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Taeniasis and cysticercosis due to Taenia solium.
... Taenia solium is a cestode tapeworm belonging to the family Taeniidae. There are many species of Taenia, some of which are zoonotic: humans are the definitive host for T. solium, T. saginata and T. asiatica, but only T. solium can cause HCC (Flisser, 1994;Ito et al., 2003a;Murrell et al., 2005;Flisser, 2013). ...
... Gravid proglottids, measuring up to 1 cm 2 and containing between 50,000 and 80,000 eggs (Flisser, 1994;Acha and Szyfres, 2003), are detached from the distal end of the tapeworm every few days and are passively expelled, often in chains, along with the host's feces (Flisser, 2013). (2018)). ...
... Taeniid eggs are spherical in shape, between 20-50 μm in diameter and have a radial or striated appearance under light microscopy (Acha and Szyfres, 2003) (Figure 3). In the center is a fully developed oncosphere or embryo that contains three pairs of hooklets, surrounded by a rigid protective embryophore and various other layers and membranes (Flisser, 1994;Acha and Szyfres, 2003;Murrell et al., 2005). Eggs are extremely resistant to environmental degradation and may remain infective for up to 12 months under favorable conditions (Acha and Szyfres, 2003;Sánchez Thevenet et al., 2017). ...
https://biblio.ugent.be/publication/8582700
... cal distribution but occur principally in developing countries wherever there is a close association between man, pigs and poor sanitary conditions (Flisser, 1994). Human infection with T. solium is common in Mexico and studies in central Mexico have demonstrated that transmission of the parasite there is associated with primitive methods of pig hus-bandry, poverty and lack of good sanitation (Keilbach et al., 1989;Lara-Aguilera et al., 1992;Sarti et al., I992a, b, 1994Sarti et al., I992a, b, , 1997. ...
... Mexico is highly endemic for T. solium (Flisser, 1994). However, there is little information available on the epidemiology of T. solium taeniasis and cysticercosis in the south of the country; most data on these diseases in Mexico relate to studies performed in rural populations in the centre of the country, which has a significantly different climate and geography (Sarti et al., 1988(Sarti et al., , 1992a(Sarti et al., , b, 1994(Sarti et al., , 1997Keilbach et al., 1989;Diaz-Camacho et al., 1990). ...
... Although seropositivity for cysticercosis and a history of epileptic seizures have appeared to be associated in previous studies (Diaz et al., 1992;Sarti et al., 1992aSarti et al., , 1994Schantz et al., 1994), there was no significant association visible in the present study. However, sharing a house with a case of taeniasis did appear to be a risk factor for cysticercosis (P = 0.05), ingestion of tapeworm eggs from human faeces being the cause of human cysticercosis (Flisser, 1994). ...
A survey to detect human taeniasis and cysticercosis was conducted in a community in Yucatan state, Mexico, an area endemic for Taenia solium. Information on the environmental, demographic and risk factors associated with transmission of T. solium within the community was recorded on questionnaires. Although no Taenia eggs or proglottides were found in the initial faecal samples collected from each of the 475 subjects, the results of a capture-ELISA for T. solium coproantigen were positive for 10 of the subjects (of both genders and various ages). After treatment with niclosamide, proglottides were detected in purge samples from seven of these 10 subjects. The prevalence of parasitologically confirmed taeniasis was therefore 1.5% (seven in 475). The other three ELISA-positive cases delayed supplying faecal material post-treatment, and it is unclear whether they had expelled proglottides before providing the samples. All 10 ELISA-positive subjects became ELISA-negative after treatment.
Seroprevalence of human cysticercosis, based on the detection in immunoblots of antibodies to antigens of 8- and 26-kDa from a crude saline extract of T. solium metacestodes, was 3.7% (i.e. five positives out of 134 subjects). None of the seropositive cases demonstrated clinical symptoms of infection. Again, the positive cases were of both genders and various ages.
Although tongue palpation indicated that 17 (23%) of 75 pigs kept within the community had T. solium cysticercosis, the results of immunoblotting demonstrated antibodies to the 8- and/or 26-kDa antigens of T. solium in 26 (35%). The pigs allowed to roam throughout the community were far more likely to have cysticercosis than those kept in pens (odds ratio = 42, with a 95% confidence interval of 5.05–920.2; P<0.00001).
Not surprisingly, the risk factors associated with human taeniasis and cysticercosis included the eating of infected pork and close proximity to a carrier of T. solium. The main risk factor identified for porcine cysticercosis was free-range husbandry, permitting access to human faeces. This is the first comprehensive report of taeniasis and cysticercosis in a rural population from the Yucatan peninsula of Mexico.
... NCC is caused by T. solium cystic larva entering the central nervous system (CNS) after a human host ingests T. solium eggs in fecal comtamination. The lifecycle of T. solium requires a human as a de nite host that can house the adult tapeworm and the larval form and the pig as an intermediated host that can only house the larvae [10]. Humans ingest T. solium cysts from contaminated improperly cooked pork which develops into an adult tapeworm in the human intestinal wall. ...
... The fundamental principle of cysticercosis control is by breaking the T. solium transmission cycle between humans and pigs [10]. The studies identi ed in this review collectively summarized six major intervention types: national policy, community sanitation improvement, health education, mass drug administration, pig vaccination and treatment, and combined human and pig treatment. ...
Neurocysticercosis (NCC) is a leading cause of preventable epilepsy in lower- and upper- middle-income countries (LMICs/UMICs). NCC is a human-to-human transmitted disease caused by ingestion of Taenia solium eggs from a Taenia carrier. T. solium infection control is the key to reduce NCC incidence. This systematic review aims to identify T. solium control programs that can provide frameworks for endemic areas to prevent NCC-related epilepsy. A systematic search was conducted in PubMed/Medline, Embase, Web of Science, and Cochrane Library databases in March 2021. After title and abstract review, full texts were screened for qualitative analysis. Additional articles were identified via citation search. Of 1322 total results, 34 unique studies were included. Six major intervention types were identified: national policy (8.8%), community sanitation improvement (8.8%), health education (8.8%), mass drug administration (29.4%), pig vaccination and treatment (32.4%), and combined human and pig treatment (11.8%). Overall, 28 (82.4%) studies reported decreased cysticercosis prevalence following the intervention. Only health education and combined human and pig treatment were effective in all selected studies. NCC causes preventable epilepsy in LMICs/UMICs and its incidence can be reduced through T. solium control. Most interventions that disrupt the T. solium transmission cycle are effective. Long-term sustained results require comprehensive programs, ongoing surveillance, and collaborative effort among multisectoral agencies.
... In the intestines, the protoscolex evaginates and attaches to the mucosa with its double row of hooks and its four suckers in the upper third section of the small intestine, which is the duodenum-jejunum (Murrell et al., 2005). The adult tapeworm develops in the small intestines of humans by forming proglottids which arise from the caudal end of the scolex (neck) (Soulsby, 1982;Flisser, 1994). The body formation which is called strobilation is rapid with development of a mature tapeworm which is 2-7 meters long after 2-3 months post-infection (Flisser, 1994). ...
... The adult tapeworm develops in the small intestines of humans by forming proglottids which arise from the caudal end of the scolex (neck) (Soulsby, 1982;Flisser, 1994). The body formation which is called strobilation is rapid with development of a mature tapeworm which is 2-7 meters long after 2-3 months post-infection (Flisser, 1994). The earlier proglottids gradually enlarge and mature as they are separated from the scolex by newly produced proglottids with functional testes and ovaries. ...
Taenia solium (T. solium) infections are of public health concern in most developing countries where diagnosis of the diseases is still a major challenge. This is due to the high cost and technique nature of most of the reliable diagnostic tools that are commercially available. In this study, serological tests developed from crude cyst antigens (Ags) of T. solium, were established at the University of Zambia, and evaluated for their sensitivity and specificity in detecting circulating cysticerci serum antibodies (Abs) in human. The crude antigen was produced from cysts of T. solium collected from pigs from rural Zambia. The antibodies –Enzyme-linked immunosorbent assay (Ab-ELISA) and Electroimmunotransfer blot (EITB) tests were evaluated using a commercial (QualiCode™ Cysticercosis Kit) Immunoblot, in order to estimate their sensitivity and specificity. The Ab-ELISA used a cut off-point of 15 antigen concentration of dilute serum. The Ab-ELISA showed a sensitivity and specificity of 16.67% and 91.94%, respectively. The crude antigen EITB used the 8-10 kDa antigenic bands to detect T. solium sera Abs in human. The commercial blot used any of the six bands 50, 42, 39, 24, 21, 18 and 14 kDa to detect T. solium sera Abs in human. Compared to the commercial blot, whose sensitivity and specificity was 98.00% and 100%, respectively, the crude antigen EITB had a sensitivity of 19.44% and specificity of 85.48%. The crude antigen EITB and Ab-ELISA tests showed significant difference (p<0.05), as the former detected more positives (25) compared to the latter (14) out of 199 samples tested.To our knowledge, this is the first study that attempted to establish an EITB from crude antigens. Most EITB that have been developed so far are based on purified antigens. The study demonstrated that the crude antigen EITB and Ab-ELISA tests are significantly less sensitive than the commercial Immunoblot test. Inspite of this, both the Ab-ELISA and EITB can be useful as screening tests in edemic areas before more sensitive and expensive tests are employed. Besides, Ab-ELISA tests have an advantage of giving the level of antibody titres in the patient’s blood, thus can be used to monitor the progress of the disease treatment. Future research should consider the use and evaluation of more immunogenic components of the cyst fluid or the use of purified or synthetic Ags, in an attempt to increase the test sensitivity.
... Neurocysticercosis accounts for an important fraction of hospital admissions; it is a disabling disease mainly in young people, and it affects the economy, and social and family life (VELASCO-SUAREZ, 1982). Epidemiological studies performed in Mexico have estimated that up to 10% of the general population have been exposed to the parasite (FLISSER, 1988(FLISSER, , 1994SCHANTZ et al., 1994;SARTI, 1997) and from 0.1% to 3.4% of rural inhabitants could have the adult tapeworm (TAY et al., 1976;SARTI et al., 1988;CAMACHO et al.. 1990). These data imnlv that around one and a half n&ion 'Mexicans might-b; expelling T. solium eggs that may cause new cases of neurocysticercosis (SARTI, 1997). ...
... At Tl no decrease was seen; however, all positive pigs were older than 1 year, and thus were probably infected before the study started. Anti-cysticercus antibodies may be considered as detecting exposure to the parasite (FLISSER, 1988(FLISSER, , 1994SCHANTZ & SARTI, 1989;GONZALEZ et al., 1990;SARTI et al., 1992aSARTI et al., , 1992bSCHANTZ et aZ., 1994). The significant reduction observed between TO and Tl suggests a decrease in exposure, but the seroprevalence at T2 was not significantly different from the baseline level. ...
... intestino humano, y hacen del ser humano un portador(10). La tenia es altamente infecciosa, ya que produce numerosos huevos infecciosos que son expulsados en la materia fecal(1). Por ende, la infección del SNC y otros tejidos en humanos depende de un contacto estrecho con el portador de la tenia, más comúnmente el cerdo que el humano, y no resulta de ingerir carne de cerdo infectada(11). ...
... La ingesta de carne de cerdo mal cocinada que contenga quistes resulta en el alojamiento de la tenia adulta en el intestino humano, y hacen del ser humano un portador (10). La tenia es altamente infecciosa, ya que produce numerosos huevos infecciosos que son expulsados en la materia fecal (1). ...
... When humans eat undercooked pork containing the worm cyst, the cyst matures in the intestine, releasing the eggs in the feces. Humans thus become the definitive host as they harbor the adult form of the tapeworm [4,5]. This presence of the adult form in the intestine is known as tapeworm teniasis. ...
... The disease occurs when larvae of this zoonotic parasite (= cysticerci) lodge in the central nervous system. [1] NCC is a public health concern in many lowincome and middle-income countries (LMIC), including most countries of sub-Saharan Africa, in which sanitation and hygiene is poor and where pigs roam freely. The disease presents with a variety of different neurological signs and symptoms which depend on the number, stage and location of NCC-typical lesions and on the intensity of the inflammatory reaction. ...
Background
Neurocysticercosis (NCC) is common among people with epilepsy in low-resource settings. Prevalence of NCC and radiological characteristics of patients with NCC vary considerably even within small areas but differences have been poorly characterized so far.
Methods
We conducted a cross-sectional study between August 2018 and April 2020 in three district hospitals in southern Tanzania (Ifisi, Tukuyu and Vwawa). Patients with and without epileptic seizures were included in this study. All patients were tested with a novel antibody-detecting point-of-care test for the diagnosis of Taenia solium cysticercosis. All test positives and a subset of test negatives had a further clinical work-up including medical examination and computed tomography of the brain. NCC was defined according to the Del Brutto criteria. We assessed epidemiological, clinical and radiological characteristics of patients with NCC by presence of epileptic seizures and by serology status.
Results
In all three district hospitals, more than 30% of all people with epileptic seizures (PWE) had NCC lesions in their brain (38% in Vwawa, 32% in Tukuyu and 31% in Ifisi). Most PWE with NCC had multiple lesions and mostly parenchymal lesions (at least 85%). If patients were serologically positive, they had in the median more lesions than serologically negative patients (15 [interquartile range 8–29] versus 5 [1.8–11]), and only serologically positive patients had active stage lesions. Furthermore, serologically positive PWE had more lesions than serologically positive people without epileptic seizures (10.5 [7–23]), and more often had active lesions. PWE diagnosed with NCC (n = 53) were older, and more commonly had focal onset seizures (68% versus 44%, p = 0.03) and headache episodes (34% versus 14%, p = 0.06), which were also stronger than in PWE without NCC (p = 0.04).
Conclusion
NCC is common among PWE. A combination of clinical and serological factors could help to establish an algorithm to identify patients potentially suffering from active NCC, who benefit from further clinical investigation including neuroimaging.
... Similar to sparganosis, transmission commonly occurs due to ingesting raw or undercooked pork or drinking contaminated water [19] . Cysts are able to attach to intestinal walls and cross the intestinal mucosa into the bloodstream, which carries it to peripheral tissue, including the brain, subarachnoid space, ventricles, and rarely the spinal cord, where they develop into cysticerci [21] . Cysticerci lead to various clinical symptoms, including seizures, focal neurologic deficits, intracranial hypertension, cognitive decline, headache, associate stroke, or involuntary movements, due to inflammation from cyst degeneration, their mass effect, and reduction of CSF circulation [20 ,22] . ...
Cerebral sparganosis is a rare parasitic infection that can be difficult to diagnose due to similarities in clinical and imaging features with more common parasitic infections, such as neurocysticercosis, and other neurologic conditions. We present a case of a 61-year-old female with a verified case of cerebral sparganosis. We also review the current literature regarding the sparganosis infection process, imaging features, and unique therapeutic options. With awareness of the risk factors for cerebral sparganosis and consideration for this diagnosis when the response to therapy for other organisms appears suboptimal, the time to accurate diagnosis may be reduced, and treatment outcomes improved.
... T. solium'a bağlı insan infeksiyonu, larva içeren az pişmiş veya çiğ domuz ürünleri tüketildiğinde ortaya çıkmaktadır. Larvalar, insan ince bağırsağının mukozasına skolekslerini (kafa) kullanarak bağlanır ve yetişkin tenyalara dönüşür (Flisser 1994). Bu yetişkin solucanların yumurtaları insan dışkısı ile yayılmaktadır. ...
Domuz ve domuz ürünleri, dünya çapında gıda sistemlerinin merkezi bir parçası
haline gelmiş bulunmaktadır. Küresel domuz eti üretimi, son 30 yılda hızla artarak
domuz endüstrisinin yoğunlaşmasına yol açmıştır. Günümüzde domuz yetiştiriciliğine
yapılan daha az çiftlik olmasına rağmen, bu çiftliklerde daha fazla sayıda hayvan
yetiştirilmektedir. Bu durum, patojen etkenlerin hem hayvan sürüleri arasında hem de
hayvanlardan sorumlu personele bulaşını artırmaktadır. Ayrıca artan stres faktörleri ve
tarımsal ortamda patojenlerin çoğalma potansiyeli, et ürünlerinden hastalıkların yayılmasına
yol açan mikroorganizma yükünün artmasına neden olabilmektedir. Sonuç
olarak dünya çapında domuz eti tüketen bireylerin sağlığının etkilenmesi riski bulunmaktadır.
Bu nedenle, domuz ve domuz eti ürünleri ile, çeşitli bulaşma yolları ile yeni
zoonotik hastalıkların popülasyonlarda yayılması potansiyeli bulunmaktadır. Bu bölümde
bakteriyel, viral ve paraziter etkenlerden ileri gelen bazı önemli domuz kökenli
zoonotik hastalıklar incelenecektir.
... Pigs are the most common intermediate host and humans as the sole definitive host. 2,3 The adult parasite lives in the human small intestine attached to the mucose by its head or scolex, and sheds gravid proglottids containing numerous eggs, which are released through the feces; when the intermediate host ingests these eggs, they hatch in the pig's intestine releasing the embryos or oncospheres that actively cross the intestinal wall to reach a blood vessel and are disseminated by the blood stream to most tissues, where they develop into encysted cysticerci. 4,5 The life cycle is completed when undercooked pork meat is eaten by a human, and the cysticercus evaginates and attaches to the intestinal wall to develop into an adult tapeworm. ...
Carolina Guzman,1 Hector H Garcia1,2 for The Cysticercosis Working Group in Peru1Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Perú; 2Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, PerúCorrespondence: Hector H Garcia Email hgarcia@jhsph.eduAbstract: Neurocysticercosis (NCC) causes significant neurological morbidity around the world, and is the most common preventable factor for epilepsy in adults. It is endemic in most developing countries, and also diagnosed with some frequency in industrialized countries because of travel and migration. The clinical manifestations of NCC are extremely variable and may include almost any neurological symptom, depending on the number of lesions, location, size and evolutive stage of the infecting parasitic larvae and the immune response of the host. Thus, the diagnosis of NCC relies mostly on neuroimaging and immunological tests. Despite being a disease with a known etiology, the lack of specificity of clinical manifestations and auxiliary examinations makes its diagnosis difficult. In an attempt for developing a standard diagnosis approach, a chart of diagnostic criteria for NCC was initially published in 1996, and revised in 2001 and 2017. This chart of diagnostic criteria systematized the diagnosis of NCC and became widely used worldwide. This manuscript describes the structure of the chart, the principles behind the changes for each revision, as well as the context of its use and potential for improvement.Keywords: cysticercosis, neurocysticercosis, Taenia solium, diagnosis, epilepsy, epidemiology
... Seizures, intracranial hypertension, headache and psychiatric disturbances are the most common manifestations of NCC. Signs and symptoms depend on the number of lesions as well as the developmental stage of the metacestode(s) (Medina & De Giorgio, 2002;Flisser, 1994;Del Brutto et al., 1992;Parija, 2008;Prasad et al., 2008a). ...
Neurocysticercosis (NCC) is an important but neglected tropical infectious disease, which is recently recognized as a global problem due to its potentiality for human-to-human transmission beyond tropics. The laboratory diagnosis of NCC is considered useful to confirm clinical and radiological diagnosis. However there is a lack of indigenous diagnostic method particularly in the tropical developing countries. Present study aimed to develop and evaluate indigenously developed anti-cysticercus IgG-ELISAs for possible diagnosis of NCC among patients presenting with seizures. Three indigenous antibody detection assays were developed employing three different antigenic preparations from T. solium metacestode larvae (viz., TsM-CF, TsM-CW and TsM-PS). The overall test results showed varying levels of IgG titers in response to the three antigenic preparations as compared with the standard commercially procured antibody-ELISA. Total soluble protein extract of protoscoleces or TsM-PS-Ag employed in the indigenously developed IgG ELISA is recommended to be used as a routine screening test for a confirmatory diagnosis of NCC and other forms of cysticercosis in humans.
... 1,3 Human beings are the only definitive hosts for this parasite, whereas both human beings and pigs function as intermediate hosts. 4 The 2017 Infectious Disease Society of America (IDSA)/ American Society of Tropical Medicine and Hygiene (ASTMH) guidelines for the diagnosis and management of NCC advocate antiparasitic therapy for viable parenchymal neurocysticerci (VPN), in addition to antiepileptics, analgesics, and anti-inflammatory agents. 2 The treatment reduces the likelihood of seizure recurrence and disease progression. [5][6][7][8] Monotherapy with a cysticidal drug (albendazole or praziquantel) is recommended for 1-2 VPN, whereas duotherapy with both is advocated for more than two lesions. ...
Antiparasitic treatment improves the prognosis for neurocysticercosis (NCC)-induced seizures. However, patients with high lesion loads are typically denied the possible benefit of cysticidal therapy due to fear of complications, and such patients are not represented in clinical trials involving cysticidal therapy. We provide proof of concept for combination treatment with dual antiparasitic therapy and corticosteroids in patients with diffuse lesions, including starry sky patterns, or calcific NCC. The safety and efficacy of treating patients with high lesion loads or calcific NCC should be tested in a randomized controlled trial.
... Asymptomatic carriers infected with the adult stage are the main risk factor associated with the development of NCC. Tapeworms are established in the gastrointestinal tract as a result of consuming undercooked pork meat contaminated with cysticerci (Flisser, 1994). Cysticerci consist of an invaginated scolex containing a rostellum armed with 2 rows of hooks, 4 suckers, and a spiral canal, all surrounded by the bladder (Rabiela et al., 2000). ...
Taenia solium is a helminth parasite that causes 2 diseases in humans: cysticercosis and taeniasis. The establishment of T. solium metacestodes in the central nervous system causes neurocysticercosis, while development of the adult tapeworm in the small intestine causes taeniasis. Serological diagnosis of neurocysticercosis is performed by Western blot with an enriched fraction of glycoproteins that has been extensively used for clinical diagnosis and epidemiological surveys. The lectin-bound fraction that is used for this assay contains 7 antigenic glycoproteins. These antigenic proteins are considered to be highly specific for cysticercosis when tested with heterologous parasitic diseases. However, recent studies show that people with taeniasis have cross-reactive antibodies against the neurocysticercosis diagnostic glycoproteins and vice versa. Nevertheless, it is not known if these diagnostic proteins are expressed in the adult stage of the parasite. In this paper, we describe the location of 3 of these glycoproteins in T. solium adults and cysticerci using polyclonal antibodies raised against a synthetic peptide based on the amino acid sequence of TS14, a recombinant protein T24H, and the native GP50. The glycoproteins' distribution was different in invaginated and evaginated cysticerci as well as in adult tapeworms. Specifically, the 3 glycoproteins studied were differentially expressed during embryogenesis. Our findings indicate that expression of the diagnostic glycoproteins is developmentally regulated; this is noteworthy since these glycoproteins are considered specific for the diagnosis of neurocysticercosis but nevertheless are present in different structures throughout the development of T. solium. Here we describe the glycoprotein expression and localization, which can be important in understanding their biological functions. In addition, our results help clarify the cross-reaction observed between people with neurocysticercosis and taeniasis to TS14, T24H, and GP50, which are used as diagnostic antigens for neurocysticercosis.
... Humans acquire the intestinal tapeworm infection (taeniasis) by consuming larval cysts that may be present in raw or undercooked pork. Adult tapeworms reside in the human intestine, and may expel tens of thousands of infectious eggs each day in the host's feces [3,4], which contaminate the environment in areas where open human defecation is common. The widespread practice of free-range pig-raising in endemic areas allows pigs to consume T. solium eggs in human feces and develop larval cyst infections in their muscle tissue, thus perpetuating the life-cycle. ...
Background:
Taenia solium (cysticercosis) is a parasitic cestode that is endemic in rural populations where open defecation is common and free-roaming pigs have access to human feces. The purpose of this study was to examine the roaming patterns of free-range pigs, and identify areas where T. solium transmission could occur via contact with human feces. We did this by using GPS trackers to log the movement of 108 pigs in three villages of northern Peru. Pigs were tracked for approximately six days each and tracking was repeated in the rainy and dry seasons. Maps of pig ranges were analyzed for size, distance from home, land type and contact with human defecation sites, which were assessed in a community-wide defecation survey.
Results:
Consistent with prior GPS studies and spatial analyses, we found that the majority of pigs remained close to home during the tracking period and had contact with human feces in their home areas: pigs spent a median of 79% (IQR: 61-90%) of their active roaming time within 50 m of their homes and a median of 60% of their contact with open defecation within 100 m of home. Extended away-from-home roaming was predominately observed during the rainy season; overall, home range areas were 61% larger during the rainy season compared to the dry season (95% CI: 41-73%). Both home range size and contact with open defecation sites showed substantial variation between villages, and contact with open defecation sites was more frequent among pigs with larger home ranges and pigs living in higher density areas of their village.
Conclusions:
Our study builds upon prior work showing that pigs predominately roam and have contact with human feces within 50-100 m of the home, and that T. solium transmission is most likely to occur in these concentrated areas of contact. This finding, therefore, supports control strategies that target treatment resources to these areas of increased transmission. Our finding of a seasonal trend in roaming ranges may be useful for control programs relying on pig interventions, and in the field of transmission modeling, which require precise estimates of pig behavior and risk.
... It is described in the literature that the central nervous system is affected in cases of cysticercosis in 60 to 90% of cases, and that the period of onset of symptomatology would vary from a few months to several tens of years, even if it is often impossible to accurately determine the timing of contamination (12). It is difficult to determine its prevalence in our environment for lack of long series. ...
Cysticercosis is an endemic disease in many developing countries. This diagnosis is based on the cystic aspect of the lesions, particularly in case of stay in endemic areas and serology. The clinical manifestations are of very variable expression and go from the completely asymptomatic form to very severe tables putting at stake the vital prognosis of the patient. We report in this article the case of a 43-year-old woman who was admitted to the neuropsychiatric center Dr. Joseph Guislain of ''Brothers of Charity'' in Lubumbashi/DRC for a neurocysticercosis revealed by a behavioral disorder and generalized tonic clonic seizures. She was treated with albendazole 15 mg/kg/day/15 days, phenobarbital 100 mg/day at 20 h, haldol 5 mg/day/10 days and prednisolone 1 mg/kg/day/15 days. Its evolution was marked by a clear improvement of its clinical condition under treatment.
... Each day a few mature proglottides are detached from the distal end of the mature worm, reaching the environment mixed into the faecal material. Each gravid proglottide contains around 60,000 eggs [50]. In areas with deficient sanitation, eggs may contaminate vegetables and food. ...
Background
Taenia solium is the aetiological agent of human taeniasis, pig cysticercosis and human neurocysticercosis, which are serious public health problems, especially in developing countries.
Methods
A mathematical model of the transmission dynamics of taeniasis-cysticercosis is formulated. The model consists of a coupled system of differential equations, which are density-dependent equations for describing the flow of the parasite through the life cycle. The model is hybrid since it comprises deterministic equations with stochastic elements which describe changes in the mean parasite burden and incorporates the overall pattern of the parasites’ distribution.
Results
Sensitivity and bifurcation analyses were carried out to determine the range of values of the model. The model can reproduce the observed epidemiological patterns of human taeniasis, pig and human cysticercosis. For example, for a wide range of parameter values, the mean intensity of adult worms tends to rapidly stabilize in one parasite per individual host. From this model, we also derived a Susceptible-Infected model to describe the prevalence of infection in humans and pigs. Chemotherapeutic interventions against pig cysticercosis or human taeniasis may reduce rapidly and effectively the mean intensity of human taeniasis, pig cysticercosis and human cysticercosis. This effect can be achieved even if the protective efficacy of the drug is of the order of 90% and the coverage rate is 90%. This means that health in humans infected either with adult worms or cysticerci may be achieved by the application of anthelmintic drugs against pig cysticercosis. However, treatment against human cysticercosis alone, does not influence neither human teniasis nor pig cysticercosis. This is because human cysticercosis infection does not influence the value of the basic reproductive number (Ro).
Conclusions
Even coverage of 100% in the administration of anthelmintics did not eliminate the infection. Then elimination of the infection in all hosts does not seem a feasible goal to achieve by administering only chemotherapeutic interventions. Throughout the manuscript a discussion of our model in the context of other models of taeniasis-cysticercosis is presented.
Electronic supplementary material
The online version of this article (10.1186/s12976-018-0090-0) contains supplementary material, which is available to authorized users.
... NCC occurs when humans accidentally ingest the oncospheres of T. solium (Carpio, 2002). This may occur via food or water in areas where water sources are contaminated by human feces, or via accidental ingestion of tiny amounts of the feces of an adult tapeworm carrier in the household (Flisser, 1994). Oncospheres are also activated in the human gut as they would be in the pig gut, and are able to penetrate the gut wall and pass into the bloodstream (Carpio, 2002). ...
Neurocysticercosis (NCC) occurs following brain infection by larvae of the cestode Taenia solium . It is the leading cause of preventable epilepsy worldwide and therefore constitutes a critical health challenge with significant global relevance. Despite this, much is still unknown about many key pathogenic aspects of the disease, including how cerebral infection with T. solium results in the development of seizures. Over the past century, valuable mechanistic insights have been generated using both clinical studies and animal models. In this review, we critically assess model systems for investigating disease processes in NCC. We explore the respective strengths and weaknesses of each model and summarize how they have contributed to current knowledge of the disease. We call for the continued development of animal models of NCC, with a focus on novel strategies for understanding this debilitating but often neglected disorder.
... Derfor bør integration af T. solium kontrol i allerede eksisterende programmer vurderes yderligere. (Flisser, 1994). Taenia solium is transmitted between humans and pigs ( Figure 1). ...
... El hospedero principal de la cisticercosis es el cerdo, el cual actúa como intermediario en el ciclo cisticercosis-teniasis. El hombre también puede ser hospedero intermediario ocasional (1) . ...
La neurocisticercosis (NCC) es la parasitosis humana más frecuente del sistema nervioso central y es causada por las larvas del céstodo Taenia solium. La NCC es endémica en prácticamente todos los paises en vías de desarrollo. En general se presenta como formas intraparenquimales asociadas con convulsiones o formas extraparenquimales asociadas con hipertensión endocraneana. La sospecha clínica y epidemiológica es importante pero el diagnóstico se realiza primariamente por imágenes y se confirma con serología. La tomografía axial computarizada y la resonancia magnética son las pruebas imagenológicas usadas. Como prueba confirmatoria se usa el diagnóstico inmunológico a través de western blot, que actualmente se pude realizar en el Instituto Nacional de Ciencias Neurológicas tanto en suero como en líquido cefalorraquídeo. El tratamiento involucra medidas sintomáticas (control de convulsiones o hipertensión endocraneana según sea el caso) y tratamiento antiparasitario (albendazol o praziquantel). El tratamiento antiparasitario debe hacerse bajo condiciones de hospitalización y en hospitales de tercer nivel.
... Seizures, intracranial hypertension, headache and psychiatric disturbances are the most common manifestations of NCC. Signs and symptoms depend on the number of lesions as well as the developmental stage of the metacestode(s) (Medina & De Giorgio, 2002;Flisser, 1994;Del Brutto et al., 1992;Parija, 2008;Prasad et al., 2008a). ...
Neurocysticercosis (NCC) is an important but neglected tropical infectious disease, which is recently being recognized as a global problem due to its potentiality for human-to-human transmission beyond tropics. The laboratory diagnosis of NCC is considered useful to confirm clinical and radiological diagnosis. However there is a lack of indigenous diagnostic method particularly in the tropical developing countries. Present study aimed to develop and evaluate indigenously developed anti-cysticercus IgG-ELISAs for possible diagnosis of NCC among patients presenting with seizures. Three indigenous antibody detection assays were developed employing three different antigenic preparations from T. solium metacestode larvae (viz., TsM-CF, TsM-CW and TsM-PS). The overall test results showing varying levels of IgG titers in response to the above three antigenic preparations are compared with the standard commercially procured antibody-ELISA. Total soluble protein extract of protoscoleces or TsM-PS-Ag employed in the indigenously developed IgG ELISA is recommended to be used as a routine screening test for a confirmatory diagnosis of NCC and other forms of cysticercosis in humans.
... The specific identification of the worm was based on standard procedures. 4 Briefly, detection of Taenia species eggs was performed upon microscopic examination of stool sample (Figure 1). Six active proglottid chains were observed in stool. ...
Taeniasaginata can cause severe health and economic problems particularly in endemic areas. The disease cause by this cestode is related to poor sanitary conditions, inadequate hygiene, open defecation, inadequately cooked beef and poverty.
A 35 years man found yellowish white tapeworm proglottids moving in his feces and consulted to the Department of Emergency, ShahidRajaei hospital, Karaj, Iran. He complained of lower abdominal discomfort, anal itching and moving something in the stomach. He was given wrong prescription. The patients had the history of eating undercooked beef.
We report one case of T. saginata infection based on adult tapeworm recovery from the patients. The specific identification of the worm was based on based on standard procedures. Three months after expelling the tapeworm, the man felt better and returned to his normal life.
... The clinical manifestations of NCC are non-specific and varied, depending on the number of lesions as well as the developmental stage of the parasite. Seizures are the commonest manifestation, occurring in 50%-80% of patients [3,4]. NCC is considered to be the single most common cause of epilepsy in the developing countries which are known to be endemic for T. solium taeniasis/ cysticercosis [5,6]. ...
Objective
To report cases of neurocysticercosis (NCC) from three neighboring districts of Andhra Pradesh state in India where NCC burden was never explored before.
Methods
A total of 160 patients presenting with recent onset seizures were recruited from neurology, general medicine, and pediatric outpatient clinics of a local major tertiary care teaching hospital serving above districts during the period 2011–2014. Brain imaging was performed in all the above cases. A commercial immunoglobulin G-ELISA kit (sensitivity = 85%; specificity = 94%) was employed for the serological diagnosis of NCC.
Results
The recruited patients presented with generalized, simple partial, and complex partial seizures (55%, 31.25% and 13.75% respectively). NCC was diagnosed in 44 of 160 (27.5%) seizure cases based on imaging characteristics, and a positive serum antibody ELISA. No association was detected between seropositivity with the number and location of the lesion(s) in the brain.
Conclusions
The possible potentiality of NCC could be identified as an underlying cause of the recent onset of seizures in this region as explored in the present study. It is recommended that NCC should be suspected as one of the major differential in every recent onset seizure with or without a radio imaging supportive diagnosis, especially in areas endemic for taeniasis/cysticercosis.
... The clinical manifestations of NCC are non-specific and varied, depending on the number of lesions as well as the developmental stage of the parasite. Seizures are the commonest manifestation, occurring in 50%–80% of patients [3,4]. NCC is considered to be the single most common cause of epilepsy in the developing countries which are known to be endemic for T. solium taeniasis/cysticercosis [5,6] . ...
... It is the most serious form of cysticercosis and is the most common cause of acquired epilepsy worldwide. 4,6,9,[14][15][16] Neurocysticercosis is a serious public health concern in developing countries in Latin America, Asia, and Africa and is the most common helminthic eggs hatch into oncospheres in the intestine, which then invade the intestinal wall and migrate to striated muscles, brain, liver, and other tissues. Once in those tissues, they develop into cysticerci. ...
An 8-y-old, intact, male rhesus macaque (Macaca mulatta) was sedated to undergo MRI in preparation for the implantation of cranial hardware. During imaging, 9 focal lesions were noted in the brain and musculature of the head. The lesions were hyper echoic with hypoechoic rims. The animal was deemed inappropriate for neuroscience research, and euthanasia was elected. Gross examination revealed multiple round, thick-walled, fluid-filled cysts (diameter, approximately 0.5 cm) in multiple tissues: one each in the left caudal lung lobe, left masseter muscle, and the dura overlying the brain and 8 throughout the gray and white matter of the brain parenchyma. Formalin-fixed sections of cyst-containing brain were stained with hematoxylin and eosin. Microscopic examination and molecular analysis of the COX1 (COI) gene recognized the causative organism as Taenia solium at 99.04% identity.
... The actual lifespan of a T. solium tapeworm is unknown, but studies have indicated that the tapeworm is not long lived as anecdotally mentioned in the literature [1]. An adult tapeworm can approximately excrete 50,000 eggs per day [28], which is equivalent to 1,500,000 eggs per month. A person can only harbour one tapeworm at the time in cystiSim [29]. ...
Taenia solium taeniosis/cysticercosis was declared eradicable by the International Task Force for Disease Eradication in 1993, but remains a neglected zoonosis. To assist in the attempt to regionally eliminate this parasite, we developed cystiSim, an agent-based model for T. solium transmission and control. The model was developed in R and available as an R package (http://cran.r-project.org/package=cystiSim). cystiSim was adapted to an observed setting using field data from Tanzania, but adaptable to other settings if necessary. The model description adheres to the Overview, Design concepts, and Details (ODD) protocol and consists of two entities—pigs and humans. Pigs acquire cysticercosis through the environment or by direct contact with a tapeworm carrier's faeces. Humans acquire taeniosis from slaughtered pigs proportional to their infection intensity. The model allows for evaluation of three interventions measures or combinations hereof: treatment of humans, treatment of pigs, and pig vaccination, and allows for customary coverage and efficacy settings. cystiSim is the first agent-based transmission model for T. solium and suggests that control using a strategy consisting of an intervention only targeting the porcine host is possible, but that coverage and efficacy must be high if elimination is the ultimate goal. Good coverage of the intervention is important, but can be compensated for by including an additional intervention targeting the human host. cystiSim shows that the scenarios combining interventions in both hosts, mass drug administration to humans, and vaccination and treatment of pigs, have a high probability of success if coverage of 75% can be maintained over at least a four year period. In comparison with an existing mathematical model for T. solium transmission, cystiSim also includes parasite maturation, host immunity, and environmental contamination. Adding these biological parameters to the model resulted in new insights in the potential effect of intervention measures.
... Neurocysticercosis continues to be a major public health problem with a worldwide distribution, showing a higher prevalence in the developing regions of the world. [5] However, the prevalence is a variable depending mainly on sociocultural and economic factors. In addition, immigration from endemic to nonendemic areas is also one of the major factors influencing the prevalence. ...
Neurocysticercosis is the most common parasitic infection of the central nervous system worldwide. However, Cysticercosis affecting the spine is considered extremely rare. We report two cases of spinal cysticercosis with review of literature.
... La transmisión de esta enfermedad se da por la ingestión de huevos de Taenia solium, posteriormente ocurre la lisis de la cubierta del huevo a nivel intestinal, originando procesos de irritación local con la consecuente erosión de la mucosa y el paso de la oncósfera al torrente venoso, pudiendo acceder al corazón para alcanzar circulación sistémica, llegando preferentemente a los capilares arteriales musculares o cerebrales y de allí al parénquima cerebral, espacio subaracnoideo y ventrículos (ver figura 5) (Flisser, 1994). Los cerdos infectados con quistes de T. solium juegan un papel importante en la transmisión y mantenimiento de la cisticercosis y la teniasis en seres humanos, ocasionando la imperiosa necesidad de servicios efectivos en salud animal y de inspección de los productos de origen animal, que son los de consumo humano (carne de cerdo) (Carrada-Bravo, 1987;Pinto et al., 2000). ...
Conceptualmente se considera como vacuna a toda sustancia formada por un microorganismo completo atenuado o muerto, o bien fracciones del mismo, capaces de inducir una respuesta inmune protectora y duradera frente al patógeno. La finalidad de las vacunas es la de prevenir y controlar futuras infecciones. Características de una vacuna ideal:
a).- Reproducir (mimetizar) una respuesta inmunológica similar a la de la infección natural.
b).- La vacuna debe ser efectiva, al ofrecer más del 90% de protección; no obstante cuando la tasa de mortalidad de una enfermedad infecciosa es elevada, un 50 - 60% de protección frente a ésta, se considera sin lugar a dudas como una buena protección.
c).- Mínimos efectos secundarios o preferentemente completamente segura.
d).- Inmunidad persistente a largo plazo.
e).- Dosis única y compatible con otras vacunas.
f).- Administración no invasiva (vía oral preferentemente).
g).- Administración precoz en los primeros meses de vida.
h).- Estable a temperatura ambiente, siendo este uno de los aspectos más importantes por cuanto del costo total derivado de la vacuna, aproximadamente el 70%, corresponde a la cadena de frío que se sigue para que ésta pueda llegar hasta el usuario.
i).- Fácil producción y económicamente asequible.
... On the other hand, the adult parasites of the three species showed no differences in ATPase activity, probably because they all lodge in the host intestine; these data accord with the intense peristaltic movements of the hosts. As expected, the lowest V max value was found in T. solium cysticerci myosin , since this developmental stage is less dynamic; the cysticerci are encapsulated until after they are eaten by their hosts (Flisser, 1994). ...
... Proximity of tapeworm carriers is the main risk factor for acquiring cysticercosis. 1 Rodent models provide a useful approach for studying the host-parasite relationship of T. solium adult parasites. 2,3 Infected hamsters develop an inflammatory reaction in the mucosa surrounding the tapeworm scolex. ...
Infection with the swine tapeworm (Taenia solium) causes a significant global burden of disease, not only in terms of human health, but
also in terms of economic hardship on smallholder pig farmers due to pig cysticercosis infection. In most underdeveloped nations,
neurocysticercosis accounts for around 30% of all epilepsy cases. The primary strategy for immune-diagnosis should thus be to determine
whether the serological results are aligned with the imaging-based diagnosis. In an enzyme-linked immune-electro transfer blot format,
antibodies are detected using lentil lectin-purified parasite antigens, whilst antigens are detected using a monoclonal antibody-based
enzyme-linked immunosorbent assay (ELISA). Taenia solium’s life cycle, parasitology, and immunology is complicated. The 73rd
World Health Assembly in November 2020 accepted the Organization's neglected tropical diseases plan for 2021-2030.
Background
Neurocysticercosis (NCC), a predominant parasitic disease that affects the central nervous system and presents with diverse clinical manifestations, is a major contributor to acquired epilepsy worldwide, particularly in low-, middle-, and upper middle-income nations, such as China. In China, the Yunnan Province bears a significant burden of this disease.
Objective
To describe the demographic, clinical, and radiological features as well as serum and cerebrospinal fluid antibodies to cysticercus in patients with NCC from Dali, Yunnan Province, China.
Materials and Methods
This retrospective study included patients who were diagnosed with NCC at The First Affiliated Hospital of Dali University between January 2018 and May 2023 and were residing in Dali, Yunnan Province, China.
Results
A total of 552 patients with NCC were included, of which 33.3% belonged to Bai ethnicity. The clinical presentation of NCC exhibited variability that was influenced by factors such as the number, location, and stage of the parasites. Epilepsy/seizure (49.9%) was the most prevalent symptom, with higher occurrence in the degenerative stage of cysts (P < 0.001). Compared with other locations, cysticerci located in the brain parenchyma are more likely to lead to seizures/epilepsy (OR = 17.45, 95% CI: 7.96–38.25) and headaches (OR = 3.02, 95% CI: 1.23–7.41). Seizures/epilepsy are more likely in patients with cysts in the vesicular (OR = 2.71, 95% CI: 1.12–6.61) and degenerative (OR = 102.38, 95% CI: 28.36–369.60) stages than those in the calcified stage. Seizures was not dependent on the number of lesions. All NCC patients underwent anthelminthic therapy, with the majority receiving albendazole (79.7%).
Conclusion
This study provides valuable clinical insights into NCC patients in Dali and underscores the significance of NCC as a leading preventable cause of epilepsy.
Parasite aggregation within hosts is a fundamental feature of parasite distributions, whereby the majority of parasites are harboured by a minority of hosts. Parasite aggregation can influence their transmission and hence control. In this narrative review, possible sources of aggregation of Taenia solium cysticerci in pigs are discussed, along with implications for control of the parasite. While heavy T. solium infections in pigs could most likely be associated with ingestion of high doses of infective parasite eggs, consistent with coprophagic behaviour of pigs, lighter infections indicate a role of indirect routes of transmission to pigs, mostly from lower infection doses. Light infections are likely to be missed by commonly used diagnostic methods - tongue examination or meat inspection - and end up in the food chain. Hence, they entail a 'hidden' risk and are of a particular public health concern, especially in areas where meat is consumed raw or undercooked. To be effective and sustainable, control strategies against T. solium likely require a broader understanding of, and consideration for parasite transmission dynamics. More importantly, a holistic One Health approach incorporating interventions on humans, pigs and the environment will likely have a larger, more successful and sustainable impact.
The ILAE Neuroimaging Task Force aims to publish educational case reports highlighting basic aspects related to neuroimaging in epilepsy consistent with the educational mission of the ILAE. Neurocysticercosis (NCC) is highly endemic in resource-limited countries and increasingly more often seen in non-endemic regions due to migration. Cysts with larva of the tapeworm Taenia solium lodge in the brain and cause several neurological conditions, of which seizures are the most common. There is great heterogeneity in the clinical presentation of neurocysticercosis because cysts vary in number, larval stage, and location amongst patients. We here present two illustrative cases with different clinical features to highlight the varying severity of symptoms secondary to this parasitic infestation. We also present several examples of imaging characteristics of the disease at various stages, which emphasize the central role of neuroimaging in the diagnosis of neurocysticercosis.
Neurocysticercosis is the most common parasitic infection of the central nervous system worldwide. However , cysticercosis affecting the spine is considered extremely rare. We report one case of spinal cysticercosis with review of literature.
Introduction: Helminthic diseases are worldwide in distribution infection is most common and most serious in poor countries. The distribution of these diseases is determined by climate, hygiene, diet, and exposure to vectors. he most serious helminthic diseases are acquired in poor tropical and subtropical areas, but some also occur in the developed world other, less serious, infections are worldwide in distribution. Exposure to infection is influenced by climate, hygiene, food preferences, and contact with vectors. Many potential infections are eliminated by host defenses others become established and may persist for prolonged periods, even years. Although infections are often asymptomatic, severe pathology can occur. Because worms are large and often migrate through the body, they can damage the hosts tissues directly by their activity or metabolism. Damage also occurs indirectly as a result of host defense mechanisms. Almost all organ systems can be affected. Methodology: In this descriptive study, 100 school children from selected schools of district Una in the age group of 14-17 years were selected as the samples for the study by using total stratified sampling technique. The data was collected by using self structured knowledge questionnaire on preventive measures of helminthic disease . Data analysis was performed by descriptive statistics and inferential statistics. SPSS-17 software was used and P values less than 0.05 were considered significant. Result: The findings shows that the majority of children had fair level of knowledge (54%), 24% children had poor level of knowledge, 20% children had good level of knowledge and 2% children had excellent level of knowledge regarding preventive measures of helminthic diseases. Discussion: The result shows that out of 100 school children, only 2% of the school children had excellent level of knowledge, 20% of school children had good level of knowledge, 54% of the school children had fair level of knowledge and 24% of the school children had poor level of the knowledge regarding preventive measures of helminthic diseases which was calculated at 0.05 level of significance.
Cysticercus is the infective larval form of the cystode T. solium that causes cysticercosis. It is has been declared as one of the neglected endemic zoonoses by the WHO. Poor sanitation, and consumption of undercooked infected pork and raw vegetables contaminated by human feces are the potential sources. Cysticercosis can affect various organs. India is one of the endemic countries where the parasite is prevalent in many states. This study aimed to analyze and report cases of cysticercosis based on the histopathological diagnosis. This is a retrospective study that included cases which had been reported as cysticercosis on histopathology from 2010 to 2018 at a tertiary care hospital. The clinical presentation of these cases along with macroscopic and microscopic features were reviewed. There were six cases of cysticercosis that were diagnosed on histopathology during the study period. Among them, two cases were intramuscular lesions, three were subcutaneous, and one case was an intraventricular lesion in the brain. Three of the cases presented as cystic lesions. On histopathological evaluation, cysts were identified in four cases on macroscopy. Microscopically, the cross section of the cysticercus was seen in all six cases with associated inflammatory change. To conclude, cysticercosis can clinically present as a benign neoplastic or an inflammatory lesion. Microscopic findings dictate the diagnosis of cysticercosis, although histopathological evaluation is not common.
Taenia, one of the earliest recognized helminths, is a comparatively large genus with 42 known valid species. Three most commonly recognized species of human importance are T. solium and T. asiatica (pork tapeworms) and T. saginata (beef tapeworm). Adult tapeworms reside in human intestine, and the disease is called taeniasis. The larva (cysticercus) of only T. solium can infect internal organs of human, known as cysticercosis; when the larva infects the central nervous system (CNS) of the host, it is known as neurocysticercosis (NCC). NCC is the most severe form of the disease with considerable morbidity and mortality. It is considered as the most common cause of community-acquired epileptic seizure disorders. The life cycle of T. solium involves two hosts: humans are the only definitive host and accidental intermediate host, while pig is the natural intermediate host. The eggs passed through faeces by T. solium carriers contaminate the environment. Both human and pig can get infection (cysticercosis/NCC) through ingestion of eggs, while human acquires taeniasis through consumption of cysticercotic pork. T. solium infection is highly endemic in Africa, Asia and Latin America. Now developed world is also facing this problem due to human migration from Taenia endemic areas. Therapeutic measures for NCC-related active epilepsy include anti-epileptic drug(s) with or without steroids: surgery/placement of shunt is indicated for patients with raised intracranial pressure. Antiparasitic drug to kill the brain cysticerci remains controversial. Treatment of choice for taeniasis is niclosamide; alternatives are praziquantel and albendazole. The following measures such as antiparasitic therapy to eliminate Taenia carriers in endemic populations, health education, toilet facilities and handwash with soap, control on sale of measly pork, restriction on pig roaming and pig vaccination, etc. may help to control the disease.
Antiparasitic agents against Taenia solium cysticercosis have been in use since 1979, although its use has been questioned on the basis that cysts would die naturally and thus treatment-induced inflammation is unnecessary. In addition, isolated reports have also questioned whether neurocysticercosis (NCC) is a cause of epilepsy. After more than three and a half decades, a large body of evidence is available. Little if any doubt exists about NCC as a cause of seizures — NCC is consistently associated with seizures when appropriate groups are compared, and in a large subset of cases, seizure semiology correlates with the anatomical location of lesions. Cyst degeneration and the subsequent inflammatory reaction increase seizure expression, although patients with non-inflamed cysts may have seizures, as do patients with long-standing, not inflamed calcified scars. Assessment of the evidence on cysticidal efficacy, safety, and the impact of cyst destruction in decreasing seizures leads to the conclusion that the benefits of antiparasitic treatment in parenchymal brain cysticercosis clearly outweigh the risks, and have provided substantive evidence of the role of NCC as a cause of seizures and epilepsy. Antiparasitic therapy should be considered a primary option in the management of patients with live or degenerating brain NCC cysts.
This article is part of a Special Issue entitled “Neurocysticercosis and Epilepsy”
The aim of this study was to determine sero-prevalence of bovine and porcine cysticercosis in cattle and pigs in rural farming communities in Free State and Gauteng Provinces, Republic of South Africa. Blood samples were collected for a period of twelve months from live cattle (n=1315; 1159) and pigs (n=436; 240) and the serum extracted and stored before analysis by a monoclonal antibody based (HP10) antigen detection ELISA. Results revealed a generally high sero-prevalence and wide distribution throughout the two provinces with Free State having a higher sero-prevalence in both cattle and pigs (23% and 34%) than Gauteng province (15% and 14%). Consumption of infected meat that is either not inspected/missed at meat inspection; poor livestock management practices and limited sanitation in rural communities might have contributed to the occurrence of Taenia spp. infections in the two provinces. It is therefore, recommended that cysticercosis status of animals be established before slaughter. This would assist in ensuring that infected animals are not slaughtered for human consumption or zoonosis preventive measures are taken. Furthermore, public awareness programs on life cycles of T. saginata, T. solium and T. hydatigena and the use of more sensitive diagnostic tools are recommended as part of effective control strategies against taeniid infections.
Cysticercosis, caused by metacestodes of Taenia solium, has a significant soci-economic impact and is of considerable importance in public health. However, there are no specific diagnostic antigens to distinguish between T. solim and Taenia hydatigena. In the present study, cAMP-dependent protein kinase regulatory subunit (TsPKA-r), an excretory/secretary (ES) antigen of T. solium, was used to establish a specific and sensitive diagnostic tool for detection of porcine cysticercosis. The full-length sequence encoding TsPKA-r was amplified by PCR, sequenced and then identified by bioinformatics. The fusion protein with 6?His-tags was expressed in E. coli, purified by Ni Sepharose? 6 Fast Flow and used to test reactionogenicity by immunoblotting. TsPKA-r based indirect enzyme-linked immunosorbent assays (iELISA) showed good performance in recognition of sera of pigs experimentally infected with T. solium metacestodes, with 93.88% sensitivity and 96.40% specificity. There were no cross-reactions against the sera samples from pigs experimentally infected with T. hydatigena, Toxoplasma gondii or Trichinella spiralis. These results indicate that the TsPKA-r is a promising immunodiagnostic antigen for detection of porcine cysticercosis.
La neurocisticercosis es la primera causa de parasitosis del sistema nervioso central y de epilepsia adquirida en países en vía de desarrollo. Las manifestaciones clínicas de la neurocisticercosis, especialmente la variante racemosa, son pleomórficas e inespecíficas, características que dificultan el diagnóstico y lo convierten en un desafío para el clínico. El objetivo de este informe es describir dos casos de neurocisticercosis racemosa, en los cuales las neuroimágenes guiaron al diagnóstico definitivo. El primer caso se trató de una paciente con cefalea persistente y signos neurológicos focales, requirió múltiples ayudas paraclínicas que llevaron al diagnóstico definitivo de neurocisticercosis racemosa con vasculitis cerebral secundaria, a pesar del tratamiento médico y quirúrgico la paciente falleció después de múltiples complicaciones. El segundo caso se trató de una paciente con antecedente de neurocisticerosis, que consultó por vómito crónico incoercible, requirió múltiples ayudas paraclínicas que llevaron al diagnóstico de vómito de origen central secundario a neurocisticercosis racemosa y atrapamiento del cuarto ventrículo, después del tratamiento médico y quirúrgico la paciente presentó leve mejoría. En estos dos casos se evidencia como la adecuada interpretación de las neuroimágenes es fundamental para llegar al diagnóstico de la neurocisticercosis racemosa.
Almost every organ of the human economy may be affected by cysticerci, but with few exceptions, significant disease is mostly observed in patients with neurocysticercosis. The latter is a highly pleomorphic disease, defined as the infection of the central nervous system and its coverings by the larval stage of the tapeworm T. solium. The clinical pleomorphism of neurocysticercosis is mainly related to both the myriad of pathological changes that parasites may cause within the nervous system and the individual differences that exist in the severity of the host’s immune response against cysticerci which, in turn, causes a great variety of lesions in the adjacent cerebral tissue (Fleury et al. 2010; Mahanty and García 2010).
Taenia solium is one of the many species of cestodes (tapeworms) that can infect humans (Flisser 1994; Pawlowski 2002). It belongs to the phylum Platyhelminthes, class Cestoidea, order Cyclophyllidea, family Taeniidae. In general terms, tapeworms are complex organisms having complex life cycles that require at least two hosts for their completion. In the case of Taenia solium, humans are the most important definitive hosts, whereas both pigs and humans are the main intermediate hosts. The list of other animals that may act as definitive or intermediate hosts of Taenia solium is large but clinically irrelevant.
The adaptive processes required for the parasite to survive inside the vertebrate host avoiding the attack of the immune system either as a tissue cyst or as an intestinal tapeworm, as well as the changes occurring after detection of the cysts by the immune system and the subsequent inflammatory reaction and parasite degeneration, result in a varied array of diverse mechanisms and scenarios which in most cases are only poorly understood.
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