Seroprevalence and risk factors of Taenia solium cysticercosis among persons with epilepsy in Southern Nigeria.

Cysticercosis, a zoonotic infection caused by the larval stage of Taenia solium, poses significant public health challenges in endemic regions. This community-based case-control study examined the seroprevalence, risk factors, and potential association between human cysticercosis and epilepsy in Southern Nigeria. Between September and December 2023, a door-to-door survey screened 23,027 residents across five communities using a validated 10-item questionnaire for epileptic seizures. Confirmed cases and age-matched community controls were tested for T. solium antibodies using enzyme-linked immunoelectrotransfer blot (EITB) and for taeniasis by stool microscopy. Of 79 participants tested serologically, the overall seroprevalence of cysticercosis was 12.7% (10/79), with no statistically significant difference between persons with epilepsy (PWE) (11.9%) and controls (13.5%) (p > 0.05). Taenia spp. eggs were detected by stool microscopy in 6.6% of PWE. Multivariable logistic regression identified increasing age (adjusted OR = 0.95; 95% CI: 0.92-0.98; p = 0.01) and consumption of frozen meat (adjusted OR = 0.23; 95% CI: 0.06-0.98; p = 0.04) as factors independently associated with lower odds of cysticercosis seropositivity. One case of neurocysticercosis (NCC) (2.4%) was confirmed among PWE. These findings suggest that, while T. solium transmission occurs in Southern Nigeria, cysticercosis is unlikely to be a principal aetiological driver of epilepsy in the studied communities. Strengthened food hygiene practices and larger population-based investigations are warranted to better inform public health control strategies.