Integrating neurological expertise into One Health strategies for pediatric neurocysticercosis-associated epilepsy control in Sub-Saharan Africa: a narrative review

Neurocysticercosis (NCC), caused by the larval stage of Taenia solium, is a leading preventable cause of epilepsy in children, particularly in Sub-Saharan Africa (SSA), where inadequate sanitation practices and limited veterinary control strategies persist. A missing link in the One Health response to NCC has been the absence of communication between neurospecialists and the other partners in control strategies. This narrative review explores how integrating neurological expertise into One Health strategies can enhance the prevention and control of NCC-associated epilepsy in children across the region. We reviewed literature from PubMed/MEDLINE, Scopus, Google Scholar, Embase, Web of Science, Global Health, CINAHL, PsycINFO, and the African Index Medicus, including peer-reviewed articles and organizational reports published between 2013 and March 2025. Out of 1,509 records screened, 28 studies met the inclusion criteria, focusing on neuroparasitosis-associated epilepsy in children across SSA. These included research on disease burden and care challenges (n = 10), pathogenesis (n = 8), One Health control strategies (n = 4), and implementation barriers and solutions (n = 6). NCC remains a major contributor to pediatric epilepsy and associated disability in SSA. A One Health approach informed by direct input from neuro-specialists and better recording of infectious causes of epilepsy can assist teams to implement key strategies, including community education, improved sanitation, food safety measures, pig vaccination, and mass drug administration. Strengthening intersectoral collaboration and healthcare access is critical to reducing NCC burden and improving neurological outcomes for affected children.