Dean	No disclosure on file
Heather Adams	The institution of Heather Adams has received research support from Current: NIH; Past: Abeona; Batten Research Alliance; American University Centers on Disabilities. An immediate family member of Heather Adams has received publishing royalties from a publication relating to health care. Heather Adams has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Critical Path Institute.
Sylvia Mwanza-Kabaghe	No disclosure on file
Gretchen L. Birbeck, MD, MPH, DTMH, FAAN (University of Rochester/CHET)	An immediate family member of Dr. Birbeck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Birbeck has a non-compensated relationship as a Ambassador for Zambia with RSTMH that is relevant to AAN interests or activities.
Michael Potchen	Michael Potchen has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Jackson & Campbell, P.C.. Michael Potchen has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Rotezel & Andress.
Esau G. Mbewe	Esau G. Mbewe has received research support from Research was supported by the National Institute Of Neurological Disorders And Stroke of the National Institutes of Health under Award Number K23NS117310. .
Pelekelo Kabundula	Pelekelo Kabundula has nothing to disclose.
David Bearden, MD (University of Rochester School of Medicine)	Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.

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