Prevalence of neurocysticercosis among individuals with seizure presentations in South East Asia: A systematic review and meta- analysis.

PURPOSE: Neurocysticercosis (NCC) is a major preventable cause of acquired epilepsy in endemic regions. This study aimed to estimate its pooled prevalence among individuals with seizure presentations in the South-East Asia (SEA) Region.

METHODS

A systematic review of the existing literature was conducted via strategic search across PubMed, Embase, Scopus and Google scholar from inception to October 2025. Observational studies reporting the prevalence of NCC among individuals with seizure presentations in SEA countries were eligible and neuroimaging confirmed cases were included. Following full-text screening, pooled prevalence estimates were calculated using random effects meta-analysis.

RESULTS

Fifty studies comprising 10,743 individuals were included and the pooled prevalence of NCC across all seizure presentations in SEA was 22 % (95 % CI: 19 %-25 %). Community-based studies demonstrated a higher prevalence of 30 % (95 % CI: 22 %-38 %), compared with hospital-based studies, estimated at 20 % (95 % CI: 16 %-24 %). Country- wise prevalence was highest in India at 24 % (95 % CI: 19 %-28 %) and Nepal at 21 % (95 % CI: 16 %-28 %), followed by Bhutan at 13 % (95 % CI: 9 %-16 %). Substantial heterogeneity was observed across studies (I² > 90 %), which should be considered when interpreting pooled estimates. Publication bias was detected; however, sensitivity analyses confirmed robustness of pooled estimates.

CONCLUSION

Approximately one in five individuals with seizure presentations in the SEA region has NCC, a prevalence comparable to that reported in other endemic regions such as Sub-Saharan Africa. Further studies with broader regional coverage are needed to better define the burden and guide control strategies.