{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:05:14Z","timestamp":1789203914586,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Ministry of Education and Research (Bundesministerium f\u00fcr Bildung und Forschung, BMBF)","doi-asserted-by":"publisher","award":["81203604"],"award-info":[{"award-number":["81203604"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Ministry of Education and Research (Bundesministerium f\u00fcr Bildung und Forschung, BMBF)","doi-asserted-by":"publisher","award":["CO 1469\/15-1"],"award-info":[{"award-number":["CO 1469\/15-1"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deutsche Forschungsgemeinschaft, DFG","award":["81203604"],"award-info":[{"award-number":["81203604"]}]},{"name":"Deutsche Forschungsgemeinschaft, DFG","award":["CO 1469\/15-1"],"award-info":[{"award-number":["CO 1469\/15-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background: Neurocysticercosis (NCC) and HIV co-infection frequently occur in sub-Saharan Africa, yet the accuracy of available serological tests for NCC in immunosuppressed patients is uncertain. Methodology: We performed a cross-sectional diagnostic study on 101 people living with HIV from two endemic districts in Tanzania. Participants provided serum for cysticercosis antigen ELISA and Western Blot IgG; any positive result prompted neuroimaging investigation with cerebral computed tomography. NCC was diagnosed according to the 2017 revised Del Brutto criteria based on cCT according to Del Brutto criteria modified to exclude serology. Sensitivity, specificity, and area under the receiver\u2013operating\u2013characteristic curve (AUC) were calculated and adjusted for CD4 count and HIV stage. Two algorithms were compared: parallel testing (\u201ceither-test-positive\u201d) and sequential screening (Ag ELISA screen, western blot IgG confirm). Results: NCC prevalence was 23%. Western Blot IgG outperformed Ag ELISA (sensitivity 57% vs. 30%; specificity 87% vs. 86%; AUC 0.73 vs. 0.57). Western blot IgG sensitivity declined to 54% when CD4 &lt; 500 cells \u00b5L\u22121, while Ag ELISA remained low. Western blot IgG positivity independently predicted NCC (adjusted odds ratio 4.1, 95% CI 1.4\u201311.9); Ag ELISA did not. When we counted a positive if either test was positive (parallel rule), sensitivity rose to 78% and NPV to 87%. When we ran Ag ELISA only if IgG was negative (sequential rule), we saved 70% of IgG strips, kept specificity at 95%, and PPV at 69%, but sensitivity fell to 39%. Conclusions: Western blot IgG is the most reliable single serological test for NCC in PLHIV. Parallel testing increased sensitivity and NPV and may suit better primary-level facilities without routine imaging. Sequential testing achieved high specificity, PPV, and conserved test kits, making it ideal for centers with limited reagents or scanner access. Tiered use of these assays can streamline NCC diagnosis in T. solium endemic, resource-limited settings.<\/jats:p>","DOI":"10.3390\/tropicalmed10090246","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:18:15Z","timestamp":1756484295000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic Accuracy of Antigen ELISA and Western Blot IgG for Neurocysticercosis in People Living with HIV\/AIDS in Tanzania"],"prefix":"10.3390","volume":"10","author":[{"given":"Yakobo","family":"Lema","sequence":"first","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich Fabien","family":"Prodjinotho","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), 80333 Munich, Germany"},{"name":"Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), 80333 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2484-617X","authenticated-orcid":false,"given":"Charles","family":"Makasi","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"},{"name":"Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marrywinnie A.","family":"Nanyaro","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1122-1760","authenticated-orcid":false,"given":"Frank","family":"Asenga","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-0736","authenticated-orcid":false,"given":"Andrew","family":"Kilale","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-2684","authenticated-orcid":false,"given":"Sayoki","family":"Mfinanga","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"R\u00fcther","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, RoMed Hospital Rosenheim, 83022 Rosenheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Sylvia","family":"Winkler","sequence":"additional","affiliation":[{"name":"Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), 80333 Munich, Germany"},{"name":"Department of Neurology, TUM University Hospital, Klinikum Rechts der Isar, Technical University Munich (TUM), 80333 Munich, Germany"},{"name":"Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0315 Oslo, Norway"},{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0136-2826","authenticated-orcid":false,"given":"Eligius F.","family":"Lyamuya","sequence":"additional","affiliation":[{"name":"Department of Microbiology & Immunology, Muhimbili University of Health & Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard J.","family":"Ngowi","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania"},{"name":"Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya P.O. Box 608, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mkunde","family":"Chachage","sequence":"additional","affiliation":[{"name":"Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya P.O. Box 608, Tanzania"},{"name":"Mbeya Medical Research Center, National Institute for Medical Research (NIMR), Mbeya P.O. Box 2410, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Prazeres da Costa","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), 80333 Munich, Germany"},{"name":"Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), 80333 Munich, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1179\/2047773212Y.0000000047","article-title":"Neurocysticercosis in Sub-Saharan Africa: A Review of Prevalence, Clinical Characteristics, Diagnosis, and Management","volume":"106","author":"Winkler","year":"2012","journal-title":"Pathog. Glob. 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