Results obtained in studies looking for an association between cysticercosis and epilepsy classified by continent and sub-continent.

<p>Results obtained in studies looking for an association between cysticercosis and epilepsy classified by continent and sub-continent.</p

Flowchart of literature search.

<p>Flowchart of literature search.</p

Locations of studies that evaluated association of cysticercosis and epilepsy.

<p>Locations of studies that evaluated association of cysticercosis and epilepsy.</p

Results obtained in studies looking for an association between cysticercosis and epilepsy classified by year of publication.

<p>Results obtained in studies looking for an association between cysticercosis and epilepsy classified by year of publication.</p

Percent of tracking period within 50, 100, 150, and 200 meters of pig residence, (median [IQR]).

<p>Percent of tracking period within 50, 100, 150, and 200 meters of pig residence, (median [IQR]).</p

Minutes per day pigs spent interacting with home and neighboring open defecation areas, by household defecation practice.

<p>Minutes per day pigs spent interacting with home and neighboring open defecation areas, by household defecation practice.</p

GPS device secured properly to pig upon capture.

<p>GPS device secured properly to pig upon capture.</p

Map of two study villages located in the state of Piura, Peru.

<p>(A) Village of Minas de Jambur, population 140, 17 pigs tracked; (B) Village of Cachaco, population 132, 20 pigs tracked.</p

Relationship between pig characteristics, pig roaming ranges, and interactions with open human defecation areas.

<p>Relationship between pig characteristics, pig roaming ranges, and interactions with open human defecation areas.</p

Spatial relationship between <i>Taenia solium</i> tapeworm carriers and necropsy cyst burden in pigs

<div><p>Background</p><p><i>Taenia solium</i>, a parasite that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. Geographic hotspots of pigs testing positive for serologic markers of <i>T</i>. <i>solium</i> exposure have been observed surrounding the locations of human tapeworm carriers. This clustered pattern of seropositivity in endemic areas formed the basis for geographically targeted control interventions, which have been effective at reducing transmission. In this study, we further explore the spatial relationship between human tapeworm carriers and infected pigs using necroscopic examination as a quantitative gold-standard diagnostic to detect viable <i>T</i>. <i>solium</i> cyst infection in pigs.</p><p>Methodology/Principal findings</p><p>We performed necroscopic examinations on pigs from 7 villages in northern Peru to determine the number of viable <i>T</i>. <i>solium</i> cysts in each pig. Participating humans in the study villages were tested for <i>T</i>. <i>solium</i> tapeworm infection (i.e., taeniasis) with an ELISA coproantigen assay, and the distances from each pig to its nearest human tapeworm carrier were calculated. We assessed the relationship between proximity to a tapeworm carrier and the prevalence of light, moderate, and heavy cyst burden in pigs. The prevalence of pig infection was greatest within 50 meters of a tapeworm carrier and decreased monotonically as distance increased. Pigs living less than 50 meters from a human tapeworm carrier were 4.6 times more likely to be infected with at least one cyst than more distant pigs. Heavier cyst burdens, however, were not more strongly associated with proximity to tapeworm carriers than light cyst burdens.</p><p>Conclusion/Significance</p><p>Our study shows that human tapeworm carriers and pigs with viable <i>T</i>. <i>solium</i> cyst infection are geographically correlated in endemic areas. This finding supports control strategies that treat humans and pigs based on their proximity to other infected individuals. We did not, however, find sufficient evidence that heavier cyst burdens in pigs would serve as improved targets for geographically focused control interventions.</p></div