Download Example of a scientific poster

Identifying probable cases of neurocysticercosis at an urban community hospital in Los Angeles through
active surveillance: A local application addressing the under-reporting of a WHO "major neglected disease"
Jennifer Garland RN, MSN, PHN, PhD (c.) Jennifer Bradbury RN, BSN, PHN
UCLA School of Nursing
Results
Background
Neurocysticercosis (NCC) is an infection of the central nervous
system caused by the presence of larval stage, Taenia solium, the
pork tapeworm. It is a major cause of worldwide epilepsy and
disability.
The United States has seen a rise in the number of NCC cases largely due to
the flood of immigrants from endemic to non-endemic areas and the
improved access to neuroimaging (Serpa & White, 2012).
Conclusion
191 probable neurocysticercosis cases were identified. All probable living
cases were forwarded to the local county health department for follow up
confirmation and contact testing
Neurocysticercosis is vastly under-reported given the large number of
probable cases identified by the authors within the 8 month period.
Ethnicity of probable cases was comparable to existing literature.
172 (90.05%) of identified cases were Hispanic
Presentation of seizure activity was significantly lower in identified
hospital cases (7.33%) when compared to the literature (78.8%)
(Carabin, et al. 2011).
Neurocysticercosis (NCC) Hispanic vs. NonHispanic
Identifying barriers to reporting must be identified and implementing
strategies to overcome these barriers and improve reporting must be
initiated.
Reproduced from: Del Brutto, 2012, with permission.
Hispanic (90.05%)
Non-Hispanic (9.95%)
This infection is endemic in the developing world,
however, due to immigration, is being increasingly
identified in immigration hub areas of developed
countries. NCC is associated with acquired seizure
disorder, cognitive decline, and disability (Del Brutto,
2012).
Reproduced from: Del Brutto, 2012, with permission
The authors noted that no cases of NCC at an urban community hospital
were reported to the local health department, despite serving a largely
Hispanic/Latino immigrant population, demonstrating a pervasive
underreporting of disease.
126 (65.97%) cases were born in Mexico
Neurocysticercosis (NCC) Born in Mexico vs.
Other Countries
Mexico (65.97%)
Cysticercosis is a reportable disease in Los Angeles County [Title 17,
California Code of Regulations (CCR), 2500]
Other (34.03%)
T. Solium egg
References
In order to identify outbreaks and prevent transmission of communicable
disease; timely notification of reportable diseases is critical
Methods
Reproduced from: Del Brutto, 2012, with permission.
The World Health Organization (WHO) has
recently categorized NCC as one of several
“major neglected diseases.”
Methods: A pilot study was conducted at a community hospital in urban Los
Angeles utilizing active surveillance to identify probable cases of NCC (defined
by Del Brutto, et al. 2001) by reviewing CT Brain scan reports and the
corresponding medical records from January 1, 2012 to August 18, 2012.
Only 14 (7.33%) of cases had a history of seizure activity
-Without something being done for
the NTDs, Millenium Development Goals
will not be attainable
-Endemic and neighboring countries
should increase awareness about
cysticercosis and put up effective
surveillance and reporting systems
(Doyle, et al. 2002).
Anonymous (2011) Report of the WHO Expert Consultation on foodborne
trematode infections and Taeniasis/Cysticercosis. Geneva: World Health
Organization.
Carabin H, Ndimubanzi PC, Budke CM, Nguyen H, Qian Y, et al. (2011) Clinical
Manifestations Associated with Neurocysticercosis: A Systematic Review. PLoS
Negl Trop Dis 5(5): e1152. doi:10.1371/journal.pntd.0001152
Neurocysticercosis (NCC) History of
Seizures vs. No History of Seizures
Coyle CM, Mahanty S, Zunt JR, Wallin MT, Cantey PT, et al. (2012)
Neurocysticercosis: neglected but not forgotten. PLoS Negl Trop Dis 6: e1500.
doi:10.1371/journal.pntd.0001500.
Seizures (7.33%)
Authors identified probable cases through verbage on CT Brain scan reports.
Del Brutto OH. Diagnostic criteria for neurocysticercosis, revisited.
Pathog Glob Health. 2012 Sep;106(5):299-304.
No Seizures (92.67%)
Examples:
-Neglected tropical diseases (NTDs) are
a diverse group of infections which tend
to affect the poorest of the poor
T. solium scolex
“large calcification consistent with old cysticercosis”
“probable old neurocysticercosis infection”
“scattered calcifications consistent with old cycsticercosis”
“punctuate calcifications consistent with neurocysticercosis”
“muliple large calcifications indicating old cysticercosis infection”
“scattered, punctuate calcifications consistent with neurocysticercosis”
“calcified lesions indicating probable neurocysticercosis”
-Plus other variations of these statements
Del Brutto OH, et al. Proposed diagnostic criteria for neurocysticercosis.
Neurology. 2001 Jul 24;57(2):177-83.
7 (4.19%) cases died while hospitalized
Doyle, et al. (2002). Completeness of Notifiable Infectious Disease Reporting in
the United States:An Analytical Literature Review. American Journal of
Epidemiology 155:866–74.
Neurocysticercosis (NCC) Died vs. Survived
Serpa, JA & White, AC. (2012). Neurocysticercosis in the United States. Pathog
Glob Health. Sep;106(5):256-60. doi: 10.1179/2047773212Y.0000000028.
Died (4.19%)
Survived (95.81%)
All probable living cases were forwarded to the local county health
department for follow up confirmation and contact testing.
Contact Information
Jennifer Garland
UCLA School of Nursing
Box 951702
Los Angeles, CA 90095-1702
[email protected]