***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Taenia solium neurocysticercosis ( NCC ) has been documented as one of the major causes of epilepsy in developing countries . However , method ological limitations have hindered the evaluation of the epidemiological relationship between cysticercosis and epilepsy at the community level . METHODS We used the WHO protocol for epidemiological evaluation of neurological disorders to conduct a door-to-door survey among 2723 residents of San Pablo del Lago , an Ecuadorean rural community in which T. solium taeniasis/cysticercosis was known to be endemic . The WHO protocol was complemented by neuroimaging and immunological tests to confirm the diagnosis of this infection . RESULTS In all 31 people suffering from active epilepsy were detected ( prevalence 11.4 per 1000 , 95 % CI:7.7 - 15.4 ) ; 26 agreed to undergo a computer tomography ( CT ) examination , and 28 agreed to have blood drawn for serodiagnosis . Fourteen of the 26 ( 53.8 % ) had CT changes compatible with NCC and six of the 28 ( 21.4 % ) tested positive in the enzyme-linked immunoelectro-transfer blot ( EITB ) assay . In a seizure-free r and om sample of this population , 17 of 118 ( 144 per 1000 ) subjects examined by CT and 10 out of 96 ( 104 per 1000 ) examined by EITB had evidence of this infection . The differences between the epilepsy group and the r and om sample of the population were statistically significant ( OR = 6.93 , 95 % CI : 2.7 - 17.5 , P < 0.001 ) for CT diagnosis , but not for EITB results ( OR = 2.75 , 95 % CI : 0.8 - 7.1 , P > 0.12 , NS ) . CONCLUSIONS These findings confirm that T. solium NCC is a significant cause of epilepsy at the community level in And ean villages of Ecuador . It is important to initiate effective public health interventions to eliminate this infection , which may be responsible for at least half of the cases of reported epilepsy in Ecuador OBJECTIVE Neurologic diseases such as stroke are risk factors for new-onset epilepsy in older adults . Recent evidence suggests that psychiatric disorders independently predict epilepsy in older male veterans . Our aim was to examine the relationship between these disorders in a population -based study of older adults that also included women and minorities . METHODS We used a national 5 % r and om sample of 2005 Medicare beneficiaries including all 50 US states and Washington , DC . Beneficiaries were 65 years of age or older , with continuous Medicare Part A and Part B coverage and not in managed care plans . Epilepsy cases were identified from cl aims for physician visits , hospitalizations , and outpatient procedures . We used logistic regressions for the overall sample and stratified by gender to determine whether risk of new-onset epilepsy was associated with prior history of psychiatric ( i.e. , depression , psychosis , bipolar disorder , schizophrenia , posttraumatic stress disorder ( PTSD ) , adjustment disorder , and substance abuse/dependence ) and neurologic conditions ( i.e. , cerebrovascular disease , dementia , traumatic brain injury , brain tumor , metastatic cancer ) . RESULTS Preexisting psychiatric disorders were significantly associated with new-onset epilepsy in the study population as were the neurologic conditions evaluated . Five of the seven psychiatric disorders examined were independently associated with new-onset epilepsy ; substance abuse , psychosis , bipolar disorder , schizophrenia , and depression . Gender interaction effects were found for substance abuse/dependence and brain tumors . SIGNIFICANCE Both neurologic and psychiatric factors significantly predicted new-onset epilepsy in a population -based sample of male and female older adults . These results support earlier findings and extend the underst and ing of risk models for new-onset epilepsy in broader older adult population Summary Background The prevalence of epilepsy in sub-Saharan Africa seems to be higher than in other parts of the world , but estimates vary substantially for unknown reasons . We assessed the prevalence and risk factors of active convulsive epilepsy  across five centres in this region . Methods We did large population -based cross-sectional and case-control studies in five Health and Demographic Surveillance System centres : Kilifi , Kenya ( Dec 3 , 2007–July 31 , 2008 ) ; Agincourt , South Africa ( Aug 4 , 2008–Feb 27 , 2009 ) ; Iganga-Mayuge , Ug and a ( Feb 2 , 2009–Oct 30 , 2009 ) ; Ifakara , Tanzania ( May 4 , 2009–Dec 31 , 2009 ) ; and Kintampo , Ghana ( Aug 2 , 2010–April 29 , 2011 ) . We used a three-stage screening process to identify people with active convulsive epilepsy . Prevalence was estimated as the ratio of confirmed cases to the population screened and was adjusted for sensitivity and attrition between stages . For each case , an age-matched control individual was r and omly selected from the relevant centre 's census data base . Fieldworkers masked to the status of the person they were interviewing administered question naires to individuals with active convulsive epilepsy and control individuals to assess sociodemographic variables and historical risk factors ( perinatal events , head injuries , and diet ) . Blood sample s were taken from a r and omly selected subgroup of 300 participants with epilepsy and 300 control individuals from each centre and were screened for antibodies to Toxocara canis , Toxoplasma gondii , Onchocerca volvulus , Plasmodium falciparum , Taenia solium , and HIV . We estimated odds ratios ( ORs ) with logistic regression , adjusted for age , sex , education , employment , and marital status . Results 586 607 residents in the study areas were screened in stage one , of whom 1711 were diagnosed as having active convulsive epilepsy . Prevalence adjusted for attrition and sensitivity varied between sites : 7·8 per 1000 people ( 95 % CI 7·5–8·2 ) in Kilifi , 7·0 ( 6·2–7·4 ) in Agincourt , 10·3 ( 9·5–11·1 ) in Iganga-Mayuge , 14·8 ( 13·8–15·4 ) in Ifakara , and 10·1 ( 9·5–10·7 ) in Kintampo . The 1711 individuals with the disorder and 2032 control individuals were given question naires . In children ( aged < 18 years ) , the greatest relative increases in prevalence were associated with difficulties feeding , crying , or breathing after birth ( OR 10·23 , 95 % CI 5·85–17·88 ; p<0·0001 ) ; abnormal antenatal periods ( 2·15 , 1·53–3·02 ; p<0·0001 ) ; and head injury ( 1·97 , 1·28–3·03 ; p=0·002 ) . In adults ( aged ≥18 years ) , the disorder was significantly associated with admission to hospital with malaria or fever ( 2·28 , 1·06–4·92 ; p=0·036 ) , exposure to T canis ( 1·74 , 1·27–2·40 ; p=0·0006 ) ,  exposure to T gondii ( 1·39 , 1·05–1·84 ; p=0·021 ) , and exposure to O volvulus  ( 2·23 , 1·56–3·19 ; p<0·0001 ) . Hypertension ( 2·13 , 1·08–4·20 ; p=0·029 ) and  exposure to T solium ( 7·03 , 2·06–24·00 ; p=0·002 ) were risk factors for adult-onset disease . Interpretation The prevalence of active convulsive epilepsy varies in sub-Saharan Africa and that the variation is probably a result of differences in risk factors . Programmes to control parasitic diseases and interventions to improve antenatal and perinatal care could substantially reduce the prevalence of epilepsy in this region . Funding Wellcome Trust , University of the Witwatersr and , and South African Medical Research Council OBJECTIVE To determine age-specific incidence and cumulative incidence of epilepsy in a well-defined cohort of elderly people , and to examine how rates of epilepsy are modified by sex , race , stroke , dementia , head injury , and depression . METHODS The authors examined data from a reconstructed cohort based on 1919 community-dwelling volunteers , followed as part of a large ongoing prospect i ve aging study . RESULTS Age-specific incidence was 10.6 ( per 100,000 person-years ) between ages 45 and 59 , 25.8 between ages 60 and 74 , and 101.1 between ages 75 and 89 . Cumulative incidence was 0.15 % from age 45 to age 60 , 0.38 % to age 70 , 1.01 % to age 80 , and 1.47 % to age 90 . In addition , the difference in cumulative incidence among African-American subjects approached statistical significance ( 57.6/100,000 person-years versus 26.1 in Caucasian , p=0.10 ) , and the difference in incidence among subjects reporting a history of stroke was significantly elevated ( p=0.029 ) . Incidence of epilepsy was not statistically elevated among males , those with dementia , or individuals reporting a history of head injury or treatment for depression . Among " healthy " subjects without history of stroke , head injury , or dementia , we observed a cumulative risk of epilepsy with onset after age 60 of only 1.1 % . CONCLUSIONS The incidence of epilepsy was low in this relatively healthy cohort of elderly people , especially among subjects without known risk factors . In this study we identified African-American race as a risk factor in the elderly for epilepsy independent of stroke BACKGROUND The aim of the study was to estimate the prevalence of different types of epilepsy and their possible risk factors in the region of the Assiut Governorate/Egypt . MATERIAL AND METHODS A community based study with r and om sampling of 7 districts , involving 6498 inhabitants . Out of this sample , 578 dropped out leaving 3066 males ( 51.8 % ) and 2854 females ( 48.2 % ) . There were 3660 ( 61.8 % ) urban residents and 2260 ( 38.2 % ) from the rural community . Patients were evaluated using a screening question naire for epilepsy , and then referred to the hospital to be re-evaluated by a qualified neurologist and with electroencephalography ( EEG ) and computed tomography of the brain ( CT ) . RESULTS Seventy-five cases were diagnosed with epilepsy giving an overall the crude lifetime prevalence rate ( CPR ) for epilepsy of 12.67/1000 ( 95 % CI : 9.8 - 15.54 ) . The active prevalence rate was 9.3/1000 and the incidence rate was 1.5/1000 ( 95 % confidence interval : 0.53 - 2.51 ) . Fifty-six cases ( 75 % ) had idiopathic epilepsy ( CPR 9.5/1000 ) . Symptomatic epilepsy was recorded in 19 ( 25 % ) cases ( CPR 3.2/1000 ) . Generalized seizures were more common ( CPR 6.75/1000 ) than partial seizures ( CPR 2.5/1000 ) . The prevalence rate of partial seizures evolving to secondary generalization was 0.84/1000 while simple partial and complex partial seizures had CPR 1.4/1000 and 0.34/1000 , respectively . The CPR of mixed seizures was 0.17/1000 . Epilepsy was slightly but not significantly more common among males than females ( CPR of 14.4 and 10.9 per 1000 population , respectively ) . The CPR was higher in rural than urban population s ( 17.7/1000 , with 95 % CI 12.2 - 23.18 and 9.56/1000 , with 95 % CI : 6.39 - 12.7 , respectively ) and in the illiterate group than the literate population ( 12.02/1000 and 9.94/1000 , respectively ) . The highest prevalence rate was recorded in the early and late childhood period ( 69.78/100,000 and 43.78/100,000 , respectively ) . Prenatal insults and infection represented major causes of symptomatic epilepsy . CONCLUSIONS We found a high prevalence rate of epilepsy ( comparable with that in other Arabic and European countries ) in our community particularly among children and teenagers . Overall 
    Output:
    
A large proportion of the overall public health burden of epilepsy is attributable to preventable causes .