Diagnosis of neurocysticercosis using the PCR test in cerebrospinal fluid

The neurocysticosis (NC) is the most frequent central nervous system (CNS) disease throughout the world. In the last century this disease was prevailing only in poor countries with poor health infrastructure, but in the present century its frequency is increasing in industrialized countries due to migration and globalization. The NC can cause symptoms such as epileptic crises, headache and neurological deficit, with permanent sequelae, such as epilepsy, dementia and hydrocephalus, so the World Health Organization (WHO) currently considers it as a serious public health problem. The clinical diagnosis is difficult, since it depends on the number and location of the parasites in the host's CNS, as well as the immune response of the host to the parasite. Immunological diagnostic tests in blood and cerebrospinal liquid have been implemented, but have low sensitivity and specificity. Currently, the most used diagnostic test is imaging (brain tomography or magnetic resonance), but also has its limitations, in addition to its high cost that makes it inaccessible to the majority of the population of poor countries. The only reliable test is pathological confirmation through biopsy; However, this procedure has obvious limitations. For this reason, it is a priority to have new diagnostic tests of NC, in order to establish treatment early and quantify the true weight of the disease in the population. There is no ideal immune test for the diagnosis of neurocysticercosis immunodiagnostic methods to detect antibodies indicate a past or past infection, as well as circulating antigens that indicate current infection. EITB and ELISA are the most frequently used tests for the diagnosis of human cysticercosis. The positivad of this tests indicate the presence of antibody in the guest body due to an infection with tower/cysticercosis that it could have had at some time of your life and not necessarily current infection. Recently, methods based on the detection of Cysticerco DNA in the host through the PCR test have been investigated, which in addition to indicating current host's CNS infection, would allow a specific diagnosis of the 100%diagnosis. The objective of this project is to implement and validate the PCR test for the diagnosis of neurocysticercosis in a representative sample of patients in the main hospitals of the city of Cuenca, Ecuador is an exploratory, prospective study, of cases and controls, in which patients with neurocysticercosis (cases) and patients without neurocysticercosis (controls) will be selected. The selection of cases and controls will be done in patients who attend the largest (public and private) hospitals in the city of Cuenca, in order to achieve a sample of representative patients, estimated at 2 to 3 patients per month for a year. Once the diagnosis of NC is established by the project researchers team (neurologists and neurosurgeons of the referred hospitals) through previously validated diagnostic criteria, both CSF sample of both cases (patients with NC), as well as of controls (patients without NC), will be taken. The latter will be those patients to whom it has been necessary to obtain a sample of CSF due to diagnostic suspicion of other diseases, such as inherited-degenerative diseases of the CNS, hydrocephalus and meningitis of etiology that is not cysticercosis.

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