Community-Based Epidemiological Investigations of Cysticercosis Due to Taenia solium: Comparison of Serological Screening Tests and Clinical Findings in Two Populations in Mexico

TLDR: EITB was more sensitive and specific than ELISA for epidemiological studies of neurocysticercosis and was strengthened by the higher rate of abnormal findings compatible with neurocyticercosis on computed tomography of the brain among individuals with a history of convulsions.

Abstract: We compared a plate enzyme-linked immunosorbent assay (ELISA) with an immunoblot--or enzyme-linked immunoelectrotransfer blot--assay (EITB) for the identification of cases of human neurocysticercosis due to Taenia solium and of risk factors for this disease in two Mexican villages. Findings related to age- and sex-specific seroprevalence, risk factors for transmission, and associated morbidity differed significantly according to the assay used. Rates of EITB positivity were significantly higher among persons with a history of convulsions than among those without such a history (29% vs 8%; P < .05); in contrast, ELISA results were negative for all persons with a history of convulsions. The association of seizures with neurocysticercosis in this population was strengthened by the higher rate of abnormal findings compatible with neurocysticercosis on computed tomography of the brain among individuals with a history of convulsions than among those without such a history (70% vs 14%; P < .001). In summary, EITB was more sensitive and specific than ELISA for epidemiological studies of neurocysticercosis.