Medics Doctors call for more research into the prevalence of neurological diseases in southern Rwanda

Cysticercosis is a parasitic disease prevalent in regions such as Africa, Asia and Latin America, which poses significant health risks that require immediate attention.

There is currently little research on its prevalence. Still, neurology specialists in Rwanda, as well as general practitioners, have often reported encountering many cases of epilepsy in patients in southern Rwanda.

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 urges clinicians in cysticercosis-endemic regions, such as Rwanda, to consider cysticercosis in their differential diagnosis when patients present with atypical clinical presentations.

Dr Menelas Nkeshimana, co-author of the report, highlighted the potential for cysticercosis to infiltrate various body tissues, including the brain, leading to neurocysticercosis. He stressed the need for continued research, particularly by doctoral students in neurology, to explore alternative causes and determine the prevalence rates of neurological diseases in Rwanda.

Transmission of cysticercosis occurs primarily by the faecal-oral route, often due to the ingestion of eggs from Taenia solium carriers. When the central nervous system is affected, it is called "neurocysticercosis", with poor hygiene practices and consumption of undercooked pork exacerbating the transmission of the disease.

Symptoms of cysticercosis vary widely, ranging from neurological manifestations such as seizures to skin abnormalities such as subcutaneous nodules.

In Rwanda, where porcine and human cysticercosis are prevalent, intensified efforts to control the disease are imperative, particularly in pig-raising areas.

Dr Arlène Ndayisenga, the consultant neurologist at Roi Faisal Hospital, assured the availability of treatments for cysticercosis and epilepsy, emphasizing their non-contagious nature. She noted varying treatment lengths, with children typically on a two-year regimen and adults requiring 3 to 5 years. However, certain factors such as pre-existing brain damage can affect the effectiveness of the treatment, potentially leading to permanent brain damage or scarring.

Despite the challenges, Ndayisenga said about 70 percent of patients could effectively manage their illness with medication, allowing them to lead normal lives. She stressed the importance of access to clean water and better hygiene practices to mitigate the risks of reinfection, particularly among tapeworm carriers, including food handlers.