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Potential eradicability of taenisis and cysticercosis
Abstract
Taeniasis and cysticercosis are, respectively, infections with the adult and larval stages of tapeworm parasites belonging to the genus Taenia. The World Health Organization (WHO) estimates that Taenia infections afflict approximately 50 million people annually and kill 50,000. One may assume all of these deaths to be the result of T. solium neurocysticercosis. Taenia infections also lead to the death of many cattle and swine, and resulting substantial economic losses. Swine and cattle serve as the intermediate hosts for the larval stage tapeworm parasites, while humans are the obligatory final stage hosts. Humans become infected with Taenia by ingesting raw or inadequately cooked meat of infected intermediate hosts. Mature tapeworms then produce eggs in the human hosts which are excreted and eventually consumed by animal hosts. The prevalence of Taenia is highest in the rural areas of Latin American, Asia, and Africa, but the parasites are vulnerable to eradication. More success has been had in thwarting the spread of T. solium than T. saginata. Sections briefly discuss the biology and transmission of Taenia; the medical and veterinary impacts; prevalence and distribution; the case for eradication; current strategies; remaining barriers; news tools and knowledge; and research and planning needs. Current strategies include long- and short-term interventions developed by the WHO and the Pan American Health Organization based upon the mass treatment of taeniasis in existing transmission foci.
... The meta-analysis sub-grouped by region showed a relatively higher pooled prevalence estimate for the Southern region 22% (95% CI: [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] compared to 13% (95% CI: [11][12][13][14][15] in the Eastern region. The highest country-based pooled prevalence was obtained from South Africa (33%, 95% CI: and Zambia (22%, 95% CI: [16][17][18][19][20][21][22][23][24][25][26][27][28][29], whereas the lowest pooled prevalence was identified in Madagascar (5%, 95% CI: [4][5] and Rwanda (7%, 95% CI: [6][7][8]. The lack of latrine, traditional pig husbandry practices, unprotected water sources, and increase in age were identified as significant risk factors for the occurrence of porcine cysticercosis in the pooled studies. ...
... In humans, accidental ingestion of the tapeworm eggs results in migration and development of the cysticerci in different tissues. The establishment of cysticerci in the brain leads to the development of neurocysticercosis (NCC) (5)(6)(7)(8), which is a leading cause of acquired epilepsy in the endemic regions (2). The T. solium is ranked among the most important foodborne parasites globally (9). ...
... Burundi, Uganda, and Mozambique reported a 15% pooled prevalence (within 95% CI range of 6-26%), followed by Kenya at 13% (95% CI: 7-21) and Tanzania at 12% (95% CI: 9-16). Madagascar (5%, 95% CI: [4][5] and Rwanda (7%, 95% CI: 6-8) reported the lowest pooled prevalence (Supplementary Material 4). The high I 2 values (> 97%) for each of the subgroup analyses indicate a high degree of heterogeneity between studies applying a similar methodology, within and among countries, and sub-regions. ...
Taenia solium cysticercosis is the most common cause of acquired epilepsy in pig-raising and pork-consuming parts of Africa, Latin America, and Asia. This review aimed to systematically compile and synthesize data on the epidemiology of porcine cysticercosis in the Eastern and Southern Africa (ESA) region. Comprehensive searching strategies were employed to retrieve the studies published or reported between January 1,1997 and March 1, 2021, from Pub Med, Hinari, and Google Scholar databases and search platforms. The identified studies that met the inclusion criteria were then appraised for methodological quality. Finally, 44 studies obtained from nine countries were selected and included in this review. Relevant data were extracted using standardized templates for qualitative synthesis and meta-analysis. The overall pooled prevalence estimate of porcine cysticercosis in the ESA region was 17% (95% CI: 14–20%). The prevalence level between and within countries showed high variability. The pooled estimate showed high heterogeneity among the reports (the inverse variance index value (I²) of 98.99%, p < 0.05). The meta-analysis sub-grouped by the type of diagnostic test showed the pooled prevalence estimate of 27% (95% CI: 9–50) by carcass dissection; 23% (95% CI: 14–33) by Antibody-based immunodiagnostic techniques; 23% (95% CI: 18-29) by antigen detecting (Ag)-ELISA, 12% (95% CI: 7–18) by meat inspection, and 9% (95% CI: 7-11) by lingual examination. The meta-analysis sub-grouped by region showed a relatively higher pooled prevalence estimate for the Southern region 22% (95% CI: 15–30) compared to 13% (95% CI: 11–15) in the Eastern region. The highest country-based pooled prevalence was obtained from South Africa (33%, 95% CI: 20–48) and Zambia (22%, 95% CI: 16–29), whereas the lowest pooled prevalence was identified in Madagascar (5%, 95% CI: 4-5) and Rwanda (7%, 95% CI: 6–8). The lack of latrine, traditional pig husbandry practices, unprotected water sources, and increase in age were identified as significant risk factors for the occurrence of porcine cysticercosis in the pooled studies. The findings of this review will provide context-specific input to prioritize the possible intervention programs for T. solium control in the ESA region. More sensitive and specific test-based prevalence estimates, detailed risk factor investigations, and financial losses analysis are needed to establish feasible control strategies.
Systematic Review Registration
http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021238931.
... Clinical features: Clinical manifestation of cysticercosis often develop at the time of cyst degeneration although the trigger is unknown [31]. Myocardial inflammatory response varies resulting in granuloma formation and fibrosis, which may consequently lead to arrhythmias and conduction abnormalities spontaneously or during treatment [32][33][34][35]. Cardiac involvement in cysticercosis was believed to be rare but autopsy studies reveal a prevalence of 20% to 25% in patients with concomitant diagnosed neurocysticercosis [33][34][35]. ...
... Myocardial inflammatory response varies resulting in granuloma formation and fibrosis, which may consequently lead to arrhythmias and conduction abnormalities spontaneously or during treatment [32][33][34][35]. Cardiac involvement in cysticercosis was believed to be rare but autopsy studies reveal a prevalence of 20% to 25% in patients with concomitant diagnosed neurocysticercosis [33][34][35]. Cardiac cysticercosis is often asymptomatic and discovered during surgery or post-mortem. Cysticerci are usually multiple and randomly distributed in cardiac tissues including sub-pericardium, sub-endocardium and myocardium. ...
... Patients with extra-neural cysticercosis should be evaluated for possible neural involvement using brain imaging. The role of anti-helminthic treatment (albendazole and praziquantel) or surgery in cardiac cysticercosis has not been directly evaluated; however, they may be effective given their efficacy on other sites [33][34][35]. Adjunctive corticosteroid therapy is sometimes administered during neurocysticercosis [44,45]. The potential benefit of reducing treatment related to inflammation in cardiac cysticercosis has not been defined but theoretically plausible [3]. ...
Neglected tropical diseases form an important component of the burden of cardiac disease in resource-constrained countries. Some diseases resulting from infection by helminthic parasites such as endomyocardial fibrosis, schistosomiasis and hookworm infections are part of the neglected tropical diseases. The neglect has contributed to the under-appreciation and under-research of helminthic cardiac diseases. In contrast, infections by helminthic parasites are prevalent in resource-constrained countries and are among the leading aetiology of cardiac diseases including cardiomyopathy often associated with an ominous prognosis. Infection by a wide variety of helminth parasites, more commonly Trichinella, Taenia solium, Echinococcus, Schistosoma, Toxocara and Ascaris, and less commonly, Heterophyes, Paragonimus, Strongyloides and Dirofilaria Immitis can result in myocardial injury ultimately progressing to cardiomyopathy. However, data on epidemiology, presentation, diagnosis and management of helminthic cardiomyopathy are few and disparate effectively undermining exact understanding. Moreover, expert guidelines specific to the diagnosis and management of helminthic cardiac diseases are also conspicuously lacking. Current clinical practices on management of helminthic cardiomyopathy appear to depend on health centre experience. This paper aims to provide a broadened view of the clinical status of helminthic cardiomyopathy by reviewing published evidence with a particular focus on the causative helminthic parasites, pathophysiology, diagnosis and clinical management.
... Human cysticercosis is one of a small number of diseases that have been formally recognised as being capable of being eradicated [2]. Improvements in sanitation and pig rearing practices in developed countries have led to a cessation in T. solium transmission, however attempts to institute cysticercosis control measures in poor communities have had limited success [3]. ...
... Summary of pig vaccinations and oxfendazole treatments. Number of pigs receiving their second and/or subsequent vaccination at the second, third and final intervention.2 Number of animals that fit the eligibility criteria3 Not all animals could be found or caught at the time of the treatment https://doi.org/10.1371/journal.pntd.0006838.t001Table ...
Taenia solium is a zoonotic cestode parasite which causes human neurocysticercosis. Pigs transmit the parasite by acting as the intermediate host. An intervention was implemented to control transmission of T. solium by pigs in Dalit communities of Banke District, Nepal. Every 3 months, pigs were vaccinated with the TSOL18 recombinant vaccine (Cysvax, IIL, India)) and, at the same time, given an oral treatment with 30mg/kg oxfendazole (Paranthic 10% MCI, Morocco). The prevalence of porcine cysticercosis was determined in both an intervention area as well as a similar no intervention control area, among randomly selected, slaughter-age pigs. Post mortem assessments were undertaken both at the start and at the end of the intervention. Participants conducting the post mortem assessments were blinded as to the source of the animals being assessed. At the start of the intervention the prevalence of porcine cysticercosis was 23.6% and 34.5% in the control and intervention areas, respectively. Following the intervention, the prevalence of cysticercosis in pigs from the control area was 16.7% (no significant change), whereas no infection was detected after complete slicing of all muscle tissue and brain in animals from the intervention area (P = 0.004). These findings are discussed in relation to the feasibility and sustainability of T. solium control. The 3-monthly vaccination and drug treatment intervention in pigs used here is suggested as an effective and practical method for reducing T. solium transmission by pigs. The results suggest that applying the intervention over a period of years may ultimately reduce the number of tapeworm carriers and thereby the incidence of NCC.
... In Southeast Asia, T. solium, T. saginata and T. asiatica causes taeniasis (intestinal tapeworm infection) in humans while T. solium, T. asciatica and T. hydatigena causes cysticercosis in pigs (Conlan et al., 2011). Despite having been declared a potentially eradicable disease in 1992 (Schantz et al., 1993), it remains highly prevalent and a major public health and economic concern in many developing countries in Asia, Africa, and South America (Sarti et al., 1992). An important example of a One Health disease, taeniasis/ cysticercosis transmission is dependent on human and animal hosts as well as environmental contamination and socioeconomic factors such as livestock husbandry practices, socioeconomic status, housing conditions, hygiene and eating habits. ...
... The target pig sample sizes were guided by the PigFluCam project aims, based on what was deemed necessary to estimate swine influenza seroprevalence with sufficient precision. (Assuming a true influenza seroprevalence of~15% in pigs (Schantz et al., 1993), and allowing for a moderate design effect of 1.5 due to clustering at herd (household/farm/ slaughterhouse)-level, we would be able to estimate seroprevalence within each category with precision of between ± 6.1% and ± 8.6% at the 95% confidence interval.) Due to logistical challenges and drop-out of some participants between recruitment and pig sampling, the target pig sample sizes could not be reached for all categories, with a total of 620 pig sera eventually being tested for cysticercosis (see Results). ...
Background: Taeniasis/cysticercosis, caused by the pork tapeworm Taenia solium, represents an important public health and economic burden in endemic countries. However, there is a paucity of data on infection among pigs in many parts of Southeast Asia, particularly Cambodia. We aimed to estimate seroprevalence of porcine cysticercosis, and investigate husbandary practices and knowledge of the disease among livestock workers, across different pig sector units in south-central Cambodia.
Methods: A cross sectional survey was conducted among pig smallholders, commercial farms, slaughterhouses and traders/middlemen from south-central Cambodia, selected through multistage sampling in proportion to local pig populations sizes. Questionnaires were administered to 163 pig workers to obtain data pig production, trading and slaughtering practices. Sera from 620 pigs were tested for Taenia antigens using a commercial ELISA-based test. Associations between seroprevalence and pig husbandry practices were assessed using generalised linear mixed models, adjusting for random-effects at herd-level.
Results: Of 620 pigs sampled, 29 (4.7%) tested positive for Taenia antigens. Seropositivity was associated with type of pig sector unit (P = 0.008), with the highest seroprevalence among pigs sampled from traders/middlemen (16.7%; 95% CI: 4.4%–37.8%), smallholders (7.6%; 95% CI: 3.8%–14.1%) and slaughterhouses (4.1%; 95% CI: 2.0%–7.5%), while none of the pigs sampled from small/medium or large commercial farms tested positive. Although the vast majority of pigs were penned, practices that might facilitate human-to-pig transmission, such as use of household waste and surface water sources to feed pigs, were prevalent among smallholders. However these were not found to be significantly associated with infection. Of 163 interviewed pig workers, 115 (70.5%) were aware of porcine cysticercosis, and 78 (47.8%) also knew it could affect humans. Twenty-six (16.0%) reported having noticed lesions typical of cysticercosis in their pigs.
Conclusions: Despite most pigs being kept confined in pens rather than raised in free-roaming systems, porcine cysticercosis appears to be endemic in south-central Cambodia and is associated with smallholder production. Further investigation is needed to identify which Taenia species are causing infections among pigs, and how seroprevalence and zoonotic risk may vary across the country, to understand the risks to public health and assess where interventions might be needed.
... Furthermore, as they represent a significant population of family farming that provides food for the Brazilian population, the risk of the disease can affect not only the settled population but also the population that has access to food. TC represents a threat to the health of settled families and is still a neglected zoonosis, as it has long been recognized as potentially eradicable due to the availability of diagnoses and treatments, a life cycle that involves domestic animals and for not having a vector invertebrate in its biological cycle (Schantz et al. 1993). ...
Thousands of families live in agrarian reform rural settlements, these existing in Brazil since the 1980s. Factors such as agglomerations of families living in the same environment and the production of domestic animals can promote the transmission and maintenance of zoonosis in these areas. The epidemiology and geographic distribution of zoonotic diseases in settlement communities need to be highlighted. The present study aimed to investigate the prevalence, risk factors and spatial distribution of the teniasis-cysticercosis complex in the agrarian reform rural settlements in the state of Minas Gerais. A total of 497 family farming properties, distributed in 52 settlements, were randomly selected and sampled. Biological samples of humans, cattle and pigs were collected and processed. Survey questionnaires were applied in each family farming property to collect data on animal production as well as sanitary, hygienic and social conditions of each family. Human fecal samples were analyzed for detection of teniasis infection, while animal blood samples were collected and subjected to serological testing to detect the cysticercosis infection. A total of three (0.35%) positive cases of human teniasis were identified, 64 (4.2%) of bovine cysticercosis and 17 (3.3%) of swine cysticercosis. Prevalence per family farming unit was 0.6% (3/497) of taeniasis through fecal test, 5.8% (17/294) for swine cysticercosis and 11.1% (52/469) for bovine cysticercosis. The spatial profile for human teniasis and swine cysticercosis were clustered in two different regions, while bovine cysticercosis showed a dispersed geographical distribution. Two risk factors were associated with the occurrence of bovine cysticercosis: stream as source of water (p=0.009) and the environment as destination of sewage (p=0.031), while burning of garbage was shown to be a significant protective factor (p<0.001). Risk factor for swine cysticercosis was associated with the presence of free range pigs (p=0.008) and the environment as the destination of sewage (p≤0.024). The low number of positive human taeniasis did not allow statistical analysis. These zoonotic diseases represent a significant risk to public health because of their occurrence in livestock which are produced for both beef consumption and for commercialization. Significant endemic areas in the state of Minas Gerais have been determined in this study, and these discoverments suggest the importance of further investment in public health education about teniasis-cysticercosis transmission, the improvement of sanitary facilities for the settlements such as source and treatment of water and adequate destination of sewage. Integrated actions between the human, animal and environmental health sectors, at local and regional levels are needed, aiming at the adoption of effective public policies for the control and eradication of the teniasis-cysticercosis complex where the disease occurs.
... When it comes to cysticercosis and taeniasis, approximately 50 million people are suffering from neurocysticercosis due to T. solium worldwide, with more than 50,000 deaths per year [2,16,17]. In Vietnam, human taeniasis has been reported in 50 of 63 provinces, while cysticercosis has been reported in 55. ...
Trichinellosis and cysticercosis remain challenges to human health and animal productivity worldwide, especially in developing countries. While information on the occurrence of both diseases is infrequent, they are endemic in parts of Vietnam and mainly related to indigenous pigs kept by ethnic minorities. This study aimed to determine the seroprevalence and risk factors of both diseases in indigenous pigs and explore the perception and awareness of both human and pig trichinellosis and cysticercosis of pig farmers. A total of 352 pig sera samples from 131 holdings were collected and analyzed using ELISA antibody tests in six communes in the Da Bac districts of Hoa Binh province, Vietnam. A survey was conducted with representatives from these households to understand the knowledge and perspective on food-borne parasitic diseases. Overall, the seroprevalence of trichinellosis and T. solium cysticercosis was 13.6% (95% CI 10.2–17.7) and 1.7% (95% CI 0.6–3.7), respectively. The seroprevalence of trichinellosis was significantly higher in female and older pigs. Risk perception and knowledge of interviewed people on both human and pig trichinellosis and cysticercosis of pig farmers was poor. Risky practices, including free roaming of pigs and eating undercooked or fermented pork, were observed. Educational and awareness campaigns aligned with further research on feasible practice changes are critical to addressing these issues.
... Cysticercosis is a neglected tropical disease (NTD) that exacts a substantial health and economic burden in low-income countries. The global burden of cysticercosis includes approximately 5 million people with neurocysticercosis (NCC) or epilepsy due to NCC [1] and hundreds of millions of dollars in annual livestock losses from discarded pork [2]. ...
Background
The pork tapeworm ( Taenia solium) is a parasitic helminth that imposes a major health and economic burden on poor rural populations around the world. As recognized by the World Health Organization, a key barrier for achieving control of T . solium is the lack of an accurate and validated simulation model with which to study transmission and evaluate available control and elimination strategies. CystiAgent is a spatially-explicit agent based model for T . solium that is unique among T . solium models in its ability to represent key spatial and environmental features of transmission and simulate spatially targeted interventions, such as ring strategy.
Methods/Principal findings
We validated CystiAgent against results from the Ring Strategy Trial (RST)–a large cluster-randomized trial conducted in northern Peru that evaluated six unique interventions for T . solium control in 23 villages. For the validation, each intervention strategy was replicated in CystiAgent, and the simulated prevalences of human taeniasis, porcine cysticercosis, and porcine seroincidence were compared against prevalence estimates from the trial. Results showed that CystiAgent produced declines in transmission in response to each of the six intervention strategies, but overestimated the effect of interventions in the majority of villages; simulated prevalences for human taenasis and porcine cysticercosis at the end of the trial were a median of 0.53 and 5.0 percentages points less than prevalence observed at the end of the trial, respectively.
Conclusions/Significance
The validation of CystiAgent represented an important step towards developing an accurate and reliable T . solium transmission model that can be deployed to fill critical gaps in our understanding of T . solium transmission and control. To improve model accuracy, future versions would benefit from improved data on pig immunity and resistance, field effectiveness of anti-helminthic treatment, and factors driving spatial clustering of T . solium infections including dispersion and contact with T . solium eggs in the environment.
... Cysticercus cellulosae, the larval stage of T. solium, resides in the central nervous system, skeletal muscle, and other organs of both pigs and humans [1,2], resulting in the high prevalence of cysticercosis worldwide. As a neglected tropical disease prioritized by the World Health Organization, serious human disease burden [3,4] and annual economic losses in livestock are caused by infection with this pork tapeworm. ...
Background
The life cycle of Taenia solium is characterized by different stages of development, requiring various kinds of hosts that can appropriately harbor the eggs (proglottids), the oncospheres, the larvae and the adults. Similar to other metazoan pathogens, T. solium undergoes transcriptional and developmental regulation via epigenetics during its complex lifecycle and host interactions.
Result
In the present study, we integrated whole-genome bisulfite sequencing and RNA-seq technologies to characterize the genome-wide DNA methylation and its effect on transcription of Cysticercus cellulosae of T. solium . We confirm that the T. solium genome in the cysticercus stage is epigenetically modified by DNA methylation in a pattern similar to that of other invertebrate genomes, i.e., sparsely or moderately methylated. We also observed an enrichment of non-CpG methylation in defined genetic elements of the T. solium genome. Furthermore, an integrative analysis of both the transcriptome and the DNA methylome indicated a strong correlation between these two datasets, suggesting that gene expression might be tightly regulated by DNA methylation. Importantly, our data suggested that DNA methylation might play an important role in repressing key parasitism-related genes, including genes encoding excretion-secretion proteins, thereby raising the possibility of targeting DNA methylation processes as a useful strategy in therapeutics of cysticercosis.
... Human taeniasis is caused by ingesting undercooked pork carrying the tapeworm Taenia solium. It is a significant zoonotic disease because it may cause cysticercosis in the tapeworm carriers, family members, and other close contacts [26]. The World Health Organization (WHO) recognises taeniasis as one of 17 neglected tropical diseases that affect poor people worldwide [7,32]. ...
Taeniasis remains a prevalent public health problem in Thailand. National helminthiasis surveys report only the incidence of Taenia spp. eggs. The ability to differentiate Taenia species using morphological and molecular techniques is vital for epidemiological surveys. This study detected taeniasis carriers and other helminthic infections by Kato’s thick smear technique and identified the Taenia species by multiplex PCR. The study subjects were the ethnic Karen people in Tha Song Yang District, Tak Province, Thailand, bordering Myanmar. In total, 983 faecal samples from villagers were examined for helminthiases. Interview-based questionnaires were used to gather information on possible risk factors for infection. The prevalence of helminth infections was 42.7% (420/983), including single (37.3%, 367/983) and mixed infections (5.4%, 53/983). The most common infection (19.23%, 189/983) was Ascaris lumbricoides , whereas taeniasis carriers comprised 2.8% (28/983). Multiplex PCR of Cox1 was used for species identification of Taenia tapeworms, eggs, or both in 22 taeniasis carriers. Most of the parasites (20 cases) were Taenia solium , with two cases of Taenia saginata . Taenia saginata asiatica was not found in the villagers examined. The analysis of 314 completed questionnaires showed that a statistically significant ( p < 0.05) risk of taeniasis was correlated with being male, a history of being allowed to forage during childhood, a history of seeing tapeworm proglottids, and a history of raw or undercooked pork consumption. Health education programmes must seek to reduce and prevent reinfection in these communities.
... Cases of cysticercosis are also found in non-endemic areas due to global travel [4]. In 1992, the International Task Force for Disease Eradication declared that human infection with the adult (taeniasis) and larval (cysticercosis) forms of this tapeworm are potentially eradicable [5]. ...
Information on age-based Taenia solium taeniasis prevalence is crucial for control of cysticercosis. T. solium taeniasis prevalence was determined for a village in Liangshan Prefecture, Sichuan Province, China that was co-endemic for T. solium, Taenia saginata asiatica, and Taenia saginata. Individuals who were Taenia egg-positive by stool microscopy and/or expelled tapeworms or proglottids post-treatment were diagnosed as having taeniasis. Infecting species was identified via multiplex PCR on tapeworm specimens or coproPCR followed by sequencing. In addition, initial stool samples from 10 children with taeniasis suspected of having spontaneous expulsion of tapeworms within the period between diagnosis and treatment were subject to species confirmation via coproPCR and sequencing. Of the 389 study subjects, 194 (49.9%) were diagnosed with taeniasis. Children (< 16 years of age) had a higher T. solium taeniasis prevalence (8.8%) than older individuals (2.5%) (P = 0.0127). Molecular analysis of initial stool samples from 7 of 10 children suspected of spontaneously passing tapeworms indicated 6 infections due to T. solium and 1 infection due to T. saginata. This study found that young children had a higher T. solium taeniasis prevalence than older individuals, providing additional support for the belief that adult T. solium likely has a relatively short lifespan compared to other Taenia species with human definitive hosts.
... T. solium cysticercosis affects human and animal health, while T. asiatica affects the latter. Bovine and porcine cysticercosis represent economic burdens to farmers in affected countries, due to the need for inspection, detection and condemnation of infected carcasses, affecting animal husbandry and food-safety (Jansen et al., 2018;Rossi et al., 2020;Schantz et al., 1993). ...
Zoonotic taeniasis caused by the adult stage of Taenia solium, Taenia saginata or Taenia asiatica are considered neglected tropical diseases by the World Health Organization. The life cycle of these 3 metazoan species is very similar and includes an intermediate host: pigs in the case of T. solium and T. asiatica, and cattle in the case of T. saginata. By eating meat (pork/T. solium, T. asiatica; beef/T. saginata) containing live cysticerci, humans develop taeniasis, which is practically asymptomatic but is the main risk factor for intermediate hosts to become infected. T. saginata causes bovine cysticercosis, while T. solium and T. asiatica cause swine cysticercosis, of veterinary and economic importance. T. solium cysticerci cause neurological disease in humans: neurocysticercosis. Cysticerci develop after ingesting microscopic eggs released from a human tapeworm carrier. Here we describe the life stages of the parasites, diagnosis, pathogenesis, symptomatology of neurocysticercosis, and prevention and control measures. Highlighting the need to validate diagnostic tools, treatments and vaccination in endemic areas, with the challenge of addressing the most vulnerable populations that lack resources. If people understand the transmission route, avoid eating uncooked or insufficiently cooked meat and have adequate hygienic habits, the life cycle of the 3 zoonotic Taenia species may be interrupted. In addition, we describe the growing field of immune response and immunomodulation elicited by the parasites, which may provide essential tools for diagnosis, treatment, control of taeniasis/cysticercosis, as well as for identification of parasite-derived immunomodulators that could aid in the treatment of emerging inflammatory diseases worldwide.
... Despite being declared eradicable by the International Task Force on Disease Eradication (ITFDE) in 1992 [12,13], T. solium remained neglected and a major economic and public health concern in endemic areas. In 2010, the World Health Organization (WHO) included T. solium infections in a list of Neglected Tropical Diseases (NTDs) as a way of increasing advocacy for controlling the disease [14]. ...
A field trial was conducted in Tanzania to determine the effectiveness of TSOL18 vaccine used concurrently with oxfendazole (OFZ), and of OFZ alone, on T. solium cysticercosis determined by organ and half carcase dissection of slaughter age pigs. This study followed a quasi-experimental group design. Suitable trial sites were randomly allocated to either treatment group T1 (OFZ treatment alone [30mg/kg, Paranthic 10%]) or T2 (TSOL18 [1ml, Cysvax] plus OFZ). Three 4-monthly treatments were administered to eligible pigs. A random selection of pigs were necropsied at baseline and at endline, 2-3.5 months after the final treatment. Additionally, untreated pigs from T1 and T2 areas were necropsied at end-line to provide contemporaneous comparisons with T1 and T2 pigs. Baseline prevalence of viable T. solium cysticerci for T1 was 25.5% (Exact 95% CI: 13.9, 40.3; n = 12/47), and for T2 was 12.0% (CI: 6.4, 20.0; n = 12/100). At endline, prevalence was 2.8% for T1 (CI: 0.1, 14.5, n = 1/36) and 0% for T2 (CI: 0, 4.7, n = 0/77). Among untreated pigs, three had viable cysticerci, one from T1 area (12.5%, CI: 0.3, 52.7; n = 1/8) and two from T2 area (5.7%, CI: 0.7, 19.2, n = 2/35). Fisher's exact test showed significant changes in prevalence from base-line to endline in both groups (T1: p = 0.005, T2: p = 0.001). Firth's penalized Maximum Likelihood method suggested the changes were not significant relative to their controls (T1: p = 0.245, T2: p = 0.076). These findings showed a significant reduction in the prevalence of viable cysticerci from baseline to endline after both interventions. However, the changes could not be definitively attributed to the interventions due, in part, to small numbers of control pigs. Concurrent administration of the TSOL18 and OFZ cleared infection among assessed pigs whereas infection remained after treatment with OFZ only. Further studies including PLOS NEGLECTED TROPICAL DISEASES PLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd. larger sample sizes would be required for more definitive conclusions. A One Health approach is recommended for rapid and sustainable impact. Author summary The pork tapeworm T. solium affects the health and income of poor people in endemic areas. A pig vaccine-TSOL18, and a drug-oxfendazole (OFZ) present options for its control. In this study we assessed the effectiveness of the two tools against the parasite in pigs. We provided one group of pigs (T1) with a concurrent administration of TSOL18 and OFZ, and another group (T2) with OFZ only, in three rounds at 4 months intervals. We compared infection prevalence before and after the interventions by detection of cys-ticerci through carcase dissections. In addition, untreated pigs from the T1 and T2 areas were also sacrificed to serve as controls. We found a significant reduction in prevalence within the groups after the interventions. However, the reductions were not significant when compared with the reductions in the control groups, hence could not be definitively attributed to the interventions. Further, concurrent administration of TSOL18 and OFZ cleared infection among assessed pigs whereas OFZ alone did not clear the infection. Further studies would be required to make more definitive conclusions. We advocate for a One Health approach for a more rapid and sustainable impact.
... Cysticercus cellulosae, the larval stage of T. solium, resides in the central nervous system, skeletal muscle, and other organs of both pigs and humans (Schantz et al., 1993), resulting in the high prevalence of cysticercosis worldwide. As a neglected tropical disease prioritized by the World Health Organization, serious human disease burden (Sciutto et al., 2000) and annual economic losses in livestock are caused by infection with this pork tapeworm. ...
Background: The life cycle of Taenia solium is characterized by different stages of development, requiring various kinds of hosts that can appropriately harbor the eggs (proglottids), the oncospheres, the larvae and the adults. Similar to other metazoan pathogens, T. solium undergoes transcriptional and developmental regulation via epigenetics during its complex lifecycle and host interactions.
Result: In the present study, we integrated whole-genome bisulfite sequencing and RNA-seq technologies to characterize the genome-wide DNA methylation and its effect on transcription of Cysticercus cellulosae of T. solium. We confirm that the T. solium genome in the cysticercus stage is epigenetically modified by DNA methylation in a pattern similar to that of other invertebrate genomes, i.e., sparsely or moderately methylated. We also observed an enrichment of non-CpG methylation in defined genetic elements of the T. solium genome. Furthermore, an integrative analysis of both the transcriptome and the DNA methylome indicated a strong correlation between these two datasets, suggesting that gene expression might be tightly regulated by DNA methylation. Importantly, our data suggested that DNA methylation might play an important role in repressing key parasitism-related genes, including genes encoding excretion-secretion proteins, thereby raising the possibility of targeting DNA methylation processes as a useful strategy in therapeutics of cysticercosis.
... In endemic regions, up to one third of seizure disorders are attributed to neurocysticercosis (NCC), a severe neurological infection caused by the parasite [1,2], and lost income from infected pork lead to financial losses for pig farmers [3]. Humans acquire the adult-stage intestinal tapeworm (human taeniasis) by consuming raw or undercooked pork that is infected with intermediate-stage larval cysts, while pigs acquire this cyst infection (porcine cysticercosis) through contact with eggs present in the feces of infected humans. ...
Background:
The pork tapeworm, Taenia solium, is a serious public health problem in rural low-resource areas of Latin America, Africa and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts.
Methods:
We developed a spatially-explicit agent-based model (ABM) for T. solium ("CystiAgent") that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters.
Results:
LHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of "tuning" parameters defining the probabilities of infection in humans and pigs given exposure to T. solium.
Conclusions:
CystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium.
... The pork tapeworm, Taenia solium, remains a major public health concern in poor rural areas of the world. In endemic regions, up to one third of seizure disorders are attributed to neurocysticercosis (NCC), a severe neurological infection caused by the parasite [1,2], and lost income from infected pork lead to nancial losses for pig farmers [3]. Humans acquire the adult-stage intestinal tapeworm (human taeniasis) by consuming raw or undercooked pork that is infected with intermediate-stage larval cysts, while pigs acquire this cyst infection (porcine cysticercosis) through contact with eggs present in the feces of infected humans. ...
Background The pork tapeworm (Taenia solium) is a serious public health problem in rural low-resource areas of Latin America, Africa, and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts.
Methods We developed a spatially-explicit agent-based model (ABM) for T. solium (“CystiAgent”) that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling–partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters.
Results LHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of “tuning” parameters defining the probabilities of infection in humans and pigs given exposure to T. solium.
Conclusions CystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium.
... In poor localities, however, major changes in living conditions are unlikely to occur in the short term and active interventions are required to control or eliminate Taenia solium. Taeniasis/cysticercosis was recognized as potentially eradicable long ago (236), on the basis of availability of diagnostics and treatments, a life cycle that involves a domestic animal, and the lack of an invertebrate vector. Early efforts using mass human deworm-ing with praziquantel in Ecuador (237) were followed by mass chemotherapy experiences in other Latin American countries (68,(238)(239)(240)(241) and later in Asia and Africa (242)(243)(244). ...
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
... The pork tapeworm, Taenia solium, remains a major public health concern in poor rural areas of the 3 world. In endemic regions, up to one third of seizure disorders are attributed to neurocysticercosis (NCC), a severe neurological infection caused by the parasite [1,2], and lost income from infected pork lead to financial losses for pig farmers [3]. Humans acquire the adult-stage intestinal tapeworm (human taeniasis) by consuming raw or undercooked pork that is infected with intermediate-stage larval cysts, while pigs acquire this cyst infection (porcine cysticercosis) through contact with eggs present in the feces of infected humans. ...
Background The pork tapeworm ( Taenia solium ) is a serious public health problem in rural low-resource areas of Latin America, Africa, and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts.
Methods We developed a spatially-explicit agent-based model (ABM) for T. solium (“CystiAgent”) that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling–partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters.
Results LHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of “tuning” parameters defining the probabilities of infection in humans and pigs given exposure to T. solium.
Conclusions CystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium .
... The pork tapeworm, Taenia solium, remains a major public health concern in poor rural areas of the world. In endemic regions, up to one third of seizure disorders are attributed to neurocysticercosis (NCC), a severe neurological infection caused by the parasite [1,2], and lost income from infected pork lead to financial losses for pig farmers [3]. Humans acquire the adult-stage intestinal tapeworm (human taeniasis) by consuming raw or undercooked pork that is infected with intermediate-stage larval cysts, while pigs acquire this cyst infection (porcine cysticercosis) through contact with eggs present in the feces of infected humans. ...
Background
The pork tapeworm (Taenia solium) is a serious public health problem in rural low-resource areas of Latin America, Africa, and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts.
Methods
We developed a spatially-explicit agent-based model (ABM) for T. solium (“CystiAgent”) that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling–partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters.
Results
LHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of “tuning” parameters defining the probabilities of infection in humans and pigs given exposure to T. solium.
Conclusions
CystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium.
... This disease is associated to 50 000 deaths every year, but these figures need to be updated. (4)(5)(6)(7)(8) The intermediate hosts of the T/C complex are cattle in the case of T. saginata, and pigs, dogs and humans in the case of T. solium. However, the adult parasite develops only in humans, in whom the tapeworm is found in the small intestine, allowing the viability of its eradication. ...
The teniosis/cysticercosis (T/C) complex is a parasitic disease caused by the cestodes Taenia solium and Taenia saginata, and is considered as a neglected zoonosis by the World Health Organization (WHO) and the Colombian Ministry of Health and Social Protection. (1-3) This parasitic infection is a public health and environmental problem in Latin-American, African and Asian countries, and is currently being introduced to developed countries through immigrant communities. Estimates are that 2 500 000 people are infected with this complex and that twice as many individuals develop the parasite at the tissue level. This disease is associated to 50 000 deaths every year, but these figures need to be updated. (4-8)
... This initial study was used primarily as a proof of concept. Subsequent iterations of the game will be expanded to incorporate information on human infection with T. solium eggs, resulting in cysticercosis and NCC, which are important from a public health perspective (Schantz et al., 1993(Schantz et al., , 1998. Questions associated with Taenia. ...
The Snakes and Ladders board game was modified so that it contained information on taeniasis. A quantitative approach was used to evaluate if elementary school children were able to answer correctly more questions about Taenia saginata and Taenia solium transmission and control after playing the game compared to before playing the game. In total, 78 children (9-12 years of age) from Dukuh elementary school in Karangasem District, Bali, Indonesia, were evaluated. The children were asked to complete a pre- and post-test assessment before and after playing the game a single time. Overall proportion of correct answers was 40.3% before playing the game and 58.8% after playing the game. There was a greater proportion of correct answers for questions pertaining to the transmission route for T. saginata (p < 0.001) and T. solium (p < 0.001), human infection type with T. solium (p = 0.035) and T. saginata (p < 0.001), and animal infection type with T. solium or T. saginata (p < 0.001) after playing the game compared to before playing the game. However, there was no significant difference for any question for the youngest grade level. Use of this popular board game appears to be a promising tool for teaching older (10 years of age and above) children about taeniasis in endemic areas.
... While the distribution of taeniasis is often focally endemic in rural areas, through globalization, there is the opportunity for taeniasis and cysticercosis to occur in areas not considered endemic, including predominately Jewish and Muslim communities (Earnest et al., 1987;Hira et al., 2004;O'Neal and Flecker, 2015;O'Neal et al., 2011;Schantz et al., 1992;Sorvillo et al., 1992;Yanagida et al., 2010Yanagida et al., , 2012. High-risk populations, for the more severe DCC, include tapeworm carriers, family members, and others who may have more intimate contact with the carriers (Lescano et al., 2019;Pray et al., 2017;Sarti et al., 1988Sarti et al., , 1992Schantz et al., 1993Schantz et al., , 1998. Often the first indication that something is wrong is sudden onset of seizures, which may occur even with a solitary NCC lesion (Rajshekhar and Chandy, 2000;Schantz et al., 1992). ...
Taeniasis is an important parasitic condition in Asia, especially since all three human-infecting Taenia spp., Taenia solium, Taenia saginata, and Taenia asiatica are found in this region. These three species are believed to be sympatrically distributed, with the largest disease burden found in remote and rural areas where people raise pigs and cattle in a traditional manner. Recent studies revealed that T. asiatica and T. saginata are genetically-related sister species that are not completely reproductively isolated from each other. Current evidence indicates that most T. asiatica adult worms are hybrid-derived descendants. Moving forward, nuclear DNA analysis will be critical in further assessing the species circulating locally. Lifestyle choices, such as the consumption of undercooked meat, are important in maintaining the life cycles of these parasites. In addition, poor hygiene and sanitation, in highly endemic areas, make disease control difficult, resulting in the need for sustainable education programs. An overview of the present situation of taeniasis and cysticercosis in Asia is provided, followed by a discussion of molecular approaches to species assessment and the impact of human lifestyles on parasite transmission.
... Consumption of uninspected pig meat is the major source of human T. solium taeniosis and consequently, a major risk factor for human and pig cysticercosis (Bahtia, 1991;Eom and Rim, 2001;Phiri et al., 2002;Zoli et al., 2003;Dorny et al., 2004). Prevention and control of taeniosis and cysticercosis may take place by condemnation of infected carcasses through meat inspection, appropriate cooking of meat, prevention of ingestion of contaminated water and vegetables and proper sanitation for human to prevent pigs to have access to feces (Soulsby, 1982;Schantz et al., 1993;Who, 2003;Murrell et al., 2005;Willingham III and Engels, 2006). In developing countries, meat inspection is frequently used to prevent porcine cysticercosis transmission to humans. ...
... Because of its complicated and exacting life cycle, which can be interrupted, and the development of high-grade immunity in swine to the infecting form, control of infection is possible. 2 . Suitable control interventions include corralling pigs, avoiding ingestion of undercooked pork, or vaccination of pigs combined with treatment of human tapeworm carriers and/or treatment of pigs 23 . ...
... For T. solium the first criterion is fulfilled, the second is debatable, while the last criterion is clearly not fulfilled, as there is a pig intermediate host and an important role for environmental contamination. Still, T. solium cysticercosis has been considered a potentially eradicable disease (Schantz et al., 1993). Indeed, T. solium disappeared in most European countries as hygienic and sanitary conditions improved, and (indoor) pig husbandry and rigorous meat inspection were implemented (Schantz, 2006). ...
The taeniosis/cysticercosis neglected zoonotic disease complex is caused by Taenia solium, and is associated with significant economic and public health impacts. This paper reviews the current knowledge on T. solium in Zambia and the control strategies already studied, covering almost 20 years of research, and explores the way forward. Studies on occurrence of porcine cysticercosis indicated very high prevalences, ranging from 15 to 34% based on detection of circulating antigens, and of 46% to 68% based on full carcass dissection in slaughter age pigs. Taeniosis prevalences have been reported to range from 6.3% to 12% based on copro-Ag-ELISA. Human cysticercosis prevalence results ranged from 5.8% to 13% based on serum Ag-ELISA, and from 34% to 39% based on sero-antibody detection. Later on, a study in people with epilepsy suggested neurocysticercosis to be the single most important cause of epilepsy in this T. solium endemic area, with 57% of the people with active epilepsy diagnosed with probable or definite neurocysticercosis. While the need to reduce the disease burden of T. solium in Zambia is obvious, the exact short and long term goals, and the strategies to achieve these goals, are not clear. We have selected the most promising control/elimination strategies from reviews and assessed these for feasibility via discussions with local stakeholders from both medical and veterinary sectors. The proposed measures were evaluated using the newly developed agent-based disease transmission model, cystiSim and optimised using Zambian demographic and disease data. As a control option, yearly porcine treatments were selected as best option, while the preferred strategy for elimination was determined to be the combination of human and porcine mass drug administration combined with porcine vaccination of all eligible people and pigs, in a schedule of six iterations of four monthly interventions. These interventions are currently being field tested, combined with education. Several other hurdles to control, such as cost and socio-political factors and the need for an improved advocacy and awareness creation are discussed.
... The combined health and economic impact urges for control and, if possible, elimination of this zoonosis. The first practical recommendations upon control of T. solium date back to 1976 (FAO/UNEP/WHO, 1977), followed by the 'potential eradicable' declaration in 1993 by the International Task Force on Disease Eradication (ITFDE) (Schantz et al., 1993). Adjustments to this statement were made twice (ITFDE, 2003;Center, 2013), with the challenges identified in 2013 such as the lack of routine surveillance and reporting, the need for rapid diagnostic tests and the need for data of how preventative chemotherapy affects prevalence (Center, 2013) still remaining (Thomas, 2015;Gabriël et al., 2016). ...
The combined health and economic impact of Taenia solium urges for control and, if possible, elimination of this neglected parasitic zoonosis. Up till now there is still no consensus about the most cost-effective and feasible approaches for control. The objective of this systematic review is to identify and summarize the evidence in English scientific literature on the control and elimination of T. solium since 2014, based on the rapidly evolving field of evidence on control and elimination of T. solium. The search resulted in the identification of 458 records of which 31 were included, covering 13 field trials and 18 articles containing experimental data, mathematical models, and other information directly relevant the control of T. solium. Recent field studies confirm that combinations of interventions or multiple rounds are more successful in obtaining rapid reductions in transmission and parasite occurrence, with the quick impact of the combination of human and pig treatment confirmed in a South Asian and Peruvian context. Moreover, elimination of transmission through a one-year intensive program, combining human and pig treatment/vaccination was described in a Peruvian study. Recent studies also provide more data on the positive impact of specific health education, as well as newly developed electronic educational tools, providing opportunities for area specific community-engaged participatory interventions. Once control has been achieved, monitoring of migration of both potentially infected people and pigs from outside the control area is important for sustained disease control.
... Areas with a confluence of inadequate water supplies, insufficient sanitation, and people living in close contact with wild and domesticated animals are hotbeds for gastrointestinal parasitic diseases . (Mara, 2003;Haque et al., 2007;Garcia et al., 1991;Schantz et al., 1993;Ali and Hill, 2003;Hotez et al., 2008;Wu et al., 2012). The impact these infections have on tropical communities has been well documented ( Capello, 2004). ...
Understanding the relationship between anthropogenic disturbances and wildlife gastrointestinal parasite communities is important to both human health and conservation efforts. Forest logging and fragmentation, burgeoning human population growth, wildlife extraction, and expansion of livestock into formerly undisturbed landscapes can affect and compound the transmission of various pathogens between wildlife and people. This study therefore aims to further understand the relationship between two types of anthropogenic disturbance (forest degradation and human encroachment), and gastrointestinal parasite communities in both humans and mantled howler monkeys, Alouatta palliata aequatorialis by addressing the following: 1) chronicle primate parasitism, 2) investigate association of environmental degradation and parasitism, and 3) assess human attributes and actions associated with parasitism and potential transmission between human and howler monkey populations. Human and monkey endoparasite communities were characterized using morphological and genetic analyses, and people from surrounding communities were administered demographic surveys to evaluate risk factors associated with parasitism. Of 96 howler monkey fecal samples collected, 2 species of apicomplexan, 6 other protozoa, 4 nematodes, and 1 platyhelminth were detected. Four congeners were found in howlers and people: Entamoeba sp., Balantidium sp., Blastocystis sp., and Strongyloides spp. Several key parasites were non-randomly distributed throughout the sampled population. Proximity of agricultural plots and a local biological research station were both associated with the presence of Strongyloides spp. Individuals were more than four times likely to harbor Strongyloides spp. if they lived in areas considered disturbed forest. Individuals infected with Controrchis sp. were found further from human settlements than uninfected individuals and nearly ten times more likely to be found in primary forest. No evidence of shared Blastocystis subtypes were found between howlers and people, though Capillaria sequence types were similar, suggesting either zoonotic transmission or a common source. Several significant human factors were associated with parasite communities. The results from this study support the hypothesis that anthropogenic disturbances can place both primate populations and humans at risk of select gastrointestinal parasites. Aside from the various direct impacts of anthropogenic disturbances, additional focus should be placed on the indirect effects changing ecological systems have on parasite communities in threatened hosts.
... La cisticercosis ha sido conceptualizada como una de las pocas enfermedades erradicables, es decir potencialmente capaces de ser desaparecidas de la faz de la tierra. Las razones por las cuales se considera erradicable incluyen el hecho de tener un solo hospedero definitivo, tener al cerdo que es un animal doméstico y de fácil accesibilidad como hospedero intermediario usual, y la existencia de tratamientos efectivos para el gusano adulto o la fase larvaria (32,33) . Después de muchos años de trabajar en la epidemiología de esta enfermedad y luego de algunas experiencias iniciales en control, el Grupo de trabajo en Cisticercosis en Perú decidió acometer la tarea de demostrar la factibilidad de la eliminación de la transmisión de la cisticercosis, bajo el apoyo de un proyecto de control de siete años financiado por la fundación Bill & Melinda Gates de los EE.UU. ...
La neurocisticercosis, infección del sistema nervioso humano por el estadio larvario de la Taenia solium, es una causa importante de epilepsia y otras manifestaciones neurológicas en el Perú y en la mayoría de países en desarrollo. Desde 1987, el Grupo de Trabajo en Cisticercosis en Perú ha desarrollado una serie de estudios epidemiológicos que han llevado a estimar el impacto y entender la transmisión de la Taenia solium, y que posteriormente se aplicaron al diseño y ejecución de un programa de control en Tumbes, en la costa norte del país. En este artículo se revisan los principales hallazgos epidemiológicos, así como las líneas generales del programa de eliminación y las herramientas utilizadas. Los avances en el control de la teniasis/cisticercosis en nuestro país abren el camino hacia su eliminación y eventual erradicación.
... The latter disease state is called "neurocysticercosis" (NCC) and it is the most serious condition associated with T. solium as well as the main cause of adult-onset epilepsy in low and middle income countries (Bern et al., 1999;Garcia et al., 2005;Ndimubanzi et al., 2010;Prasad et al., 2011). Despite this disease burden, T. solium has been declared as being potentially eradicable (Center for Disease and Prevention, 1993;Schantz et al., 1993) owing in part to the fact that while different wild animals have been found to be infected with cysticercosis, only domesticated pigs serve as reservoirs for human infection. Indeed, T. solium has been eliminated from many developed countries through the improvement of sanitation conditions and through the implementation of animal and meat inspections at slaughter houses (Engels et al., 2003;Willingham and Engels, 2006). ...
... Although taeniasis or cysticercosis has been included in one of the short listed A B S T R A C T diseases considered to be eradicable in the short term, no sustainable eradication has been achieved. Whereas endemic taeniasis and cysticercosis occurs in very different scenarios (highlands, tropics, arid coast, etc.), and at different intensities of prevalence (Schantz et al., 1993). ...
Diseases caused by tapeworms remain a public health problem in low and middle-income countries including Pakistan. The current study was aimed to assess the prevalence of Taenia saginata and Hymenolepis nana (tapeworms) infections among farmers, education concerned and shepherds of Swat, Pakistan. A total of 1041 stool samples were examined from January 2006 to December 2008 using direct smear and concentration methods. Two hundred and twenty one (21.2%) participants were found infected with one or more than one intestinal tapeworms. Seventy seven (7.39%) of the participants were infected with single parasite and one hundred forty four (13.8%) with multiple infections. Taenia saginata 32.6% (n=146/447), Ascaris lumbricoides 20.3% (n=91/447), Hymenolepis nana 19.7% (n=88/447), Trichuris trichura 14.3% (n=64/447), Enterobius vermicularis 6.48% (n=29/447), Ancylostoma duodenale 2.90% (n=13/447), Entamoeba histolytica 2.68% (n=12/447), and Giardia lamblia/intestinalis 0.89%(n=4/447) were detected in order of their prevalence. The individuals below 15 years of age were found marginally more parasitized than above 15 years (0.3856, P<0.05). Males were more infected than females with (0.3157, P<0.05). No significant association was found among the occupational groups and parasitic infection (0.3089, P<0.05). However, shepherds were found more infected than farmers and education concerned. Due to comparative based approach in different occupational groups the present study is of particular interest. Such studies should be continue time to time to know the hazardous of potentially important pathogenic parasitic infections particularly in remote parts of the country.
... 43 The International Task Force for Disease Eradication has targeted T solium infection for focal elimination and eventual eradication. 59 Furthermore, field control efforts have been attempted since 1987 in Latin American countries including Ecuador, Mexico, Peru, Guatemala, and Honduras. 60,61 Preventive measures recommended by the CDC include good hand washing hygiene using soap and warm water after bathroom use and changing diapers and before handling food. ...
Neglected tropical diseases are a group of protozoan, parasitic, bacterial, and viral diseases endemic in 149 countries causing substantial illness globally. Extreme poverty and warm tropical climates are the 2 most potent forces promoting the spread of neglected tropical diseases. These forces are prevalent in Central and South America, as well as the U.S. Gulf Coast. Advanced cases often require specialized medical imaging for diagnosis, disease staging, and follow-up. This article offers a review of epidemiology, pathophysiology, clinical manifestations, diagnosis (with special attention to medical imaging), and treatment of neglected tropical diseases specific to the Americas.
... While T. saginata has a global distribution, T. solium is distributed mostly in developing countries of Latin America, sub-Saharan Africa and Asia, and T. asiatica is restricted to certain Asian countries [3,4]. Taeniasis is estimated to infect 2.5 to 5 million people globally [5][6][7]. All three-tapeworm species utilize humans as the definitive hosts (adult tapeworm) due to the ingestion of undercooked and/or raw meat or liver [1,8]. ...
Background
Taenia solium, the cause of neurocysticercosis (NCC), has significant socioeconomic impacts on communities in developing countries. This disease, along with taeniasis is esti- mated to infect 2.5 to 5 million people globally. Control of T. solium NCC necessitates accurate diagnosis and treatment of T. solium taeniasis carriers. In areas where all three species of Taenia tapeworms (T. solium, Taenia saginata and Taenia asiatica) occur sympatrically, conventional microscope- and copro-antigen based diagnostic methods are unable to distin- guish between these three Taenia species. Molecular diagnostic tools have been developed to overcome this limitation; however, conventional PCR-based techniques remain unsuit- able for large-scale deployment in community-based surveys. Moreover, a real-time PCR (qPCR) for the discrimination of all three species of Taenia in human stool does not exist. This study describes the development and validation of a new triplex Taq-Man probe-based qPCR for the detection and discrimination of all three Taenia human tapeworms in human stools collected from communities in the Central Highlands of Vietnam. The diagnostic char- acteristics of the test are compared with conventional Kato Katz (KK) thick smear and copro-antigen ELISA (cAgELISA) method utilizing fecal samples from a community based cross-sectional study. Using this new multiplex real-time PCR we provide an estimate of the true prevalence of taeniasis in the source population for the community based cross-sectional study.
Methodology/Principal findings
Primers and TaqMan probes for the specific amplification of T. solium, T. saginata and T. asiatica were designed and successfully optimized to target the internal transcribed spacer I (ITS-1) gene of T. solium and the cytochrome oxidase subunit I (COX-1) gene of T. saginata and T. asiatica. The newly designed triplex qPCR (T3qPCR) was compared to KK and cAgELISA for the detection of Taenia eggs in stool samples collected from 342 indi- viduals in Dak Lak province, Central Highlands of Vietnam. The overall apparent prevalence of taeniasis in Dak Lak province was 6.72% (95% confidence interval (CI) [3.94–9.50]) in which T. solium accounted for 1.17% (95% CI [0.37–3.17]), according to the T3qPCR. There was sympatric presence of T. solium, T. saginata and T. asiatica. The T3qPCR proved superior to KK and cAgELISA for the detection and differentiation of Taenia species in human feces. Diagnostic sensitivities of 0.94 (95% credible interval (CrI) [0.88–0.98]), 0.82 (95% CrI [0.58–0.95]) and 0.52 (95% CrI [0.07–0.94]), and diagnostic specificities of 0.98 (95% CrI [0.94–1.00]), 0.91 (95% CrI [0.85–0.96]) and 0.99 (95% CrI [0.96–1.00]) were estimated for the diagnosis of taeniasis for the T3qPCR, cAgELISA and KK thick smear in this study, respectively.
Conclusions
T3qPCR is not only superior to the KK thick smear and cAgELISA in terms of diagnostic sensitivity and specificity, but it also has the advantage of discriminating between species of Taenia eggs in stools. Application of this newly developed T3qPCR has identified the existence of all three human Taenia tapeworms in Dak Lak province and proves for the first time, the existence of T. asiatica in the Central Highlands and the south of Vietnam.
... Clinical signs of the condition in human depend on an anatomical location of the parasite. Neurological and usually fatal clinical manifestations occur when cysticerci lodge in central nervous tissues [5,6]. ...
... In the infected person, the eggs develop into cysticerci that are mainly located in the muscular, sub cutaneous and nervous tissues. The clinical signs of the condition occur particularly when cysts colonize the central nervous tissues (Schantz et al., 1993;Garcia and Del Brutto, 2005). T. solium is considered to be under control if geographical distributions are known (Morales et al., 2008;Ngowi et al., 2010). ...
... Though the magnitude of NCC burden in endemic countries is high, its neurological involvement is being recognized only recently as an important but neglected cause of epilepsy [6] . As per WHO estimation of 50 000 deaths due to T. solium, neural involvement was assumed to be the major reason [7], making NCC the single most important cause of acute epilepsy in developing countries. It is prevalent in Latin America, a major part of Asia (including China and the Southeast Asia), Eastern Europe, and most of Africa [2][3][4] with seroprevalence rates reaching up to 25% in general populations in areas known to be endemic for T. solium [8] . ...
Seizures due to neurocysticercosis (NCC) is a neglected human-to-human transmitted disorder and an emerging problem worldwide. A substantial portion of recent onset seizures is known to be attributed to NCC in Taenia solium endemic areas where populations which neither raise pigs nor eat pig meat are also at risk. High prevalence of NCC causing epilepsy has been reported in the underdeveloped areas of Southeast Asia (SEA) however, only fragmentary information on its incidence is available in countries like Malaysia. In Malaysia T. solium infection was previously thought to be infrequent due to Muslim population majority and the religious prohibition of consuming pork, but it is not totally absent. There is an evident lack of knowledge and awareness of the actual burden, routes of transmission, and the impact of NCC in this region. The problem is assumed to be more prevalent particularly in cities because of the frequent inflow of possibly T. solium infected individuals or carriers among those who migrate from neighboring endemic countries to Malaysia. The issue of imported cases that are likely to be emerging in Malaysia is highlighted here. An accurate quantification of regional burdens of epilepsy due to NCC in Malaysia is warranted considering the disease emergence in its neighboring countries. It is suggested that the importance of NCC be recognized through quantification of its burden, and also to collect epidemiological data for its subsequent elimination in line of World Health Organization’s mission for control of cysticercosis as a neglected tropical disease. In this review the need as well as a strategy for neuro-care center screening of epilepsy cases, and various issues with possible explanations are discussed. It is also proposed that NCC be declared as a reportable disease which is one of the eradicable public health problems in SEA.
... In 2010 it was estimated that approximately 300,000 individuals were infected with T. solium cysticercosis globally, resulting in over 28,000 deaths [2]. Between 2.5 and 5 million people are estimated to harbour adult tapeworms of T. solium [3][4][5]. Trichinellosis is reported to be present in 55 countries [6] with 66,000 individuals estimated to have been infected during the period 1986 to 2009 [1]. In 2010 it was estimated that globally there were around 4400 cases of trichinellosis reported, with four deaths [2]. ...
Taeniasis, cysticercosis and trichinellosis have been ranked as the most important food-borne parasites of humans in terms of public health, socioeconomic and trade impact. Despite this, information on these food-borne zoonoses in Vietnam is scarce and fragmented, and many local reports remain inaccessible to the international research community. This study aims to conduct comprehensive literature searches to report on the incidence and estimate the true prevalence of taeniasis in humans and T. solium cysticercosis in humans and pigs in Vietnam utilizing Bayesian models; in addition, to report the incidence and the distribution of trichinellosis. A Bayesian approach was used to estimate the true prevalence of taeniasis and cysticercosis based on published diagnostic test characteristics used in each published cross-sectional survey. The utilization of coproscopic-based examination of Taenia eggs in stool, although highly specific for genus-level detection, has poor sensitivity and led to an underestimation of the prevalence of human taeniasis. Similarly, post-mortem-based surveys of T. solium cysticercosis in pigs also led to the underestimation of prevalence of porcine cysticercosis. On the other hand, the low specificity of immunodiagnostic methods, in particular Ab-ELISA, led to a likely overestimation of T. solium cysticercosis in humans. Due to the use of imperfect diagnosis tests combined with poor descriptions of sampling methods, our ability to draw solid conclusions from these data is limited. We estimate that the true prevalence of taeniasis and T. solium cysticercosis in rural ‘hotspots’, is as high as 13% for each, in humans. Taeniasis and T. solium cysticercosis occurs in 60 of the 63 provinces of Vietnam. Most of the information relating to the distribution and prevalence of porcine cysticercosis is limited to commercial abattoir surveys. In Vietnam, Taenia asiatica appears to be confined to the north where it occurs sympatrically with T. solium and Taenia saginata. The status of T. asiatica in Central and South Vietnam remains unascertained. To date, five outbreaks of trichinellosis have been reported in the north and northwest of Vietnam, affecting a total of 114 people and responsible for eight fatalities. In the same region, studies of free-roaming pigs showed evidence of high levels of exposure to Trichinella and, in cases where larvae were recovered, the species present were identified as Trichinella spiralis. Based on five studies, the main risk factors for pork-borne zoonoses in Vietnam include the consumption of undercooked/raw meat and vegetables and the use of night-soil for fertilization of local produce. This systematic review draws attention to the importance of these pork-borne zoonoses.
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... Cuando la larva se localiza en el Sistema Nervioso Central (SNC) se le denomina neurocisticercosis (NCC) (1)(2)(3)(4)(5)(6)(7)(8). La NCC se presenta como la patología más grave producida por este complejo parasitario, causando la disminución en la percepción de vivir, la pérdida de autoestima, incapacidad física y, en extremos graves, la muerte del individuo (1)(2)(3)(4)(5)(6)(7)(8)(9). ...
RESUMEN Antecedentes: la teniosis/cisticercosis es una zoonosis desatendida considerada un problema de salud pública en países en vías de desarrollo, es causada por el parásito Taenia solium, y las personas infectadas desarrollan teniasis o cisticercosis y/o neurocisticercosis. Objetivo: determinar la seroprevalencia de cisticercosis humana en pacientes atendidos en el año 2014 en la consulta neurológica en Popayán, Cauca, Colombia. Materiales y métodos: estudio descriptivo de corte transversal incluyendo pacientes que llegaron a la consulta neurológica en Popayán. Se solicitó consentimiento informado para recolectar 5 mL de sangre y realizó una encuesta. Se determinaron los anticuerpos anticisticerco (fracción proteica de 53 kDa) con la técnica ELISA, con una sensibilidad del 95.3% y especifi cidad del 100%. Se empleó el programa SPSS v19 para el análisis estadístico. Resultados: se evaluaron 200 pacien-tes con un edad promedio de 41,49 años, resultaron con anticuerpos anticisticerco el 54% (108/200). El 53,2% (25/47) presentó crisis focales y fueron seropositivos. Hubo signifi cancia estadística con el consumo de verduras (P=0,048). Conclusiones: el estudio reveló la más alta positividad serológica para cisticercosis humana en pacientes de consulta neurológica registrada para Colombia e incluso para Latinoamérica. Es relevante comunicar a las autori-dades pertinentes la inclusión de ésta parasitosis en la política institucional de salud pública conducente al control y erradicación. Palabras clave: Taenia solium, cisticercosis, Colombia. 1 MD, Esp. Ento., Esp. Epi., MSc. Microbiol. Parasitol. Centro de Estudios en Microbiología y Parasitología (CEMPA). ABSTRACT Background: Teniosis/cysticercosis and/or neurocysticercosis is a parasitic zoonosis neglec
Between 1930 and 1960, 450 British soldiers who were being assessed for epilepsy and other neurological disease after returning from duty in India were found to be affected by neurocysticercosis (NCC), the infection of the human nervous system by the cystic larvae of the pork tapeworm Taenia solium.¹ This unexpectedly frequent finding brought attention to a globally common but yet poorly known disease. Introduction of the computed tomography scan in the 1970s substantially improved the premortem diagnosis of NCC and slowly began to unveil the scope of the problem. T solium is now known to be endemic in wide areas of the world, including Latin America, sub-Saharan Africa, Eastern Europe, and parts of Asia, including the Indian subcontinent, Southeast Asia, and large regions of China.² Endemicity of T solium is deeply rooted in poverty and involves domestic pig raising and poor sanitary conditions. As such, the burden of neurologic disease associated with continued transmission falls mainly on impoverished rural populations. However, NCC cases are diagnosed worldwide, even where transmission is not endemic.
In this perspectives paper, we discuss fertilization strategies for Taenia saginata and Taenia saginata asiatica as well as heterogeneity in Taenia solium, the causative agent of human cysticercosis. Two different genotypes of T. solium (Asian and Afro/American) were confirmed by mitochondrial DNA analysis approximately two decades ago. Since then, outcrossings of the two genotypes have been identified in Madagascar where the two genotypes are distributed sympatrically. Outcrossings were confirmed by the presence of discordance between mitochondrial and nuclear DNA. Since multiple tapeworm infections are common in endemic areas, outcrossing events likely occur quite frequently. Therefore, mitochondrial DNA from T. solium specimens collected from humans and pigs in endemic areas should be analyzed. If variations are found between specimens, nuclear DNA analysis should be performed to confirm the presence of discordance between mitochondrial and nuclear genes. Additional outcrossings likely add complexity to understanding the existing genetic diversity. Serological surveys are also recommended since serodiagnostic glycoprotein can also differentiate between the two genotypes. Viable eggs from different genotypes or from hybrids of two different genotypes should be used for experimental infection of pigs or dogs in order to observe any pathological heterogeneity in cysticercosis development. Although genetic diversity of T. solium is expected to result in clinical heterogeneity of cysticercosis in humans and pigs, there is currently no evidence showing that this occurs. There are also no comparative experimental studies on this topic. Therefore, studies evaluating the link between parasite heterogeneity and clinical outcome are warranted.
Neurocysticercosis is endemic in most of the world and in endemic areas it accounts for approximately 30% of cases of epilepsy. Appropriate diagnosis and management of neurocysticercosis requires understanding the diverse presentations of the disease since these will vary in regards to clinical manifestation, sensitivity of diagnostic tests, and most importantly, therapeutic approach. This review attempts to familiarize tropical neurology practitioners with the diverse types of neurocysticercosis and the more appropriate management approaches for each.
The heart and pericardium may be affected directly or indirectly by a variety of parasites. These can be grouped into parasites that preferentially involve the myocardium and occasionally involve the pericardium (such as Trypanosomes, Toxoplasma, Trichinella), parasites that occasionally involve the pericardium or cause pancarditis (such as Echinococcus, Entamoeba histolytica, Taenia solium) and parasites that cause miscellaneous syndromes (such as Schistosoma, Dirofilaria immitis, Wuchereria bancrofti, Brugia malayi, helminth, Toxocara canis and Toxocara cati, Baylisascaris procyonis, Sarcocystis). The involvement of the heart and its structures to parasitic diseases may manifest in different ways; however, the syndromes resulting from impairment of the myocardium and pericardium are the most frequent, such as myocarditis or cardiomyopathy and pericarditis or pericardial effusion. This chapter summarizes the relevant clinical picture, the diagnostic procedures and the therapeutic protocols involving both conservative treatment and surgical management of the parasitic diseases of the heart.
La teniosis/cisticercosis es una enfermedad parasitaria causada por la infección del estado larvario de Taenia solium. La Organización Mundial de la Salud (oms) considera esta patología un problema de salud pública, así como una infección olvidada. Las manifestaciones pueden variar según el tipo de presentación de la lesión, requiere manejo farmacológico en la mayoría de los casos e incluso puede llegar a requerir tratamiento quirúrgico, en algunas condiciones específicas. Se han reportado casos de resistencia del parásito al manejo con cisticidas, reportes en los cuales la ivermectina, antiparasitario de uso veterinario, se convierte en una importante opción de manejo. Para esta disertación, se presenta un caso de neurocisticercosis racemosa gigante, que requirió manejo quirúrgico en el cual se evidencia persistencia de las lesiones luego del tratamiento con cisticidas, el cual presentó mejoría con el manejo con albendazol de marca, en combinación con ivermectina.
The objective of this study was to identify and treat carriers of adult Taenia solium present in two rural Venezuelan communities through examination of faecal samples by coproscopical analysis, and by the application of a polyclonal and a monoclonal (VP-1) coproantigen ELISA. Both the polyclonal and monoclonal ELISA's were negative when tested with soluble extracts of adults of Ascaris lumbricoides, Hymenolepis nana and Trichuris trichura. The polyclonal ELISA was positive for soluble extracts adults of T. solium and T. saginata, whereas the monoclonal ELISA, which recognizes a glycoprotein, was restricted to T. solium, and was also negative with faecal samples from five cases of T. saginata adult infections. In the first community studied, Potrero Largo (Total population: 300), of 248 faecal samples examined, 2 individuals were positive for Taenia spp eggs by coproscopical analysis and the VP-1 ELISA, and yielded T. solium adults upon purging. In contrast, when the polyclonal coproAg ELISA was applied to the same 248 faecal samples, there were a considerable number of positives. Indeed, seven patients highly positive in the polyclonal ELISA did not yield a Taenia spp upon purging and were negative in the VP-1 ELISA. In the second community studied La Yuca (Total population 560), none of the 333 individuals who donated faeces was positive for Taenia spp eggs. Many, however, were infected with a range of intestinal helminth and protozoan parasites. A representative 76 of these faecal samples gave an unacceptable number of significant optical densities in the polyclonal coproAg ELISA. In contrast, all were negative in the VP-1 ELISA, thus providing an excellent negative control. These results with the VP-1 coproAg ELISA, although preliminary, justify further validation through the testing of more faecal samples from T. solium and T. saginata adult infected individuals.
Neurocysticercosis (NCC) is a major contributor to the burden of seizure disorders and epilepsy in most of the world. NCC encompasses a variety of clinical presentations, depending on number, location, size, evolutionary stage of lesions, and the inflammatory response of the host, with late-onset seizures, headache, and intracranial hypertension the most frequent manifestations. Diagnosis and therapy depend on the type of NCC, considering its location and stage of the lesions. Medical therapy for NCC should be oriented to obtain appropriate symptom control and then use of antiparasitic agents considered. Antiparasitic treatment is of benefit in most cases of viable and degenerating NCC.
Background:
Neurocysticercosis (NCC) of Taenia solium has never been reported in Mongolia. A Mongolian traveler who visited China and India presented with epileptic seizures after his return to Mongolia. Magnetic resonance imaging showed multiple ring enhancing lesions with edema surrounding several lesions in his brain that were initially diagnosed to be viral encephalitis or NCC.
Methods:
Serology for cysticercosis using diagnostic antigens partially purified by cation-exchange chromatography and chimeric recombinant antigens and DNA analysis of a proglottid found in the patient's stool were applied for differential diagnosis.
Results:
Serology showed strong positivity for NCC, and mitochondrial cox1 gene analysis revealed Indian but not Chinese haplotype of T. solium.
Conclusion:
This NCC case was considered to be caused by eggs released from adult tapeworm(s) established after eating uncooked or undercooked pork contaminated with cysticerci during his stay in India. This is a case report of taeniasis and secondary NCC associated with travel to India with an updated review of NCC in Asia. Molecular tracking of the specimen is highly informative as a way to identify where the infection was acquired.
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