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Mortality in Parenchymal and Subarachnoid Neurocysticercosis

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  • 1 Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru;
  • 2 Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis Del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
  • 3 Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
  • 4 Hospital Nacional Alberto Sabogal, Essalud, Callao, Peru

Abstract.

Neurocysticercosis (NCC) is endemic in many parts of the world, carrying significant neurological morbidity that varies according to whether lesions are located inside the cerebral parenchyma or in extraparenchymal spaces. The latter, in particular subarachnoid NCC, is assumed to be more severe, but no controlled studies comparing mortality between types of NCC exist. The aim of this study was to compare all-cause mortality between patients with intraparenchymal NCC and those with subarachnoid NCC. Vital status and sociodemographic characteristics were evaluated in patients with intraparenchymal viable, intraparenchymal calcified, and subarachnoid NCC attending a neurological referral hospital in Lima, Perú. Survival analyses using Kaplan–Meier curves and Cox proportional regression models were carried out to compare mortality rates between groups. From 840 NCC patients followed by a median time of 82.3 months, 42 (5.0%) died, six (1.8%) in the intraparenchymal viable group, four (1.3%) in the calcified group, and 32 (16.6%) in the subarachnoid group (P < 0.001). Older age and lower education were significantly associated with mortality. The age-adjusted hazard ratio for death in the subarachnoid group was 13.6 (95% CI: 5.6–33.0, P < 0.001) compared with the intraparenchymal viable group and 10.7 (95% CI: 3.7–30.8, P < 0.001) when compared with the calcified group. We concluded that subarachnoid disease is associated with a much higher mortality in NCC.

Author Notes

Address correspondence to Jesus Abanto, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, 15102, San Martin de Porres, Lima, Peru. E-mail: jesus.abanto@upch.pe

Authors’ addresses: Jesus Abanto and Diego Siu, Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: jesus.abanto@upch.pe and diego.siu@upch.pe. Daniel Blanco, Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mail: daniel.blanco.v@upch.pe. Herbert Saavedra, Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mail: hsaavedrapastor@hotmail.com. Isidro Gonzales, Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, and Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mail: isidrogonzalesq@hotmail.com. E. Javier Pretell, Hospital Nacional Alberto Sabogal, Essalud, Callao, Peru, E-mail: ejpretell@hotmail.com. Javier A. Bustos and Hector H. Garcia, Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru, and Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mails: javier.bustos@jhu.edu and hgarcia1@jhu.edu.

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