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Arango-Londoño MM, López-Osorio S, Rojas-Bermudéz F, Chaparro-Gutiérrez JJ. The Frequency of Porcine Cysticercosis and Factors Associated with Taenia solium Infection in the Municipality of Tuchín-Córdoba, Colombia. Pathogens 2024; 13:311. [PMID: 38668266 PMCID: PMC11054264 DOI: 10.3390/pathogens13040311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/22/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
Taeniasis and cysticercosis are parasitic infections that affect humans and pigs. Their global distribution constitutes a serious public health issue with significant implications for pork production. The purpose of this study was to evaluate the presence of porcine cysticercosis in backyard swine from 42 indigenous communities throughout Tuchín-Córdoba, Colombia. Between December 2020 and March 2021, free-range pigs (n = 442) were assessed using the ELISA cysticercosis Ag test; 85 pigs were examined through sublingual visual evaluation, and 4 slaughtered pig carcasses were subjected to standard operation inspection. The collected cysticercus underwent histological and PCR analysis. Furthermore, 192 surveys of knowledge, attitudes, and practices (KAP) were used to identify the factors that facilitate infection transmission. Serological investigation revealed that 9.7% (46/472) of the animals were positive for cysticerci Ag. Sublingual inspection identified cysticercus in 28.7% (25/87) of the animals, while PCR analysis indicated that cysticercus corresponded to the T. solium American/African genotype. The factors associated with T. solium infection in the pigs in the surveyed areas numbered 14. The majority are associated with factors that promote the active persistence of Taenia solium's life cycle in an area, such as lack of environmental sanitation, a lack of coverage or care for drinking water and wastewater treatment services, and no solid waste disposal.
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Affiliation(s)
- Margarita M. Arango-Londoño
- CIBAV Research Group, Veterinary Medicine School, Faculty of Agrarian Sciences, Universidad de Antioquia, UdeA, Medellín 050034, Colombia; (M.M.A.-L.); (S.L.-O.)
| | - Sara López-Osorio
- CIBAV Research Group, Veterinary Medicine School, Faculty of Agrarian Sciences, Universidad de Antioquia, UdeA, Medellín 050034, Colombia; (M.M.A.-L.); (S.L.-O.)
| | | | - Jenny J. Chaparro-Gutiérrez
- CIBAV Research Group, Veterinary Medicine School, Faculty of Agrarian Sciences, Universidad de Antioquia, UdeA, Medellín 050034, Colombia; (M.M.A.-L.); (S.L.-O.)
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Tassou WA, Attindéhou S, Gbati OB, Adjassin JS, Salifou S. Nexus between prevalence of Taenia solium (Cysticercus cellulosae) in pigs and retrospective study of humans cysticercosis cases in Benin hospitals. Vet Res Commun 2024; 48:1083-1096. [PMID: 38105360 DOI: 10.1007/s11259-023-10281-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
The cysticercosis is a major zoonotic disease in many developing countries. This study was carried out to determine the prevalence of porcine cysticercosis and to identify potential risk factors associated and their seroprevalence as well in Benin. The tongue palpation was performed on 4150 pigs from the pig farmers were randomly selected to diagnose cysticercosis and to assess the risk factors associated. In slaughterhouses, 792 pigs were inspected. Serum samples from 460 pigs were tested of the presence of Taenia solium cysticercosis using the HP10 antigen-ELISA (Ag-ELISA). A logistic regression model with a 95% confidence interval was used to analyse the main risk factors associated. The tongue palpation revealed a prevalence of 4.79% at the level of slaughterhouses versus 7.82% in the post-mortem inspection. The Ag-ELISA revealed that more than 40% of the pigs were positive. The risk factors identified were the origin area of pigs, the history of cysticercosis in the farms, the presence or absence of a latrine, the pig-farming systems, the age class of pigs and the source of watering. In addition, 34.48% individuals was tested for taenia versus 13.79% for cysticercosis in the hospitals surveyed. Our results showed the major revelation of porcine cysticercosis and its very high level of risk for a public health in all departments of Benin. Therefore, this study suggests the need to continue epidemiological and sociological surveys with a "One Health" approach in order to design and implement effective control measures in this country of high consumption of pigs.
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Affiliation(s)
- Wassiou Abdou Tassou
- Research Unit of Animal Health and Biosecurity (URSAB), Laboratory of Animal Sciences and Fisheries (LASAH), National University of Agriculture, 01 P.O Box 55, Porto-Novo, Benin.
| | - Sabbas Attindéhou
- Research Unit of Animal Health and Biosecurity (URSAB), Laboratory of Animal Sciences and Fisheries (LASAH), National University of Agriculture, 01 P.O Box 55, Porto-Novo, Benin
| | - Oubri Bassa Gbati
- Department of Public Health and Environment, Interstate School of Veterinary Science and Medicine, P.O Box 5077, Dakar, Senegal
| | - Josias Steve Adjassin
- Laboratory of Ecology, Heath and Animal Productions (LESPA), University of Parakou, P.O Box 123, Parakou, Benin
- INRAE, Université Clermont Auvergne, VetAgro Sup, UMR 1213 Herbivores, 63122, Saint-Genès-Champanelle, France
| | - Sahidou Salifou
- National Laboratory of Veterinary Parasitology (LNPV), Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou Republic, Benin
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Hernández-Chea R, Morales-Ramírez P, Hernández M, Hun A, Silva I, Fleury A, Sciutto E. Epidemiology of swine cysticercosis in two rural communities of Zacapa, Guatemala. Vet Parasitol Reg Stud Reports 2024; 47:100951. [PMID: 38199694 DOI: 10.1016/j.vprsr.2023.100951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/16/2023] [Accepted: 11/02/2023] [Indexed: 01/12/2024]
Abstract
Taeniasis/cysticercosis complex caused by Taenia solium, is a serious public health problem and causes major economic losses to swine producers in developing countries in Asia, Africa and the Americas. Despite scarce epidemiological data, Guatemala is considered endemic for T. solium. A cross-sectional study was conducted in Azacualpa and Malpais, two villages in the department of Zacapa, to assess the prevalence of swine cysticercosis and associated factors. Between March and October 2019, 149 pigs were examined by tongue palpation and serum samples were then collected to detect antibodies by ab-ELISA, and necropsy was performed on pigs that were positive by tongue palpation and/or ab-ELISA, to assess parasite load. Pig owners were asked to fill out a questionnaire on factors related to pig husbandry and occurrence of swine cysticercosis. Pearson's chi-square test and multivariate analysis were used to measure the association between serological results and other variables (p < 0.05 was considered significant). The seroprevalence of swine cysticercosis was 13.4% (13/97, 95% C.I. 6.6%-20.2%) and 25% (13/52, 95% C.I. 13.2%-36.8%) in Azacualpa and Malpais, respectively, yielding an overall seroprevalence of 17.4% (26/149, 95% C.I. 11.4%-23.5%). Parasite loads ranged from 1 to over 23,000 metacestodes per carcass. No bivariate association was found between exposure variables and seropositivity. A positive diagnosis by tongue palpation increased the odds of finding pigs seropositive for cysticercosis by a factor of 16.1 in the multivariate analysis. Despite the high prevalence and parasite load of T. solium, risk factors associated with cysticercosis were not significant in this study.
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Affiliation(s)
- Roderico Hernández-Chea
- Dirección Departamental de Redes Integradas de Servicios de Salud, Guatemala-área sur, Ministerio de Salud Pública y Asistencia Social, Guatemala, Amatitlán, Guatemala.
| | | | - Marisela Hernández
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alejandro Hun
- Escuela de Posgrado, Facultad de Medicina Veterinaria y Zootecnia, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - Ilde Silva
- Facultad de Ciencias Jurídicas y Sociales, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - Agnès Fleury
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico; Unidad Periférica del Instituto de Investigaciones Biomédicas, Departamento de Medicina Genómica y Toxicología ambiental, Universidad Nacional Autónoma de México, Mexico City, Mexico; Instituto de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico.
| | - Edda Sciutto
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.
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Kabululu ML, Johansen MV, Lightowlers M, Trevisan C, Braae UC, Ngowi HA. Aggregation of Taenia solium cysticerci in pigs: Implications for transmission and control. Parasite Epidemiol Control 2023; 22:e00307. [PMID: 37261135 PMCID: PMC10227459 DOI: 10.1016/j.parepi.2023.e00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/02/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023] Open
Abstract
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.
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Affiliation(s)
| | | | - Marshall Lightowlers
- Department of Biosciences, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Chiara Trevisan
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Uffe C. Braae
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Helena A. Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
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Mananjara DEA, Rakotoarinoro M, Rakotoarison VC, Raliniaina M, Razafindraibe NP, Ravonirina C, Randriamparany T, Rasamoelina-Andriamanivo H, Rakotozandrindrainy R, Cardinale E, Lightowlers MW, Donadeu M, Mwape KE. Confirmation by necropsy of a high prevalence of porcine cysticercosis in a rural district of Madagascar. Parasitology 2023; 150:852-857. [PMID: 37496390 PMCID: PMC10478050 DOI: 10.1017/s0031182023000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023]
Abstract
Neurocysticercosis is recognized as an important health issue in the Malagasy population. To date, investigations into prevalence of infection with the causative agent, Taenia solium, in the parasite's natural animal intermediate hosts, have relied on serological methods which have been found to be non-specific. We determined the prevalence of porcine cysticercosis among pigs from a contiguous area of the Betafo and Mandoto administrative districts, Vakinankaratra Region, Madagascar. One hundred and four slaughter-weight pigs were examined by detailed necropsy examination including slicing of the heart, tongue, masseter muscles, diaphragm and carcase musculature. Thirty-seven animals (35.6%) were found infected with T. solium, representing one of the highest rates of infection ever reported, worldwide. These findings highlight the importance of T. solium in Madagascar and support the need for increased efforts to prevent the parasite's transmission to reduce its burden on the health of the Malagasy population.
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Affiliation(s)
- Diana Edithe Andria Mananjara
- National Center for Applied Research on Rural Development (FOFIFA), BP04 Rue Farafaty Ampandrianomby, Antsirabe, Antananarivo 101, Madagascar
| | - Mihajamanana Rakotoarinoro
- National Center for Applied Research on Rural Development (FOFIFA), BP04 Rue Farafaty Ampandrianomby, Antsirabe, Antananarivo 101, Madagascar
| | - Valisoa C. Rakotoarison
- National Center for Applied Research on Rural Development (FOFIFA), BP04 Rue Farafaty Ampandrianomby, Antsirabe, Antananarivo 101, Madagascar
| | - Modestine Raliniaina
- National Center for Applied Research on Rural Development (FOFIFA), BP04 Rue Farafaty Ampandrianomby, Antsirabe, Antananarivo 101, Madagascar
| | | | - Claudia Ravonirina
- Regional Directorate of Agriculture and Livestock Vakinankaratra, Madagascar
| | - Tantely Randriamparany
- National Veterinary Diagnostic Laboratory, Anosimasina Itaosy, Antananarivo 102, Madagascar
| | | | | | | | - Marshall W. Lightowlers
- Department of Biosciences, Melbourne Veterinary School, 250 Princes Highway, Werribee, Victoria 3030, Australia
| | - Meritxell Donadeu
- Department of Biosciences, Melbourne Veterinary School, 250 Princes Highway, Werribee, Victoria 3030, Australia
- Initiative for Neglected Animal Diseases (INAND), Constantia Park, Pretoria, South Africa
| | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
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Chege B, Ndambuki G, Owiny M, Kiyong’a A, Fèvre EM, Cook EAJ. Improved latrine coverage may reduce porcine cysticercosis: a comparative cross-sectional study, Busia County, Kenya 2021. Front Vet Sci 2023; 10:1155467. [PMID: 37476824 PMCID: PMC10354266 DOI: 10.3389/fvets.2023.1155467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Smallholder pig farming is an important economic activity for many poor, rural communities in developing countries. Porcine cysticercosis is a growing public health risk in countries where pig rearing is popular. A sanitation-based intervention to reduce the prevalence of open defecation was completed in Busia County, Kenya in 2016. We capitalized on this third party intervention to evaluate its impact on porcine cysticercosis prevalence. Methods We conducted a comparative cross-sectional survey from August through to September 2021. Household selection was done using multistage sampling. Household questionnaire data on pig production, transmission, risk factors and awareness of porcine cysticercosis were collected from 251 households. Lingual palpation was used to test for cysticerci in 370 pigs while serum was tested for circulating antigen using Ag-ELISA. We compared results of our survey to an effective baseline, which was a near equivalent cross sectional survey conducted in 2012 before the third party sanitary intervention was established. The difference in prevalence was measured using Chi-square tests. Multivariable logistic regression analysis was used to identify risk factors for lingual cysts in pigs. Results The prevalence of palpable lingual cysts was estimated to be 3.8% (95% CI 2.3-6.3%) (14/370). This was 6% (95% CI 0.8-13.9%; p-value 0.0178) lower than the prevalence reported in the pre-implementation period of 9.7% (95% CI: 4.5-17.6%). Circulating antigen was detected in 2 samples (0.54%, 95% CI: 0.2-1.9). Latrine coverage was 86% (95% CI: 81-90%), which was 11% (95% CI: 4.8-16.8%; p < 0.001) higher than the pre-implementation period coverage of 75% (95% CI: 71-79%). There was reduced prevalence of lingual cysts in pigs from households that had a latrine (OR = 0.14; 95% CI: 0.05-0.43; p < 0.001) and where pigs were confined or tethered (OR = 0.27; 95% CI: 0.07-1.02; p = 0.053). Conclusion There was a reduction in the prevalence of porcine cysticercosis in Busia County over the study period from 2012 to 2021. This was not a trial design so we are unable to directly link the decline to a specific cause, but the data are consistent with previous research indicating that improved sanitation reduces porcine cysticercosis. Programs for controlling porcine cysticercosis should include a focus on sanitation in addition to other integrated One Health approaches.
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Affiliation(s)
- Bernard Chege
- Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, Kenya
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Gideon Ndambuki
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Maurice Owiny
- Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, Kenya
| | - Alice Kiyong’a
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute (ILRI), Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Mulilo MA, Mwape KE, M’kandawire E, Mkupasi EM. Quantitative risk assessment for human Taenia solium taeniasis/cysticercosis exposure through consumption of pork in Mpwapwa District of Dodoma Region, Tanzania. Vet World 2023; 16:895-911. [PMID: 37576769 PMCID: PMC10420725 DOI: 10.14202/vetworld.2023.895-911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/15/2023] [Indexed: 08/15/2023] Open
Abstract
Background and Aim Pig farming is a livelihood activity undertaken by many rural communities in Tanzania. However, pigs in rural communities become infected with Taenia solium, a zoonotic parasite leading to porcine cysticercosis (PCC). Thus, routine meat inspection is fundamental in ensuring that the meat consumed is PCC-free. However, routine meat inspection is constrained by low sensitivity as a diagnostic test. Regardless of its low sensitivity, at the local level, no substitute tool would potentially lead to meat being risk-free for human infection. This study aimed at quantifying the risk of humans getting exposed to T. solium taeniasis through the consumption of pork approved safe for human consumption by employing a quantitative risk assessment (QRA) model. Materials and Methods A cross-sectional study employing a quantitative risk assessment technique was conducted to quantify the risk of human infection in Mpwapwa District through exposure to T. solium infection through consumption of officially inspected pork. The input parameters in this study were simulated in @risk software to obtain the risk of exposure and the risk factors for exposure to T. solium taeniasis. Results The risk of one getting exposed to T. solium taeniasis/cysticercosis (TSTC) through consumption of pork approved for human consumption was found to be 0.018 (95% confidence interval [CI] = 0.00-0.0250). Likewise, the probability that a cyst is localized in a pork portion was found to be the most influencing input risk factor of getting exposed to TSTC. Furthermore, the probability of developing T. solium taeniasis was estimated to be 0.73605 (95% CI = 0-0.950) when infected undercooked pork portion is consumed and 0.99652 (95% CI = 0.98161-0.99908) from consuming raw pork portion. Likewise, about 47 (95% CI = 42-52) people who consumed undercooked pork and 26 (95% CI = 22-30) who consumed raw pork would get infected in Mpwapwa District per year. Conclusion The results from this study are anticipated to create public awareness of the problem and promote the use of one-health approach in the control and prevention of the consumption of infected pork.
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Affiliation(s)
- Misheck A. Mulilo
- Livestock Training Agency, Department of Training, Research and Consultancy, Mpwapwa, Dodoma, Tanzania
| | - Kabemba E. Mwape
- Department of Clinical Studies, The University of Zambia, School of Veterinary Medicine, Lusaka, Zambia
| | - Ethel M’kandawire
- Department of Disease Control, The University of Zambia, School of Veterinary Medicine, Lusaka, Zambia
| | - Ernatus M. Mkupasi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, College of Veterinary Medicine and Biomedical Sciences, Morogoro, Tanzania
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Sanga TA, Maganira JD, Kidima WB. An epidemiological survey of porcine cysticercosis in Rungwe District, Tanzania. Prev Vet Med 2023; 213:105866. [PMID: 36736267 DOI: 10.1016/j.prevetmed.2023.105866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/17/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
Taeniasis/cysticercosis caused by tapeworms belonging to the genus Taenia, poses serious veterinary and public health problems, resulting in economic burden in endemic low-income countries worldwide. However, little epidemiological data exist on infection status among pigs in many areas in Tanzania. We conducted a cross-sectional survey in Rungwe District, Mbeya Region, Tanzania, to define the prevalence and risk factors associated with porcine cysticercosis transmission. One-hundred sixty-nine pigs from 152 households were examined for circulating taeniid antigens by cysticercosis antigen (Ag) enzyme-linked immunosorbent assay (ELISA). Agarose gel electrophoresis was used to differentially diagnose Taenia species-specific cysticerci DNA bands. Structured questionnaires were administered in the surveyed households to collect information on risk factors for porcine cysticercosis transmission. Sera from eleven household pigs tested positive for porcine cysticercosis in the Ag-ELISA with an apparent prevalence of 6.5 % (95 % C.I. 3.8-11.3 %) and estimated true prevalence of 6.1 % (95 % C.I. 3.3-10.9 %). DNA Gel electrophoresis confirmed that 100 % of cysticerci isolated amongst pigs slaughtered in the study area belonged to T. solium. Of the five surveyed wards, positive household pigs were from Bulyaga, Kiwira, and Mpuguso. Lack of knowledge on porcine cysticercosis among household members was found to be significantly associated with positivity of Taenia species antigen in pigs sera (OR = 7.742, p = 0.017). Our results show that porcine cysticercosis is prevalent in Rungwe. There is a definite need to establish control measures against this potential zoonosis to safeguard veterinary and public health in the Rungwe District.
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Affiliation(s)
- Tusane Alatupa Sanga
- Department of Zoology and Wildlife Conservation, University of Dar es Salaam, P.O. Box 35064, Dar es Salaam, Tanzania
| | - Justine Daudi Maganira
- Department of Biosciences, Sokoine University of Agriculture, P.O. Box 3038, Morogoro, Tanzania.
| | - Winifrida Benedict Kidima
- Department of Zoology and Wildlife Conservation, University of Dar es Salaam, P.O. Box 35064, Dar es Salaam, Tanzania
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Foodborne Parasites and Their Complex Life Cycles Challenging Food Safety in Different Food Chains. Foods 2022; 12:foods12010142. [PMID: 36613359 PMCID: PMC9818752 DOI: 10.3390/foods12010142] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Zoonotic foodborne parasites often represent complex, multi host life cycles with parasite stages in the hosts, but also in the environment. This manuscript aims to provide an overview of important zoonotic foodborne parasites, with a focus on the different food chains in which parasite stages may occur. We have chosen some examples of meat-borne parasites occurring in livestock (Taenia spp., Trichinella spp. and Toxoplasma gondii), as well as Fasciola spp., an example of a zoonotic parasite of livestock, but transmitted to humans via contaminated vegetables or water, covering the 'farm to fork' food chain; and meat-borne parasites occurring in wildlife (Trichinella spp., Toxoplasma gondii), covering the 'forest to fork' food chain. Moreover, fish-borne parasites (Clonorchis spp., Opisthorchis spp. and Anisakidae) covering the 'pond/ocean/freshwater to fork' food chain are reviewed. The increased popularity of consumption of raw and ready-to-eat meat, fish and vegetables may pose a risk for consumers, since most post-harvest processing measures do not always guarantee the complete removal of parasite stages or their effective inactivation. We also highlight the impact of increasing contact between wildlife, livestock and humans on food safety. Risk based approaches, and diagnostics and control/prevention tackled from an integrated, multipathogen and multidisciplinary point of view should be considered as well.
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Wu Y, Yao Z, Zhang J, Han C, Kang K, Zhao A. Real-world landscape transition of death causes in the immunotherapy era for metastatic non-small cell lung cancer. Front Immunol 2022; 13:1058819. [PMID: 36439167 PMCID: PMC9691859 DOI: 10.3389/fimmu.2022.1058819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background With approval of anti-PD-1/PD-L1, metastatic non-small cell lung cancer (NSCLC) has entered the era of immunotherapy. Since immune-related adverse events (irAEs) occur commonly in patients receiving anti-PD-1/PD-L1, the landscape of death causes may have changed in metastatic NSCLC. We aim to compare patterns of death causes in metastatic NSCLC between the pre-immunotherapy and immunotherapy era to identify the consequent landscape transition of death causes. Methods In this cohort study, 298,48patients with metastatic NSCLC diagnosed between 2000 and 2018 were identified from the Surveillance, Epidemiology, and End Results Program. Unsupervised clustering with Bayesian inference method was performed for all patients' death causes, which separated them into two death patterns: the pre-immunotherapy era group and the immunotherapy era group. Relative risk (RR) of each death cause between two groups was estimated using Poisson regression. Reduced death risk as survival time was calculated with locally weighted scatterplot smooth (Lowess) regression. Results Two patterns of death causes were identified by unsupervised clustering for all patients. Thus, we separated them into two groups, the immunotherapy era (2015-2017, N=40,172) and the pre-immunotherapy era (2000-2011, N=166,321), in consideration of obscure availability to immunotherapy for patients diagnosed in 2012-2014, when the follow-up cutoff was set as three years. Although all-cause death risk had reduced (29.2%, 13.7% and 27.8% for death risks of lung cancer, non-cancer and other cancers), non-cancer deaths in the immunotherapy era (N=2,100, 5.2%; RR=1.155, 95%CI: 1.101-1.211, P<0.001) significantly increased than that in the pre-immunotherapy era (N=7,249, 5.0%), which included causes of chronic obstructive pulmonary disease, cerebrovascular disease, pneumonia and influenza, septicemia, infectious diseases, accidents and adverse effects, hypertension, and chronic liver disease and cirrhosis. However, cancer-caused deaths (excluding lung cancer) had no significant changes. Conclusions The real-world landscape of death causes has changed in metastatic NSCLC when entering the immunotherapy era, and the increased non-cancer diseases may contribute to the changes that may be associated with commonly occurring irAEs.
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Affiliation(s)
- Yijun Wu
- Department of Thoracic Oncology, Cancer Center, and Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuoran Yao
- Department of Thoracic Oncology, Cancer Center, and Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jianhui Zhang
- Institute of Biomechanics and Medical Engineering, School of Aerospace, Tsinghua University, Beijing, China
| | - Chang Han
- Department of Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kai Kang
- Department of Thoracic Oncology, Cancer Center, and Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Ailin Zhao, ; Kai Kang,
| | - Ailin Zhao
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Ailin Zhao, ; Kai Kang,
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Stelzle D, Schmidt V, Keller L, Ngowi BJ, Matuja W, Escheu G, Hauke P, Richter V, Ovuga E, Pfausler B, Schmutzhard E, Amos A, Harrison W, Kaducu J, Winkler AS. Characteristics of people with epilepsy and Neurocysticercosis in three eastern African countries-A pooled analysis. PLoS Negl Trop Dis 2022; 16:e0010870. [PMID: 36342903 PMCID: PMC9639810 DOI: 10.1371/journal.pntd.0010870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. METHODOLOGY We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sites were in Uganda, Malawi and in Tanzania (Dar es Salaam and Haydom). The study in Uganda and Malawi were community-based, the two studies in Tanzania were hospital-based. The same questionnaire was used for assessment of clinical characteristics of patients with epilepsy. Computed tomography (CT) scans and serological testing were performed in order to diagnose NCC. RESULTS Overall, 1,179 people with epilepsy were included in our analysis. Of those, 941 PWE underwent CT scanning and were pooled for NCC analysis. Seventy patients were diagnosed with NCC, but NCC prevalence differed considerably between sites ranging from 2.0% (95%CI 0.4% to 3.6%) in Dar es Salaam to 17.5% (95%CI 12.4% to 22.6%) in Haydom. NCC prevalence did not show any association with sex but increased with age and was higher in rural than urban settings. In addition, being a farmer, non-Muslim, eating pork and living with pigs close by was associated with a higher NCC prevalence. PWE with NCC experienced their first epileptic seizure around 3 years later in life compared to PWE without NCC and their epileptic seizures seemed to be better controlled (p<0.001). There was no difference between focal onset seizures and focal signs on neurological examination in both groups (p = 0.49 and p = 0.92, respectively). The rT24H-EITB had a sensitivity for the detection of NCC of 70% (95% confidence interval [CI] 51 to 84%), the LLGP of 76% (95%CI 58 to 89%) and the antigen ELISA of 36% (95% CI 20 to 55%). CONCLUSIONS NCC is prevalent among PWE in eastern Africa, although it may not be as common as previously stated. Demographic characteristics of PWE with NCC differed from those without NCC, but semiological characteristics and results on neurological examination did not differ compared to PWE without NCC. Interestingly, seizures seemed to be less frequent in PWE with NCC. Being aware of those differences and similarities may help triaging PWE for neuroimaging in order to establish a diagnosis of NCC.
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Affiliation(s)
- Dominik Stelzle
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Luise Keller
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Bernard J. Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
- University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania
| | - William Matuja
- Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gabrielle Escheu
- Department of Neurology, Kliniken Ostallgaeu-Kaufbeuren, Kaufbeuren, Germany
| | - Peter Hauke
- Department of Neurology, Kliniken Ostallgaeu-Kaufbeuren, Kaufbeuren, Germany
| | - Vivien Richter
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Emilio Ovuga
- Department of Mental Health, Gulu University, Gulu, Uganda
| | - Bettina Pfausler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Erich Schmutzhard
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Action Amos
- National Epilepsy Association Malawi, International Bureau of Epilepsy, Lilongwe, Malawi
| | - Wendy Harrison
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | - Andrea S. Winkler
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- * E-mail:
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12
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The prevalence of Taenia spp. in pigs slaughtered in Kinshasa. Vet Parasitol Reg Stud Reports 2022; 36:100794. [PMID: 36436903 DOI: 10.1016/j.vprsr.2022.100794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
Taenia hydatigena is a non-zoonotic worm that has dogs and wild canids as definitive hosts. Its presence induces cross reactions in certain diagnostic tests for porcine cysticercosis caused by T. solium, the occurrence of which has a considerable public health and economic impact. In the Democratic Republic of the Congo (DR Congo), T. solium is considered endemic, however, the prevalence of T. hydatigena has not been estimated yet. The objective of the study was therefore to estimate the prevalence of T. hydatigena cysticercosis by serological and molecular diagnostic tools in pigs slaughtered in DR Congo. A total of 480 pigs slaughtered in 6 slaughter slabs in Kinshasa, DR Congo, were examined. The thoracal and abdominal cavity organs were inspected for cysts, which were analyzed using PCR-RFLP. Furthermore, 480 sera were collected, and analyzed for the presence of circulating Taenia spp. cysticercus antigens, using the B158/B60 Ag-ELISA. Upon inspection of the carcass, 41 cysts suspected to be metacestodes of Taenia spp. were collected, from the following viscera: spleen (24/41, 59%), liver (13/41, 32%), intestine (3/41, 7%) and lung (1/41, 2%). Molecular analyses revealed a T. hydatigena prevalence of 0.2% (95% CI: 0.0001-0.0116), based on a single lesion (1/480), taken from the spleen. Out of the 480 sera collected, the presence of circulating Taenia spp. cysticerci antigens was detected in 32 (6.7%; 95% CI: 4.5-11.2). The results of this study revealed that T. hydatigena is present in pigs sold in markets in the city of Kinshasa in DR Congo, albeit at a very low prevalence, thus the impact on the interpretation of the B158/B60 seems low in this setting. Detection of circulating antigens in porcine sera by Ag-ELISA, shows that pigs slaughtered in Kinshasa, DR Congo, were infected with viable cysticerci of Taenia spp. which in turn can infect humans.
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Keller L, Stelzle D, Schmidt V, Carabin H, Reinhold AK, Keller C, Welte TM, Richter V, Amos A, Boeckman L, Harrison W, Winkler AS. Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study. PLoS Negl Trop Dis 2022; 16:e0010675. [PMID: 36108075 PMCID: PMC9477368 DOI: 10.1371/journal.pntd.0010675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the proportion of NCC among people with epilepsy (PWE) in a large cross-sectional study in a rural district of southern Malawi.
Methods
We conducted a community-based door-to-door screening study for epileptic seizures in Balaka, Malawi between October and December 2012. Past epileptic seizures were reported through a 15-item questionnaire answered by at least one person per household generating five major criteria. People who screened positive were further examined by a neurologist to establish diagnosis. Patients diagnosed with epilepsy were examined and offered Taenia solium cyst antigen and antibody serological tests, and a CT scan for the diagnosis of NCC.
Results
In total, screening information on 69,595 individuals was obtained for lifetime occurrence of epileptic seizures. 3,100 (4.5%) participants screened positive, of whom 1,913 (62%) could be followed-up and underwent further assessment. Lifetime prevalence was 3.0% (95% Bayesian credible interval [CI] 2.8 to 3.1%) and 1.2% (95%BCI 0.9 to 1.6%) for epileptic seizures and epilepsy, respectively. NCC prevalence among PWE was estimated to be 4.4% (95%BCI 0.8 to 8.5%). A diagnosis of epilepsy was ultimately reached for 455 participants.
Conclusion
The results of this large community-based study contribute to the evaluation and understanding of the burden of epilepsy in the population and of NCC among PWE in sub-Saharan Africa.
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Affiliation(s)
- Luise Keller
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hélène Carabin
- Département de Pathologie et Microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
- Département de médecine sociale et préventive, École de santé publique de l’université de Montréal, Montréal, Canada
- Centre de Recherche en Santé Publique (CReSP) de l’université de Montréal et du CIUSS du Centre Sud de Montréal, Montréal, Canada
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Université de Montréal, Saint-Hyacinthe, Canada
| | - Ann-Kristin Reinhold
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Anaesthesiology, University Hospital Würzburg, Würzburg, Germany
| | - Claudius Keller
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tamara M. Welte
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Vivien Richter
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Action Amos
- National Epilepsy Association Malawi, International Bureau of Epilepsy, School of Health Social Sciences University of Edinburgh, Edinburgh, United Kingdom
| | - Lindsay Boeckman
- The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Wendy Harrison
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- * E-mail:
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Wang Z, Garcia RM, Huff HV, Niquen-Jimenez M, Marcos LA, Lam SK. Neurocysticercosis control for primary epilepsy prevention: a systematic review. Pathog Glob Health 2022; 116:282-296. [PMID: 34928183 PMCID: PMC9248947 DOI: 10.1080/20477724.2021.2015869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Zhe Wang
- Department of Neurological Surgery, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Division of Infectious Diseases, Department of Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Department of Microbiology and Immunology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,CONTACT Zhe Wang Department of Neurological Surgery, Stony Brook University Renaissance School of Medicine, HSC T12 Rm 080, 100 Nicolls Rd, Stony Brook, NY11790, USA
| | - Roxanna M. Garcia
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hanalise V. Huff
- Fogarty Fellow, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Milagros Niquen-Jimenez
- Facultad de Medicina Humana Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis A. Marcos
- Division of Infectious Diseases, Department of Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Department of Microbiology and Immunology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Sandi K. Lam
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA
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Challenges in the Diagnosis of Taenia solium Cysticercosis and Taeniosis in Medical and Veterinary Settings in Selected Regions of Tanzania: A Cross-Sectional Study. Vet Med Int 2022; 2022:7472051. [PMID: 35815231 PMCID: PMC9262556 DOI: 10.1155/2022/7472051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/16/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background Taenia solium (neuro) cysticercosis/taeniosis (TSCT) is a zoonotic disease complex. There is a perceived inefficient diagnosis of infections by either form, the adult pork tapeworm (taeniosis) and the larval stage of it (cysticercosis), in low-income settings, including Tanzania. This study aimed at identifying potential gaps around TSCT diagnosis and knowledge of primary healthcare providers (officers in charge (OICs) of primary healthcare facilities (PHFs)) and veterinarians (meat inspectors (MIs)) on various aspects of TSCT disease complex and addressing effective disease control in Tanzania. Methodology. A cross-sectional study was conducted between January and April 2020 in Manyara, Dodoma, Ruvuma, Iringa, and Arusha regions in Babati, Mbulu, Kongwa, Mbinga, and Nyasa districts. We interviewed 152 OICs of PHFs and 108 MIs using a structured questionnaire and 33 medical and veterinary officers from level I healthcare facilities and district livestock offices, respectively, from selected study districts to the respective ministerial level using key informant interviews. Results Quantitative data revealed inadequate microscopic diagnostic facilities (54.6%) and personnel (100%) for taeniosis diagnosis in PHFs (n = 152). Approximately 81.2% of MIs compared with only 42.1% of OICs of PHFs scored above average regarding T. solium cysticerci knowledge. Nevertheless, 61.2% of OICs of PHFs compared with only 42.6% of MIs scored above average regarding the adult T. solium tapeworm knowledge. Qualitative data revealed inadequate availability of advanced diagnostic facilities (neuroimaging) and trained personnel for specific diagnosis of TSCT with a focus on neurocysticercosis (NCC) in secondary and tertiary healthcare facilities. Inadequately number of qualified MIs, slaughter slabs, and resource facilitation challenged porcine cysticercosis diagnosis. Conclusion It is concluded that diagnostic capacity and knowledge of OICs of PHFs and MIs regarding TSCT are insufficient in both medical and veterinary sectors. A One Health approach should be adopted to improve TSCT diagnostic capacity and practitioners' knowledge in both medical and veterinary sectors.
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Rahantamalala A, Rakotoarison RL, Rakotomalala E, Rakotondrazaka M, Kiernan J, Castle PM, Hakami L, Choi K, Rafalimanantsoa AS, Harimanana A, Wright P, Grandjean Lapierre S, Schoenhals M, Small PM, Marcos LA, Vigan-Womas I. Prevalence and factors associated with human Taenia solium taeniosis and cysticercosis in twelve remote villages of Ranomafana rainforest, Madagascar. PLoS Negl Trop Dis 2022; 16:e0010265. [PMID: 35404983 PMCID: PMC9064101 DOI: 10.1371/journal.pntd.0010265] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/03/2022] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Infections with the tapeworm Taenia solium (taeniosis and cysticercosis) are Neglected Tropical Diseases (NTD) highly endemic in Madagascar. These infections are however underdiagnosed, underreported and their burden at the community level remains unknown especially in rural remote settings. This study aims at assessing the prevalence of T. solium infections and associated risk factors in twelve remote villages surrounding Ranomafana National Park (RNP), Ifanadiana District, Madagascar. Methodology A community based cross-sectional survey was conducted in June 2016. Stool and serum samples were collected from participants. Tapeworm carriers were identified by stool examination. Taenia species and T. solium genotypes were characterised by PCR and sequencing of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Detection of specific anti-cysticercal antibodies (IgG) or circulating cysticercal antigens was performed by ELISA or EITB/Western blot assays. Principal findings Of the 459 participants with paired stool and blood samples included ten participants from seven distinct villages harbored Taenia spp. eggs in their stools samples DNA sequencing of the cox1 gene revealed a majority of T. solium Asian genotype (9/10) carriage. The overall seroprevalences of anti-cysticercal IgGs detected by ELISA and EITB were quite similar (27.5% and 29.8% respectively). A prevalence rate of 12.4% of circulating cysticercal antigens was observed reflecting cysticercosis with viable cysts. Open defecation (Odds Ratio, OR = 1.5, 95% CI: 1.0–2.3) and promiscuity with households of more than 4 people (OR = 1.9, 95% CI: 1.1–3.1) seem to be the main risk factors associated with anticysticercal antibodies detection. Being over 15 years of age would be a risk factor associated with an active cysticercosis (OR = 1.6, 95% CI: 1.0–2.7). Females (OR = 0.5, 95% CI: 0.3–0.9) and use of river as house water source (OR = 0.3, 95% CI: 0.1–1.5) were less likely to have cysticercosis with viable cysts. Conclusions/Significance This study indicates a high exposure of the investigated population to T. solium infections with a high prevalence of cysticercosis with viable cysts. These data can be useful to strengthen public health interventions in these remote settings. Taenia solium infections in humans (taeniosis and neurocysticercosis) and in pigs (cysticercosis) are endemic in Madagascar presenting a significant public health burden. Neurocysticercosis with localization of the parasite in the Central Nervous System is the most severe and frequent form of parasitic brain diseases in humans and responsible of thousands of worldwide deaths per year. Madagascar is a T. solium endemic country where poor sanitation, free roaming pigs and outdoor defecation are common, and maintain the parasite transmission cycle. Little information is available regarding taeniosis/cysticercosis epidemiology in Madagascar. We carried out a community-based study to investigate the prevalence of human taeniosis/cysticercosis and associated risk factors in 12 rural remote villages of Ranomafana and Kelilalina townships (Ifanadiana district, Madagascar). Our results reveal that in 7/12 villages investigated, a high number of participants had teaniosis. Moreover, a high number of active cysticercosis cases were detected. Open defecation and promiscuity were seemed to be the main risk factors associated to T. solium infections. The results of this study will be useful to guide interventions in these remote settings surrounding the Ranomafana National Park.
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Affiliation(s)
- Anjanirina Rahantamalala
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
- * E-mail:
| | | | - Emma Rakotomalala
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
| | | | - Jaydon Kiernan
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Paul M. Castle
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Lee Hakami
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Koeun Choi
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | | | - Aina Harimanana
- Institut Pasteur de Madagascar, Epidemiology and Clinical Research Unit, Antananarivo, Madagascar
| | - Patricia Wright
- Centre ValBio, Ranomafana, Ifanadiana, Madagascar
- Department of Anthropology, Stony Brook University, Stony Brook, New York, United States of America
| | - Simon Grandjean Lapierre
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Matthieu Schoenhals
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
| | - Peter M. Small
- Centre ValBio, Ranomafana, Ifanadiana, Madagascar
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Luis A. Marcos
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- Division of Infectious Diseases, Department of Medicine, Department of Microbiology and Molecular Genetics, Stony Brook University, Stony Brook, New York, United States of America
| | - Inès Vigan-Womas
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
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Le TTH, Vu-Thi N, Dang-Xuan S, Nguyen-Viet H, Pham-Duc P, Nguyen-Thanh L, Pham-Thi N, Noh J, Mayer-Scholl A, Baumann M, Meemken D, Unger F. Seroprevalence and Associated Risk Factors of Trichinellosis and T. Solium Cysticercosis in Indigenous Pigs in Hoa Binh Province, Vietnam. Trop Med Infect Dis 2022; 7:tropicalmed7040057. [PMID: 35448832 PMCID: PMC9026120 DOI: 10.3390/tropicalmed7040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022] Open
Abstract
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.
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Affiliation(s)
- Trang Thi-Huyen Le
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
| | - Nga Vu-Thi
- National Institute of Veterinary Research, Hanoi 100000, Vietnam; (N.V.-T.); (N.P.-T.)
| | - Sinh Dang-Xuan
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
- Correspondence: ; Tel.: +84-09-6981-3048
| | - Hung Nguyen-Viet
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
| | - Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
| | - Luong Nguyen-Thanh
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
| | - Ngoc Pham-Thi
- National Institute of Veterinary Research, Hanoi 100000, Vietnam; (N.V.-T.); (N.P.-T.)
| | - John Noh
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA;
| | - Anne Mayer-Scholl
- Federal Institute for Risk Assessment, National Laboratory for Trichinella, 10589 Berlin, Germany;
| | - Maximilian Baumann
- Working Group Meat Hygiene, Institute of Food Safety and Food Hygiene, Freie Universität Berlin, 14163 Berlin, Germany; (M.B.); (D.M.)
| | - Diana Meemken
- Working Group Meat Hygiene, Institute of Food Safety and Food Hygiene, Freie Universität Berlin, 14163 Berlin, Germany; (M.B.); (D.M.)
| | - Fred Unger
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
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Gulelat Y, Eguale T, Kebede N, Aleme H, Fèvre EM, Cook EAJ. Epidemiology of Porcine Cysticercosis in Eastern and Southern Africa: Systematic Review and Meta-Analysis. Front Public Health 2022; 10:836177. [PMID: 35372187 PMCID: PMC8966092 DOI: 10.3389/fpubh.2022.836177] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Yewubdar Gulelat
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- International Livestock Research Institute, Nairobi, Kenya
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nigatu Kebede
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hailelule Aleme
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Elizabeth A. J. Cook
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Shyaka A, Quinnell RJ, Rujeni N, Fèvre EM. Using a Value Chain Approach to Map the Pig Production System in Rwanda, Its Governance, and Sanitary Risks. Front Vet Sci 2022; 8:720553. [PMID: 35118148 PMCID: PMC8803899 DOI: 10.3389/fvets.2021.720553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
Rwanda has a fast growing pig production sector projected to continue expansion, due to rising local and regional demand. We undertook a value chain analysis to establish the flows of pigs and pork in Rwanda and the roles of various actors involved, and to understand governance and sanitary risks in the value chain. Cross-sectional qualitative data were collected through focus group discussions and key informant interviews with farmers, brokers, butchers, abattoir managers, and veterinarians. Data were collected on pig production methods and inputs, the source and destination of live and slaughtered pigs, value-adding infrastructures (abattoirs and processing factories), the people involved and interactions between them, governance, and challenges. Pig production in Rwanda is dominated by smallholders, mainly as a source of supplementary income and secondarily for manure. Emerging medium-sized and large pig farms were also identified, located mainly around urban areas. Live pig markets are the main mechanism allowing various actors to buy/sell pigs. Brokers have an important role in pig transactions: they are key in setting prices at markets, examining pigs for disease, organising the supply of pigs for abattoirs and for export. Only a few formal pig abattoirs were identified, which mainly supply to pork processing factories based in Kigali and/or export to customers. Local consumers rely on informal slaughtering at farm or bar/restaurant backyards, with irregular veterinary inspection. Formal abattoirs were attended by a veterinary inspector, however a lack of record keeping was noted. Sanitary risks identified were a lack of biosecurity throughout the chain and poor hygiene at slaughter places. Lingual palpation was practised in pig markets to identify cysticercosis infection, however cyst-positive pigs were not destroyed, but were sold for reduced prices in the same market or later informally sold by the owner. There are few veterinarians attending farms, with most services provided by less qualified technicians or self-treatment of pigs by farmers. Overall, this production system is characterised by a high degree of informality at all nodes, combined with the rapid growth trajectory in the sector. These findings provide a basis to plan interventions tailored to vulnerabilities identified in the Rwanda pig value chain.
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Affiliation(s)
- Anselme Shyaka
- Faculty of Biological Sciences, School of Biology, University of Leeds, Leeds, United Kingdom
- School of Veterinary Medicine, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, Nyagatare, Rwanda
- Center for One Health, University of Global Health Equity, Kigali, Rwanda
- *Correspondence: Anselme Shyaka
| | - Rupert J. Quinnell
- Faculty of Biological Sciences, School of Biology, University of Leeds, Leeds, United Kingdom
- Rupert J. Quinnell
| | - Nadine Rujeni
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Eric M. Fèvre
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leeds, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
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ARSLAN YK. Altın standart test yokluğunda tanısal doğruluk ölçütlerinin Bayesci yaklaşım ile tahmini: Helicobacter Pylori verisi uygulaması. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.1003633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ngwili N, Thomas L, Githigia S, Muloi D, Marshall K, Wahome R, Roesel K. Co-infection of pigs with Taenia solium cysticercosis and gastrointestinal parasites in Eastern and Western Uganda. Parasitol Res 2021; 121:177-189. [PMID: 34816302 PMCID: PMC8610610 DOI: 10.1007/s00436-021-07380-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/10/2021] [Indexed: 11/27/2022]
Abstract
A study was carried out in Kamuli and Hoima districts in Eastern and Western regions of Uganda to determine the Taenia solium porcine cysticercosis (PCC) and gastrointestinal (GI) parasites co-infection status in pigs. One hundred sixty-one households were selected randomly and visited between November and December 2019. A household questionnaire was administered, and faecal and blood samples were collected from at least one pig older than 3 months per household. A blood sample was obtained from a jugular venipuncture, and a rectal faecal sample was obtained. Taenia spp. circulating antigen levels in the sample sera were tested using a commercial enzyme-linked immunosorbent assay kit, apDia™ cysticercosis Ag ELISA. The modified McMaster technique was used to identify and quantify the GI parasites. The apparent animal-level seroprevalence for PCC was 4.8% (95% CI 2.7–7.1) and differed across the two districts (p = 0.018). At the pig herd level, the prevalence was 9.7% (95% CI 5.5–14.4). The prevalence of the different nematode eggs and coccidian oocysts in the two districts was as follows: strongyles 79.0% (95% CI 74.3–83.6), coccidia 73.3% (95% CI 68.3–78.6), Trichuris spp. 7.4% (95% CI 4.9–10.6), Strongyloides ransomi 2.1 (95% CI 0.7–3.5) and Ascaris spp. 4.9 (95% CI 2.8–7.4). Overall, across the two districts, the arithmetic mean for the oocysts per gram (OPG) for coccidia was 2042.2 ± 5776.1, and eggs per gram (EPG) were the highest in strongyles 616.1 ± 991. Overall, 57.4% of the porcine cysticercosis seropositive pigs were also positive for at least one of the gastrointestinal helminths which included strongyles, Strongyloides ransomi, Trichuris spp. and Ascaris spp. The co-infection status of pigs with both PCC and GI parasites demonstrated by this study can provide an incentive for integrating the control and management of both parasites with oxfendazole. Further studies are required to understand the feasibility of using oxfendazole including cost–benefit analysis and the acceptability by local stakeholders for the control of T. solium cysticercosis and gastrointestinal parasites in pigs.
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Affiliation(s)
- Nicholas Ngwili
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya. .,Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya.
| | - Lian Thomas
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - Samuel Githigia
- Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Dishon Muloi
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - Karen Marshall
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
| | - Raphael Wahome
- Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Kristina Roesel
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya.,Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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Evaluation of an Antibody Detecting Point of Care Test for Diagnosis of Taenia solium Cysticercosis in a Zambian Rural Community: A Prospective Diagnostic Accuracy Study. Diagnostics (Basel) 2021; 11:diagnostics11112121. [PMID: 34829468 PMCID: PMC8618153 DOI: 10.3390/diagnostics11112121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
The lack of cheap, easy-to-use, rapid diagnostic tests has led to the development of several rapid diagnostic tests for cysticercosis. The new prototype two-strip, Taenia solium point of care test (TS POC) detects antibodies against taeniosis (TS POC T) and cysticercosis (TS POC CC). This study evaluated the diagnostic performance of the TS POC CC in the Sinda district in eastern Zambia. A sample of 1254 participants was recruited and tested with the TS POC. Out of the 1249 participants with a valid TS POC result, 177 (14%) tested positive while 1072 (86%) tested negative. All individuals with a positive TS POC and a subset of negative TS POC participants were selected for serum sampling, and were subjected to the recombinant glycoprotein T24H enzyme-linked immunoelectrotransfer blot (rT24H EITB) and the serum B60/158 (serum Ag) enzyme-linked immunosorbent assay (Ag ELISA). Performance characteristics were estimated using a Bayesian approach with probabilistic constraints. Based on 255 complete cases, the estimated sensitivity and specificity of the TS POC CC test were 35% (95% CI: 14–63%) and 87% (95% CI: 83–90%), respectively. The diagnostic performance needs to be improved, possibly by titrating antigen and other reagents’ concentration in the strip to produce a performance similar to existing cysticercosis tests such as the rT24H EITB.
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Binh VTL, Dung DT, Vinh HQ, Anke VH, Nicolas P, Pierre D, Veronique D. Human Taeniasis and Cysticercosis and Related Factors in Phu Tho Province, Northern Vietnam. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:369-376. [PMID: 34470088 PMCID: PMC8413854 DOI: 10.3347/kjp.2021.59.4.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022]
Abstract
Several factors presumed to facilitate the transmission of Taenia spp. were reported in Vietnam. We conducted a cross-sectional study taking questionnaires from 1,185 participants, and collecting 1,151 sera and 1,036 stool samples in northern Vietnam. Sera were examined for circulating antigens of Taenia solium cysticerci using ELISA, stools for Taenia eggs by Kato-Katz smear, and copro-antigens by ELISA. Ag-ELISA revealed 4.6% antigen positivity, indicating infection with viable cysticerci. Taenia eggs were detected in 1.5% of participants. Copro-antigens were found in 2.8% of participants. Eating raw meat and/or vegetables was significantly associated with the presence of copro-antigen (OR=8.6, 95% CI: 1.16–63.9, P=0.01). Considering the high taeniasis prevalence and the associated threat, public health attention should be given to treat the tapeworm carriers in the projected areas.
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Affiliation(s)
- Vu Thi Lam Binh
- National Institute of Malariology, Parasitology and Entomology (NIMPE), No 34 Trung Van, Nam Tu Liem, Ha Noi, Vietnam
| | - Do Trung Dung
- National Institute of Malariology, Parasitology and Entomology (NIMPE), No 34 Trung Van, Nam Tu Liem, Ha Noi, Vietnam
| | - Hoang Quang Vinh
- National Institute of Malariology, Parasitology and Entomology (NIMPE), No 34 Trung Van, Nam Tu Liem, Ha Noi, Vietnam
| | - Van Hul Anke
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium
| | - Praet Nicolas
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium.,The Janssen Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - Dorny Pierre
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium.,Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Dermauw Veronique
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium
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Maganira JD, Kidima W, Mwita CJ, Höglund J. Detection of Porcine Cysticercosis in Meat Juice Samples from Infected Pigs. Acta Parasitol 2021; 66:851-856. [PMID: 33587230 DOI: 10.1007/s11686-020-00295-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Seroprevalence of porcine cysticercosis has been generally studied using enzyme-linked immunosorbent assays (ELISA) detecting either antigens or antibodies in sera. However, serum is not always readily available. The objective of this study was to assess the diagnostic potential of meat juice in detecting porcine cysticercosis using a cysticercosis antibody ELISA. METHODS Sera and meat juice samples from 13 different organs/tissues were collected from nine pigs naturally infected with cysticercosis and from six uninfected pigs reared under hygienic conditions. The sensitivity of the cysticercosis antibody ELISA in detecting porcine cysticercosis in meat juice samples was compared to that in serum samples from the same pigs. RESULTS Using sera, cysticercosis was detected in all nine pigs harbouring cysticerci, but not in those reared under hygienic conditions. The sensitivity of the ELISA was highest in meat juice extracted from the diaphragm (100%), heart (89%) and neck muscle (78%) of the nine infected pigs, whereas it varied between 0 and 44% in the other samples. CONCLUSION To the best of our knowledge, this is the first study for T. solium cysticercosis serology to use meat juice. Our results show that meat juice from pig carcass organs or muscles is a promising diagnostic specimen for the detection of porcine cysticercosis. More studies including a large sample size of pigs with varying degrees of cysticercosis infection are needed to further prove this concept.
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Epidemiology of Taenia solium infection in the Russian Federation in the last 20 years: a systematic review. J Helminthol 2021; 95:e49. [PMID: 34429181 DOI: 10.1017/s0022149x21000432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Taenia solium is a zoonotic parasite that causes taeniasis and cysticercosis in humans (as final hosts) and cysticercosis in pigs (as intermediate hosts). The Russian Federation (RF) is traditionally considered as endemic for this zoonosis. However, the epidemiological data on T. solium infection have not been reviewed for the past 20 years, in which time dynamic economical and societal changes have occurred in the RF. The aim of this systematic review was to analyse the status of T. solium infection in RF in the 2000-2019 period. A literature search was conducted, which collected published articles, grey literature and official data on the epidemiology of T. solium taeniasis and cysticercosis in the RF published from 2000. From a total of 2021 articles and 24 official reports originally returned by the search, data were extracted from 12 full text articles and 11 official reports. Taenia solium taeniasis was continuously reported in the RF between 2000 and 2019, with a tenfold decrease in the incidence, from 0.2 per 100,000 population in 2000 to 0.023/100,000 in 2019. Also, the number of administrative units where taeniasis was detected continuously decreased. Cysticercosis in pigs had a declining trend after 2006. In conclusion, although decreasing, T. solium infection is still endemic in several regions and suspected to be endemic in most of the RF.
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Trevisan C, Damme IV, Ngowi B, Schmidt V, Stelzle D, Møller KS, Kabululu M, Makasi CE, Magnussen P, Bottieau E, Abatih E, Johansen MV, Ngowi H, Ndawi B, Mwape KE, Zulu G, Dorny P, Winkler AS, Gabriël S. Trial Design of a Prospective Multicenter Diagnostic Accuracy Study of a Point-of-Care Test for the Detection of Taenia solium Taeniosis and Neurocysticercosis in Hospital-Based Settings in Tanzania. Diagnostics (Basel) 2021; 11:diagnostics11091528. [PMID: 34573870 PMCID: PMC8470609 DOI: 10.3390/diagnostics11091528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/20/2022] Open
Abstract
Taenia solium diagnosis is challenging as trained personnel, good diagnostic tools, and infrastructure is lacking in resource-poor areas. This paper aims to describe the study trial design adopted to evaluate a newly developed rapid point-of-care test that simultaneously detects taeniosis and neurocysticercosis (TS POC) in three district hospitals in Tanzania. The two-stage design included three types of patients: patients with specific neurological signs and symptoms (group 1); patients with complaints compatible with intestinal worm infections (group 2); patients with other symptom(s) (group 3). For group 1, all patients were tested using the TS POC test (stage 1), after which all positive, and a subset of negative, patients were selected for laboratory reference tests, clinical examination, and a brain computed tomography (CT) scan (stage 2). For groups 2 and 3, a similar design was adopted, but clinical examination and a brain CT scan (stage 2) were only performed in patients who were TS POC test-positive for cysticercosis. Due to the lack of a gold standard, a Bayesian approach was used to determine test accuracy for taeniosis and cysticercosis. For neurocysticercosis, a composite case definition was used as the reference standard. If successful, this study will help the future developments (commercialization and implementation) of the rapid test and improve patient management and disease prevention.
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Affiliation(s)
- Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
- Correspondence: (C.T.); (S.G.)
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Bernard Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre Dar es Salaam, Dar es Salaam 11101, Tanzania; (B.N.); (C.E.M.)
- Department of Public Health, University of Dar es Salaam Tanzania, Dar es Salaam 65015, Tanzania
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, 80809 Munich, Germany
| | - Karen Schou Møller
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg, Denmark;
| | - Mwemezi Kabululu
- Tanzania Livestock Research Institute (TALIRI)-Uyole, Mbeya P.O. Box 6191, Tanzania;
| | - Charles E. Makasi
- National Institute for Medical Research, Muhimbili Medical Research Centre Dar es Salaam, Dar es Salaam 11101, Tanzania; (B.N.); (C.E.M.)
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Emmanuel Abatih
- Department of Applied Mathematics, Computer Sciences and Statistics, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium;
| | | | - Helena Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania;
| | | | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.)
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.)
- Eastern Provincial Health Office, Ministry of Health, Lusaka 30205, Zambia
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
- Correspondence: (C.T.); (S.G.)
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Immunodiagnostic usefulness of monoclonal antibodies specific to conformational epitopes of Taenia solium oncosphere protein TSOL18. J Immunol Methods 2021; 497:113121. [PMID: 34352238 PMCID: PMC8440224 DOI: 10.1016/j.jim.2021.113121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
Taenia solium oncosphere protein TSOL18 is the host-protective antigen against porcine cysticercosis. Little attention has been given to use it as target molecule in immunodiagnostic tests. The objective of this paper is to describe the immunodiagnostic potential of monoclonal antibodies (MoAbs) raised against conformational epitopes of TSOL18. Three murine IgG1 MoAbs (25D12C1, 21C2D2, 10H1F2) against three different conformational epitopes of TSOL18 were produced and evaluated with an inhibition enzyme-linked immunosorbent assay (i-ELISA) for the detection of anti-TSOL18 and anti-oncosphere antibodies. Serum samples from pigs immunized with TSOL18 inhibited the binding of the three MoAbs to TSOL18 antigen in i-ELISA. The highest inhibition of anti-TSOL18 antibodies in immunized pigs was observed with MoAb 25D12C1. Ten field sera (12.19%) from 82 non-vaccinated and non-infected pigs showed anti-oncosphere antibodies inhibiting the binding of MoAb 25D12C1. Anti-oncosphere antibodies in pigs experimentally infected with T. solium eggs inhibited the binding of MoAb 25D12C1 from 2 to 8 week-post infection. It is concluded that MoAb 25D12C1 has excellent immunodiagnostic potentials to detect anti-oncosphere antibodies in the intermediate hosts at early exposure to T. solium eggs. Further investigations on potential use of MoAb 25D12C1 in a capture antigen ELISA for the detection of post-oncospheral antigens in infected pigs cannot be overemphasized. We describe the potential usefulness of the monoclonal antibody 25D12C1 to TSOL18 protein. Serum samples from pigs immunized with TSOL18 inhibited the binding of 25D12C1 in an inhibition enzyme-linked immunosorbent assay (i-ELISA) for the detection of anti-TSOL18 and anti-oncosphere antibodies. Anti-oncosphere antibodies in pigs infected with T. solium eggs inhibited also the binding of 25D12C1. It is concluded that MoAb i-ELISA using 25D12C1 has the potential to identify animals exposed to T. solium infection.
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Van Damme I, Trevisan C, Mwape KE, Schmidt V, Magnussen P, Zulu G, Mubanga C, Stelzle D, Bottieau E, Abatih E, Phiri IK, Johansen MV, Chabala C, Winkler AS, Dorny P, Gabriël S. Trial Design for a Diagnostic Accuracy Study of a Point-of-Care Test for the Detection of Taenia solium Taeniosis and (Neuro)Cysticercosis in Community Settings of Highly Endemic, Resource-Poor Areas in Zambia: Challenges and Rationale. Diagnostics (Basel) 2021; 11:diagnostics11071138. [PMID: 34206654 PMCID: PMC8306489 DOI: 10.3390/diagnostics11071138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 11/16/2022] Open
Abstract
Field-applicable, high-quality, and low-cost diagnostic tools are urgently needed for Taenia solium. The aim of this paper is to describe the design, challenges, and rationale for the design of a diagnostic accuracy study in low-resource community settings in Zambia. The trial was designed as a prospective study with a two-stage design to evaluate a new point-of-care test (TS POC) for the detection of taeniosis and (neuro)cysticercosis. Participants within randomly selected households were tested with the TS POC test (index test). Participants who tested TS POC positive for taeniosis and/or cysticercosis and a subset of the negatives were requested to give blood and stool samples for reference testing, and to undergo clinical examination and a cerebral CT scan. The difficulties of conducting a clinical trial in settings with limited research and neuroimaging infrastructure as well as peculiarities specifically related to the disease (low prevalence of taeniosis and the lack of a gold standard) were taken into consideration for the design of this study. The two-stage design increased the efficiency of the study by reducing the number of samples, clinical examinations, and CT scans. Simplified flows and sampling processes were preferred over complex follow-up and randomization systems, aiming to reduce bias and increase the generalizability of the study.
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Affiliation(s)
- Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Correspondence: (I.V.D.); (S.G.)
| | - Chiara Trevisan
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
- Ministry of Health, Lusaka 10101, Zambia
| | - Chishimba Mubanga
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Emmanuel Abatih
- Department of Applied Mathematics, Computer Sciences and Statistics, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Isaac K. Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | | | - Chishala Chabala
- Paediatrics and Child Health, Children’s Hospital, University Teaching Hospitals, Lusaka 10101, Zambia;
- Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Correspondence: (I.V.D.); (S.G.)
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Gómez-Morales MÁ, Pezzotti P, Ludovisi A, Boufana B, Dorny P, Kortbeek T, Blocher J, Schmidt V, Amati M, Gabriël S, Pozio E, Winkler AS, Participants TRT. Collaborative Studies for the Detection of Taenia spp. Infections in Humans within CYSTINET, the European Network on Taeniosis/Cysticercosis. Microorganisms 2021; 9:microorganisms9061173. [PMID: 34072437 PMCID: PMC8229687 DOI: 10.3390/microorganisms9061173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022] Open
Abstract
Laboratory tools for diagnosing taeniosis/cysticercosis in non-endemic countries are available; however, there is little data on their performance. To provide information on the sensitivity, specificity, and reproducibility of these tools, inter-laboratory studies were organized within the EU COST-Action CYSTINET (TD1302). Two serological and one coprological Ring Trials (RTs) were organized to test a panel of human-derived sera and stool samples using assays routinely conducted by the participating laboratories to detect Taenia spp. infections. Four Western blots (WBs) and five ELISAs were used by nine laboratories for cysticercosis diagnosis. In the first serological RT, the overall sensitivity was 67.6% (95% CI, 59.1–75.4), whereas specificity was 97% (95% CI, 89.8–99.6). WBs recorded the best accuracy. A second serological RT was organized, to assess the three tests most frequently used during the first RT. Two out of six laboratories performed all the three tests. The overall sensitivity and specificity were 52.8% (95% CI, 42.8–62.7) and 98.1% (95% CI, 93.2–99.7), respectively. Laboratory performance strongly affected test results. Twelve laboratories participated in the coprological RT using conventional microscopy and six laboratories used molecular assays. Traditional diagnosis by microscopy yielded better results than molecular diagnosis. This may have been influenced by the lack of standardization of molecular tests across participating laboratories.
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Affiliation(s)
- María Ángeles Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
- Correspondence:
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Alessandra Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Belgees Boufana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
- National Reference Laboratory for Trichinella & Echinococcus National Wildlife Management Centre (NWMC) Animal and Plant Health Agency Sand Hutton, York YO41 1LZ, UK
| | - Pierre Dorny
- Veterinary Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerpen, Belgium;
| | - Titia Kortbeek
- Center IDS, National Institute of Public Health and the Environment, RIVM, 3720 Bilthoven, The Netherlands;
| | - Joachim Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria;
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
| | - Marco Amati
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Edoardo Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Andrea Sylvia Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
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Butala C, Brook TM, Majekodunmi AO, Welburn SC. Neurocysticercosis: Current Perspectives on Diagnosis and Management. Front Vet Sci 2021; 8:615703. [PMID: 34041288 PMCID: PMC8141574 DOI: 10.3389/fvets.2021.615703] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
Porcine cysticercosis, human taeniasis, and (neuro)cysticercosis are endemic in many low- and middle-income countries (LMIC) where they present a significant health burden to affected communities. Neurocysticercosis (NCC) is one of the leading causes of human epilepsy in many hyperendemic regions in Latin America, Asia, and sub-Saharan Africa. The World Health Organization (WHO) reports an estimated 2.5-8.3 million cases of NCC annually with a disability-adjusted life year (DALY) burden of 2.8 million, but as for all neglected tropical diseases (NTDs), these values are likely to be underestimated. Diagnosis of NCC is complex and most accurately diagnosed using clinical neuroimaging that is unavailable in most hyperendemic regions in LMIC. On January 28, 2021, WHO will launch its road map for the NTDs' "Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030." Taeniasis/cysticercosis is targeted for control success considered as steady increase in the number of countries with intensified control in hyperendemic areas [increasing from 2 (3%) in 2020 to 4 (6%) in 2023, to 9 (14%) by 2025, and to 17 (27%) by 2030]. Cross-cutting targets that include 100% access to at least basic water supply, sanitation, and hygiene in areas endemic for NTDs and 75% integrated treatment coverage for preventative chemotherapy will additionally impact on the taeniasis/cysticercosis/NCC complex. With no vaccine available for humans, prevention of infection depends on communication to the public of the life cycle of a complex zoonosis to promote behavior change, underpinned by practical control measures including treatment of human taeniasis and (neuro)cysticercosis with albendazole and praziquantel [widely used as part of the mass drug administration (MDA) deworming programs], surgery where appropriate, and effective vaccination and deworming for pigs supported by meat inspection. Here, we review recent advances in tools and implementation for Taenia solium taeniasis/(neuro)cysticercosis (TSTC) control and milestones on the onward path to elimination.
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Affiliation(s)
- Caitlin Butala
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - T. M. Brook
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ayodele O. Majekodunmi
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Susan Christina Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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Acosta Soto L, Parker LA, Irisarri-Gutiérrez MJ, Bustos JA, Castillo Y, Perez E, Muñoz-Antoli C, Esteban JG, García HH, Bornay-Llinares FJ. Evidence for Transmission of Taenia solium Taeniasis/Cysticercosis in a Rural Area of Northern Rwanda. Front Vet Sci 2021; 8:645076. [PMID: 33959651 PMCID: PMC8093440 DOI: 10.3389/fvets.2021.645076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/23/2021] [Indexed: 12/30/2022] Open
Abstract
Cysticercosis is a parasitic infection caused by the metacestode larval stage (cysticercus) of Taenia solium. In humans, cysticercosis may infect the central nervous system and cause neurocysticercosis, which is responsible for over 50,000 deaths per year worldwide and is the major cause of preventable epilepsy cases, especially in low-income countries. Cysticercosis infection is endemic in many less developed countries where poor hygiene conditions and free-range pig management favor their transmission. A cross-sectional study was conducted in 680 children from a rural primary school in Gakenke district (Northern province of Rwanda). Stool samples were collected from participants and analyzed using the Kato-Katz method (KK), formol-ether concentration (FEC), and/or copro-antigen enzyme-linked immunosorbent assay (CoAg-ELISA) to detect taeniasis. Blood samples were collected and analyzed using enzyme-linked immunoelectrotransfer blot (EITB) and antigen enzyme-linked immunosorbent assay (Ag-ELISA) to detect human cysticercosis. The overall proportion of taeniasis positivity was 0.3% (2/680), and both cases were also confirmed by CoAg-ELISA. A total of 13.3% (76/572) of the children studied were positive to cysticercosis (T. solium-specific serum antibodies detected by EITB), of whom 38.0% (27/71) had viable cysticercus (T. solium antigens by Ag-ELISA). This study provides evidence of the highest cysticercosis prevalence reported in Rwanda in children to date. Systematic investigations into porcine and human cysticercosis as well as health education and hygiene measures for T. solium control are needed in Gakenke district.
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Affiliation(s)
- Lucrecia Acosta Soto
- Área de Parasitología del Departamento de Agroquímica y Medioambiente, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Lucy Anne Parker
- Departamento de Salud Pública Historia de la Ciencia y Ginecología, Universidad Miguel Hernández de Elche, Alicante, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Irisarri-Gutiérrez
- Área de Parasitología, Dpto. Farmacia y Tecnología Farmacéutica y Parasitología, Facultat de Farmàcia, Universitat de València, Valencia, Spain
- Dpto. de Ciencias de la Salud, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | - Javier Arturo Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yesenia Castillo
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Erika Perez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Carla Muñoz-Antoli
- Área de Parasitología, Dpto. Farmacia y Tecnología Farmacéutica y Parasitología, Facultat de Farmàcia, Universitat de València, Valencia, Spain
| | - José Guillermo Esteban
- Área de Parasitología, Dpto. Farmacia y Tecnología Farmacéutica y Parasitología, Facultat de Farmàcia, Universitat de València, Valencia, Spain
| | - Héctor Hugo García
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fernando Jorge Bornay-Llinares
- Área de Parasitología del Departamento de Agroquímica y Medioambiente, Universidad Miguel Hernández de Elche, Alicante, Spain
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Mukendi D, Kalo JRL, Lutumba P, Barbé B, Jacobs J, Yansouni CP, Gabriël S, Dorny P, Chappuis F, Boelaert M, Winkler AS, Verdonck K, Bottieau E. High frequency of Taenia solium antigen positivity in patients admitted for neurological disorders in the Rural Hospital of Mosango, Democratic Republic of Congo. BMC Infect Dis 2021; 21:359. [PMID: 33865327 PMCID: PMC8052782 DOI: 10.1186/s12879-021-06032-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background The epidemiology of human cysticercosis and neurocysticercosis, caused by the larval stage of the pork tapeworm Taenia solium, is not well known in the Democratic Republic of Congo (DRC). Within a multicenter etiological and diagnostic study conducted by the NIDIAG consortium (“Better Diagnosis for Neglected Infections”) and investigating several challenging syndromes, we consecutively evaluated from 2012 to 2015 all patients older than 5 years presenting with neurological disorders (neurology cohort) and with fever > 7 days (persistent fever cohort) at the rural hospital of Mosango, province of Kwilu, DRC. In both cohorts, etiological diagnosis relied on a systematic set of reference laboratory assays and on pre-established clinical case definitions. No neuroimaging was available in the study hospital. In this study, we determined the frequency of T. solium infection in both cohorts and explored in the neurology cohort its association with specific neurological presentations and final etiological diagnoses. Methods We conducted a post-hoc descriptive and analytic study on cysticercosis in the neurology and persistent fever cohorts, based on the presence in serum samples of circulating T. solium antigen using the B158/B60 enzyme-linked immunosorbent assay (ELISA) and of cysticercosis IgG using the LDBIO Cysticercosis Western Blot IgG assay. Results For the neurology cohort, 340 samples (of 351 enrolled patients) were available for analysis (males: 46.8%; mean age: 38.9 years). T. solium antigen positivity was found in 43 participants (12.6%; 95% confidence interval [CI] 9.3–16.7%), including 9 of 60 (15%) patients with epilepsy. Among the 148 samples available from the persistent fever cohort (males: 39.9%; mean age: 19.9 years), 7 were positive in the T. solium antigen ELISA (4.7%; 95% CI 1.9–9.5%; P = 0.009 when compared to the neurology cohort). No significant association was found within the neurology cohort between positivity and clinical presentation or final diagnoses. Of note, the IgG antibody-detecting assay was found positive in only four (1.3%) of the participants of the neurology cohort and in none of the persistent fever cohort. Conclusions T. solium antigen positivity was found in at least 10% of patients admitted with neurological disorders in the Kwilu province, DRC, with no specific pattern of presentation. Further neuroimaging studies should be used to confirm whether neurocysticercosis is prevalent in this region.
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Affiliation(s)
- Deby Mukendi
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo. .,Départment de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
| | - Jean-Roger Lilo Kalo
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Pascal Lutumba
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Départment de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Barbara Barbé
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Cedric P Yansouni
- JD MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada
| | - Sarah Gabriël
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Andrea S Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany.,Center for Global Health, University of Oslo, Oslo, Norway
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Dixon MA, Winskill P, Harrison WE, Basáñez MG. Taenia solium taeniasis/cysticercosis: From parasite biology and immunology to diagnosis and control. ADVANCES IN PARASITOLOGY 2021; 112:133-217. [PMID: 34024358 DOI: 10.1016/bs.apar.2021.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infection with the pork tapeworm (Taenia solium) is responsible for a substantial global burden of disease, not only restricted to its impact on human health, but also resulting in a considerable economic burden to smallholder pig farmers due to pig cysticercosis infection. The life-cycle, parasitology and immunology of T. solium are complex, involving pigs (the intermediate host, harbouring the larval metacestode stage), humans (the definitive host, harbouring the adult tapeworm, in addition to acting as accidental intermediate hosts) and the environment (the source of infection with eggs/proglottids). We review the parasitology, immunology, and epidemiology of the infection associated with each of the T. solium life-cycle stages, including the pre-adult/adult tapeworm responsible for human taeniasis; post-oncosphere and cysticercus associated with porcine and human cysticercosis, and the biological characteristics of eggs in the environment. We discuss the burden associated, in endemic settings, with neurocysticercosis (NCC) in humans, and the broader cross-sectoral economic impact associated both with NCC and porcine cysticercosis, the latter impacting food-value chains. Existing tools for diagnostics and control interventions that target different stages of the T. solium transmission cycle are reviewed and their limitations discussed. Currently, no national T. solium control programmes have been established in endemic areas, with further work required to identify optimal strategies according to epidemiological setting. There is increasing evidence suggesting that cross-sectoral interventions which target the parasite in both the human and pig host provide the most effective approaches for achieving control and ultimately elimination. We discuss future avenues for research on T. solium to support the attainment of the goals proposed in the revised World Health Organisation neglected tropical diseases roadmap for 2021-2030 adopted at the 73rd World Health Assembly in November 2020.
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Affiliation(s)
- Matthew A Dixon
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Wendy E Harrison
- Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
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Skrip LA, Dermauw V, Dorny P, Ganaba R, Millogo A, Tarnagda Z, Carabin H. Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa. PLoS Negl Trop Dis 2021; 15:e0009234. [PMID: 33755677 PMCID: PMC8018642 DOI: 10.1371/journal.pntd.0009234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 04/02/2021] [Accepted: 02/10/2021] [Indexed: 01/25/2023] Open
Abstract
Background The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Methodology/Principal findings Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Conclusions/Significance Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis. It is important to consider context-specific behaviors and transmission pathways when designing scalable and sustainable intervention strategies for neglected tropical diseases (NTDs). To reduce the morbidity and mortality associated with cysticercosis, suites of interventions have been recommended but are inconsistently implemented due to cost and feasibility-related constraints. This study investigated the potential of a cooking intervention to interrupt transmission via undercooked pork in marketplaces of Burkina Faso. The sensitivity of Taenia solium parasite to temperatures attainable via improved cooking strategies provides a low-cost, human-centered approach to prevent consumption of infected pork meals. By accounting for differential behavior and the relative role of this transmission route across three provinces, we show how the potential of cysticercosis elimination (as a public health problem) varies across behavior-focused interventions. Further investigation into intervention strategies against human and pig cysticercosis warrants data-driven analyses that account for local variation in transmission behaviors.
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Affiliation(s)
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Athanase Millogo
- Department of Medicine, CHU Sourô Sanou, Bobo Dioulasso, Burkina Faso
| | - Zékiba Tarnagda
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Hélène Carabin
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, Québec, Canada
- Département de médecine sociale et préventive, École de Santé Publique, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en Santé Publique (CReSP), Montréal, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique, St-Hyacinthe, Québec, Canada
- * E-mail:
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Shongwe NA, Byaruhanga C, Dorny P, Dermauw V, Qekwana DN. Knowledge, practices and seroprevalence of Taenia species in smallholder farms in Gauteng, South Africa. PLoS One 2020; 15:e0244055. [PMID: 33338060 PMCID: PMC7748137 DOI: 10.1371/journal.pone.0244055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/02/2020] [Indexed: 02/01/2023] Open
Abstract
Porcine cysticercosis and associated human infections are endemic in Sub-Saharan Africa, Latin America, and Asia. Poor agricultural practices, sanitary practices, and lack of knowledge increase the burden of the diseases in susceptible populations. This study investigates the seroprevalence of Taenia spp. in township pigs in Gauteng, South Africa and describes knowledge and farming practices of pig farmers regarding T. solium infections. Blood samples were collected from 126 pigs in three Gauteng township areas, and analyzed for active Taenia spp. infection using the B158/B60 Ag-ELISA. Farmer questionnaire surveys were conducted in four township areas to investigate the level of knowledge and practices associated with porcine cysticercosis and neurocysticercosis. Logistic regression models were used to assess the relationship between predictor variables and the outcome variable, knowledge of porcine cysticercosis or knowledge of neurocysticercosis. Overall, 7% of the pigs were seropositive for active Taenia spp. infection. 46% of farmers practiced a free-ranging system, while 25% practiced a semi-intensive system. Latrines were absent on all farms; however, 95% of farmers indicated that they have access to latrines at home. Most farmers had no knowledge of porcine cysticercosis (55%) or neurocysticercosis (79%), and this was not associated with any of the factors investigated. The prevalence of active Taenia spp. infection was reasonably low in this study, yet the knowledge level was also low, thus calling for further educational and training programmes to prevent Taenia spp. transmission in these communities.
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Affiliation(s)
- Nothando Altrecia Shongwe
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria, South Africa
| | - Charles Byaruhanga
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria, South Africa
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Daniel Nenene Qekwana
- Section of Veterinary Public Health, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
- * E-mail:
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Prevalence and risk assessment of porcine cysticercosis in Ngozi province, Burundi. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2020; 23:100514. [PMID: 33678369 DOI: 10.1016/j.vprsr.2020.100514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
Cysticercosis is a major zoonotic disease in many developing countries leading to substantial economic and public health impacts on affected communities. Due to a lack of updated data on T. solium cysticercosis in Burundi, the present study was carried out to determine the prevalence of porcine cysticercosis and to identify potential associated risk factors in Ngozi province. This study was conducted in Ngozi and Marangara communes of Ngozi province during January and February 2020. A multistage random sampling strategy was used. Tongue palpation was performed on pigs to diagnose cysticercosis. Randomly selected heads of pig keeping households were interviewed to assess the risk factors for porcine cysticercosis. A logistic regression model was used to analyse the main risk factors associated with porcine cysticercosis. In total, 496 pigs from 321 households distributed in 16 hills, randomly selected in Ngozi and Marangara communes were inspected. The apparent prevalence by tongue palpation in Ngozi province was 15.5% (95% CI: 12.3-18.7%). In Ngozi and in Marangara communes, the prevalence was 22.9% (95% CI: 17.7-28.2%) and 8.1% (95% CI: 4.6-11.4%), respectively. The true prevalence was estimated at 31% for the province, with a prevalence of 45.8% in Ngozi and 16.2% in Marangara commune, respectively. Pig farming systems including free ranging, tethering and penned part of the day (OR = 3.5; 95% CI: 2.1-6.1; p ≤ 0.001) and lack of meat inspection at home slaughter (OR = 2.5; 95% CI: 1.1-5.6; p = 0.019) were significant risk factors associated with porcine cysticercosis. The present findings show that porcine cysticercosis is highly endemic in Ngozi province and that pig management systems currently used in the area permit pigs to have access to human stool. Moreover, lack of meat inspection during home slaughter potentially gives the possibility for household and community members to eat infected pork. Total confinement of pigs, improved hygiene and sanitation in households, and improvement of meat inspection through awareness campaigns and overall health education of the community should be implemented to control T. solium infections.
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Koutsoumanis K, Allende A, Alvarez‐Ordóñez A, Bolton D, Bover‐Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Lindqvist R, Nauta M, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Sánchez JÁ, Blagojevic B, Fürst P, Garin‐Bastuji B, Jensen HE, Paulsen P, Baert K, Barrucci F, Broglia A, Georgiadis M, Hempen M, Hilbert F. Evaluation of public and animal health risks in case of a delayed post-mortem inspection in ungulates. EFSA J 2020; 18:e06307. [PMID: 33304413 PMCID: PMC7716243 DOI: 10.2903/j.efsa.2020.6307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The potential effects of a 24 or 72-h delay in post-mortem inspection (PMI) of ungulates on public health and monitoring of animal health and welfare was evaluated. The assessment used a survey of meat inspectors, expert opinion, literature search and a stochastic model for Salmonella detection sensitivity. Disease detection sensitivity at a delayed PMI is expected to reduce detection sensitivity to a variable extent, depending on the hazard and on the signs/lesions and organs involved. No reduction is expected for Trichinella detection in meat from susceptible animal species and any decrease in detection of transmissible spongiform encephalopathies (TSEs) will not exceed the current tolerance for fallen stock. A 24-h delay in PMI could result in a small reduction in sensitivity of detection for tuberculosis, echinococcosis and cysticercosis. A greater reduction is expected for the detection of pyaemia and Rift valley fever. For the detection of Salmonella, the median model estimates are a reduction of sensitivity of 66.5% (90% probability interval (PI) 0.08-99.75%) after 24-h delay and 94% (90% PI 0.83-100%) after 72-h delay of PMI. Laboratory testing for tuberculosis following a sampling delay of 24-72 h could result in no, or a moderate, decrease in detection depending on the method of confirmation used (PCR, culture, histopathology). For chemical contaminants, a delay in meat inspection of 24 or 72 h is expected to have no impact on the effectiveness of detection of persistent organic pollutants and metals. However, for certain pharmacologically active substances, there will be a reduced effectiveness to detect some of these substances due to potential degradation in the available matrices (tissues and organs) and the non-availability of specific preferred matrices of choice.
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Marinho GLDOC, Schwarz DGG, Trigo BB, Nunes CM, Romeiro ET, de Azevedo EO, da Silva JEM, Farias MPO, Oliveira JF, Faustino MADG. Swine cysticercosis and associated risk factors in non-technified pig breeding in semi-arid region of Sergipe state, Brazil. Trop Anim Health Prod 2020; 53:37. [PMID: 33230578 DOI: 10.1007/s11250-020-02441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the frequency of Taenia solium anti-metacestode antibodies in slaughtered pigs in a semi-arid region of the "Alto Sertão" of Sergipe state, Brazil, and verify the risk factors associated with swine cysticercosis. For this, 230 samples of swine blood from two slaughterhouses were collected and analyzed by indirect ELISA. The pigs came from five non-technical properties in the semi-arid region of the Alto Sertão of Sergipe state. Searches for cysts in the skeletal muscles of the pigs were performed during slaughter. In addition, an epidemiological questionnaire was applied to the pigs' original properties to determine risk factors. Besides that, the official health services database was evaluated for confirmed cases of neurocysticercosis and taeniasis in humans in the last 5 years, living in the studied region. Seropositivity in pigs was 12.6%, with no significant difference between males and females. No cysts were found in the carcasses of the slaughtered pigs. A positive association was found for properties that discharge domestic sewage into the environment, in river or streams, increasing the risk of positivity by 5.72 times. When analyzing the database of official agencies, there were no records of cases of neurocysticercosis or taeniasis in the resident population in the last 5 years. However, there were frequent cases of idiopathic epilepsy. The results demonstrate that study area is endemic for swine cysticercosis and serves as a warning of the possibility of the occurrence of the taeniasis-cysticercosis complex.
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Affiliation(s)
- Glenda Lídice de O C Marinho
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil.
| | - David Germano G Schwarz
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil
| | - Beatriz B Trigo
- Faculdade de Medicina Veterinária, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Aracatuba, SP, Brazil
| | - Caris M Nunes
- Faculdade de Medicina Veterinária, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Aracatuba, SP, Brazil
| | - Edenilze T Romeiro
- Department of Veterinary Medicine, Universidade Federal Rural de Pernambuco (UFRPE), Recife, PE, Brazil
| | | | | | - Márcia Paula O Farias
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil
| | - Juliana F Oliveira
- Instituto Federal de Educação, Ciência e Tecnologia de Minas Gerais, IFMG - Campus Avançado Ponte Nova, Ponte Nova, Minas Gerais, Brazil
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Kabululu ML, Johansen MV, Mlangwa JED, Mkupasi EM, Braae UC, Trevisan C, Colston A, Cordel C, Lightowlers MW, Ngowi HA. Performance of Ag-ELISA in the diagnosis of Taenia solium cysticercosis in naturally infected pigs in Tanzania. Parasit Vectors 2020; 13:534. [PMID: 33109255 PMCID: PMC7590492 DOI: 10.1186/s13071-020-04416-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022] Open
Abstract
Background Taenia solium is a zoonotic parasite responsible for neurocysticercosis—a major cause of late-onset acquired epilepsy in humans. Lack of affordable, specific and sensitive diagnostic tools hampers control of the parasite. This study assessed the performance of an antigen detection enzyme-linked immunosorbent assay (Ag-ELISA) in the diagnosis of viable T. solium cysticercosis in naturally infected slaughter-age pigs in an endemic area in Tanzania. Methods A total of 350 pigs were bled before they were slaughtered and their carcases examined. Serum was analyzed for circulating antigens by using a monoclonal antibody-based B158/B60 Ag-ELISA. Each carcase was examined for the presence of Taenia hydatigena cysticerci and half carcase musculature together with the whole brain, head muscles, tongue, heart and diaphragm were sliced with fine cuts (< 0.5 cm) to reveal and enumerate T. solium cysticerci. Half carcase dissection can detect at least 84% of infected pigs. Prevalence and their 95% confidence intervals (CI) were calculated in Stata 12. Sensitivity, specificity, predictive values and likelihood ratios were determined. Results Twenty–nine pigs (8.3%, 95% CI: 5.6–11.7%) had viable T. solium cysticerci while 11 pigs had T. hydatigena cysticerci (3.1%, 95% CI: 1.6–5.5%). No co-infection was observed. Sixty-eight pigs (19.4%, 95% CI: 15.4–20%) tested positive on Ag-ELISA; of these, 24 had T. solium cysticerci and 7 had T. hydatigena cysticerci. Sensitivity and specificity were determined to be 82.7% and 86.3%, respectively. Positive and negative predictive values were 35.2% and 98.2%, respectively. Likelihood ratios for positive and negative Ag-ELISA test results were 6.0 and 0.2, respectively. There was a significant positive correlation between the titre of circulating antigens and intensity of T. solium cysticerci (r(348) = 0.63, P < 0.001). Conclusions The Ag-ELISA test characteristics reported in this study indicate that the test is more reliable in ruling out T. solium cysticercosis in pigs, than in confirming it. Hence, a negative result will almost certainly indicate that a pig has no infection, but a positive result should always be interpreted with caution. Estimates of T. solium prevalence based on Ag-ELISA results should, therefore, be adjusted for test performance characteristics and occurrence of T. hydatigena.![]()
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Affiliation(s)
| | - Maria V Johansen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - James E D Mlangwa
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Ernatus M Mkupasi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Uffe C Braae
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark.,One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Angela Colston
- Global Alliance for Livestock Veterinary Medicines (GALVmed), Nairobi, Kenya
| | - Claudia Cordel
- Global Alliance for Livestock Veterinary Medicines (GALVmed), Bloemfontein, Free State, South Africa
| | - Marshall W Lightowlers
- UVet, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC, Australia
| | - Helena A Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
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Dixon MA, Winskill P, Harrison WE, Whittaker C, Schmidt V, Sarti E, Bawm S, Dione MM, Thomas LF, Walker M, Basáñez MG. Force-of-infection of Taenia solium porcine cysticercosis: a modelling analysis to assess global incidence and prevalence trends. Sci Rep 2020; 10:17637. [PMID: 33077748 PMCID: PMC7572398 DOI: 10.1038/s41598-020-74007-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 09/14/2020] [Indexed: 11/26/2022] Open
Abstract
The World Health Organization (WHO) called, in 2012, for a validated strategy towards Taenia solium taeniasis/cysticercosis control and elimination. Estimating pig force-of-infection (FoI, the average rate at which susceptible pigs become infected) across geographical settings will help understand local epidemiology and inform effective intervention design. Porcine cysticercosis (PCC) age-prevalence data (from 15 studies in Latin America, Africa and Asia) were identified through systematic review. Catalytic models were fitted to the data using Bayesian methods, incorporating uncertainty in diagnostic performance, to estimate rates of antibody seroconversion, viable metacestode acquisition, and seroreversion/infection loss. There was evidence of antibody seroreversion across 5 studies, and of infection loss in 6 studies measured by antigen or necropsy, indicating transient serological responses and natural resolution of infection. Concerted efforts should be made to collect robust data using improved diagnostics to better understand geographical heterogeneities in T. solium transmission to support post-2020 WHO targets.
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Affiliation(s)
- Matthew A Dixon
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK.
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK.
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Wendy E Harrison
- SCI Foundation, Edinburgh House, 170 Kennington Lane, London, SE11 5DP, UK
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Technical University Munich (TUM), Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Elsa Sarti
- Sanofi Pasteur Latin America, Av. Universidad N° 1738, Colonia Coyoacán, 04000, Mexico, D.F., Mexico
| | - Saw Bawm
- University of Veterinary Science, Yezin, Nay Pyi Taw, 15013, Myanmar
| | - Michel M Dione
- International Livestock Research Institute, 01 BP 1496, Ouagadougou, Burkina Faso
| | - Lian F Thomas
- International Livestock Research Institute (ILRI), Old Naivasha Road, PO Box 30709-00100, Nairobi, Kenya
- Institute for Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK
| | - Martin Walker
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research (LCNTDR), Royal Veterinary College, Hatfield, AL9 7TA, UK
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, W2 1PG, UK
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Vaernewyck V, Mwape KE, Mubanga C, Devleesschauwer B, Gabriël S, Trevisan C. Effects of 'The Vicious Worm' educational software on Taenia solium knowledge among key pork supply chain workers in Zambia. PLoS Negl Trop Dis 2020; 14:e0008790. [PMID: 33075045 PMCID: PMC7595624 DOI: 10.1371/journal.pntd.0008790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/29/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
The neglected zoonotic cestode Taenia solium is endemic in many low- and middle-income countries, including Zambia. The parasite infects humans and pigs, inflicting high socioeconomic and disease burdens in endemic areas. Health education is regarded as an important component in T. solium control and previous studies indicate that ‘The Vicious Worm’ may be an effective T. solium health education tool for Tanzanian medical and agricultural professionals and Zambian primary school students. This study aimed to assess the effects of health education using ‘The Vicious Worm’ among Zambian pork supply chain workers, because the pork supply chain greatly influences food safety and security in Zambia. Half-day educational workshops using ‘The Vicious Worm’ and subsequent follow-up sessions were organized in the Lusaka and Katete districts of Zambia in March and April 2019. Questionnaires were administered before, after, and three weeks after the use of ‘The Vicious Worm’ to assess the program’s impact on knowledge uptake and short-term retention. Focus group discussions were conducted to assess the program’s user experience and the participants’ beliefs, attitudes, and insights. In total, 47 pork supply chain workers participated: 25 from Lusaka and 22 from Katete. Overall, knowledge about T. solium was significantly higher (p<0.001) both immediately after, and three weeks after the use of ‘The Vicious Worm’ compared to baseline knowledge. Focus group discussions indicated incipient attitudinal and behavioral change, as well as a positive reception of the software; with participants describing the software as simple, educative, and useful to share knowledge. The study results indicate that workshops using ‘The Vicious Worm’ may be effective for short-term T. solium health education among key pork supply chain workers. Follow-up studies are required to assess long-term effects, transfer of knowledge and behavioral change. However, educational interventions with ‘The Vicious Worm’ could be considered for integrated T. solium control programs in sub-Saharan Africa, especially if the educational content is further simplified and clarified. The tapeworm Taenia solium causes epilepsy and severe headaches in humans and economic losses to smallholder farmers in endemic areas where free-roaming pigs, poor sanitation and informal animal slaughter are prevalent. Treatment of human taeniosis and interventions in pigs (vaccination and anthelmintic treatment) have been established as essential tools to achieve short-term control, but health education will be crucial to sustain long-term control. ‘The Vicious Worm’ is a specific T. solium health education tool aiming to convey simple and meaningful messages concerning disease prevention and control. Previous studies found significant knowledge increases after the use of the educational tool in Tanzanian medical and agricultural professionals, and Zambian primary school students. We organized half-day educational workshops using ‘The Vicious Worm’ for pork supply chain workers at two study sites in Zambia, with follow-up visits three weeks later. We found a significant increase in participants’ knowledge, both immediately and three weeks after the health education. Furthermore, the program was well received and potentially led to attitudinal and behavioral change that could deter the propagation of T. solium. We conclude that ‘The Vicious Worm’ educational interventions may contribute to a safer pork supply chain and we encourage its implementation in future T. solium control strategies.
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Affiliation(s)
- Victor Vaernewyck
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Kabemba Evans Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chishimba Mubanga
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Brecht Devleesschauwer
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
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Abstract
Pigs act as the intermediate hosts of the zoonotic tapeworms Taenia solium and Taenia asiatica, as well as of the non-zoonotic Taenia hydatigena. In Vietnam, human taeniasis and cysticercosis have been reported throughout the country; however, data on porcine cysticercosis are scarce. Our study aimed to estimate the prevalence of Taenia spp. in slaughtered pigs in two districts in Phu Tho, a mountainous province in northern Vietnam from where neurocysticercosis patients commonly originate. The carcasses of 399 pigs from 51 small-scale abattoirs were checked for cysticerci, while tongue, liver, masseter muscles, diaphragm and heart were sliced and examined. Retrieved cysticerci underwent polymerase chain reaction-restriction fragment length polymorphism and sequencing for species confirmation. Blood was also collected to detect antibodies by lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot (LLGP-EITB) and recombinant T24H antigen (rT24H)-EITB and circulating antigens by B158/B60 Ag-ELISA. In two pigs, T. asiatica cysticerci were found, confirming the presence of the parasite in pigs in Vietnam at a low prevalence (0.5%; 95% exact confidence interval (CI): 0-1.19%). Cysticerci of T. solium were found in none of the pigs, although one serum sample was positive for antibodies in both LLGP-EITB and rT24H-EITB. Furthermore, a high prevalence of T. hydatigena cysticercosis was observed (18.0%; 95% Wilson score CI: 14.6-22.1%). In more than half of the T. hydatigena-positive pigs, circulating antigens were detected by Ag-ELISA, confirming that this test cannot be used to diagnose T. solium cysticercosis in this region. Finally, Spirometra erinaceieuropaei was found in one pig liver. It is the first record of this zoonotic cestode species in pigs in Vietnam. Overall, the findings confirmed the complex epidemiology of Taenia spp. in pigs in Vietnam.
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Lee HS, Dao DT, Bui VN, Bui NA, Le TD, Nguyen-Viet H, Grace D, Thakur KK, Hagiwara K. Prevalence and phylogenetic analysis of hepatitis E virus in pigs in Vietnam. BMC Vet Res 2020; 16:333. [PMID: 32928220 PMCID: PMC7489210 DOI: 10.1186/s12917-020-02537-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background Hepatitis E virus (HEV) is a zoonotic disease and has been reported around the world. The main objective of this study was to evaluate the sero-prevalence and phylogenetic analysis of HEV in Vietnam. Pig blood and fecal pooled samples were collected to assess the prevalence of HEV. We assessed the true prevalence (TP) of HEV from apparent prevalence (AP) by taking into account the sensitivity and specificity of diagnostic tests using a Bayesian approach. For phylogenetic analysis, the data compared with worldwide HEV reference strains including all eight genotypes (G1-G8) which were identified in previous study. Results A total of 475 sera and 250 fecal pooled samples were collected at slaughterhouses and pig farms from five provinces, in Viet Nam. Overall, the sero-AP of HEV was 58.53% (95% confidence interval: 53.95–62.70) while the sero-TP was slightly higher (65.43, 95% credible interval: 47.19–84.70). In terms of pooled samples, overall, the RNA-AP was 6.80% (95% confidence interval: 4.01–10.66). One strain in Hanoi, two strains in Dak Lak, seven strains in An Giang, four strains in Son La and two strains in Nghe An were isolated. The phylogenetic tree demonstrated that 19 Vietnamese strains were clustered into HEV 3 and 4. Conclusions This study provided evidence that HEV is circulating in domestic pigs in Vietnam. From a public health perspective, it is very important to raise public awareness for high-risk groups (e.g. slaughterhouse workers, pig traders, farmers and market sellers) who have more opportunities to come in contact with pig and contaminated meats.
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Affiliation(s)
- Hu Suk Lee
- International Livestock Research Institute (ILRI), Regional Office for East and Southeast Asia, Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam.
| | - Duy Tung Dao
- National Institute of Veterinary Research, Hanoi, Vietnam
| | | | - Ngoc Anh Bui
- National Institute of Veterinary Research, Hanoi, Vietnam
| | - Thanh Duy Le
- National Institute of Veterinary Research, Hanoi, Vietnam
| | - Hung Nguyen-Viet
- International Livestock Research Institute (ILRI), Regional Office for East and Southeast Asia, Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam
| | - Delia Grace
- International Livestock Research Institute (ILRI), Nairobi, Kenya.,Natural Resources Institute, Chatham, UK
| | - Krishna K Thakur
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
| | - Katsuro Hagiwara
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Bunkyodai, Ebetsu, Hokkaido, 069-8501, Japan.
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Kabululu ML, Ngowi HA, Mlangwa JED, Mkupasi EM, Braae UC, Trevisan C, Colston A, Cordel C, Johansen MV. Endemicity of Taenia solium cysticercosis in pigs from Mbeya Rural and Mbozi districts, Tanzania. BMC Vet Res 2020; 16:325. [PMID: 32883326 PMCID: PMC7470673 DOI: 10.1186/s12917-020-02543-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Taenia solium taeniasis/cysticercosis is a disease of substantial economic and public health importance particularly in low-income countries. The disease was reported to be endemic in Mbeya Rural and Mbozi districts, in the southern highlands of Tanzania, the major pig production area in the country. In 2008, using B158/B60 antigen detection enzyme-linked immunosorbent assay (Ag-ELISA), porcine cysticercosis prevalence of up to 32% was reported in the districts. A number of interventions have been implemented in selected villages including an integrated approach consisting of improving pig confinement and selective treatment of pigs with oxfendazole. Mass drug administration with praziquantel targeting schistosomiasis, with an expected effect on T. solium, was also provided to school-age children in the area. This study aimed at providing an update on prevalence and intensities of porcine cysticercosis; and assessing farmers' knowledge, attitudes and practices which could be associated to disease transmission in the area. The study involved a questionnaire survey conducted using face-to-face household interviews with 890 consenting farmers; and carcass dissections performed on 282 pigs randomly selected from the surveyed households. RESULTS Twenty-six pigs (9.2%) were infected with T. solium; of which two-thirds (65.4%) had light to moderate infection intensities (1-1000 cysticerci), and one-third (34.6%) had heavy intensities (> 1000 cysticerci). Questionnaire results showed that only 5.7% of the respondents perceived T. solium cysticercosis to be an important disease in pigs. About 18.5% of the respondents were aware of T. solium taeniasis, but 32% of them were unaware of how the infection is acquired. Half of the respondents had seen cysticerci in pork, of whom 61% were not aware that consumption of infected pork could cause taeniasis. Latrines were observed to often (90%) lack doors with 45% considered accessible to pigs. CONCLUSIONS This study provided an evidence that the disease was still endemic in the area. Poor knowledge of farmers, attitudes, and risky practices responsible for disease perpetuation were also revealed. A One Health approach targeting the whole area incorporating improvement of farmer knowledge regarding disease transmission needs to be trialed as a feasible approach to control.
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Affiliation(s)
- Mwemezi L Kabululu
- Tanzania Livestock Research Institute (TALIRI) - Uyole, Mbeya, Tanzania.
| | - Helena A Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - James E D Mlangwa
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Ernatus M Mkupasi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Uffe C Braae
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark.,One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Angela Colston
- Global Alliance for Livestock Veterinary Medicines (GALVmed), Nairobi, Kenya
| | - Claudia Cordel
- Global Alliance for Livestock Veterinary Medicines (GALVmed), Bloemfontein, Free State, South Africa
| | - Maria V Johansen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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45
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Hobbs EC, Mwape KE, Phiri AM, Mambwe M, Mambo R, Thys S, Zulu G, Chembensofu M, Trevisan C, Van Damme I, Phiri IK, Devleesschauwer B, Ketzis J, Dorny P, Willingham AL, Gabriël S. Perceptions and acceptability of piloted Taenia solium control and elimination interventions in two endemic communities in eastern Zambia. Transbound Emerg Dis 2020; 67 Suppl 2:69-81. [PMID: 31231968 PMCID: PMC7496623 DOI: 10.1111/tbed.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/23/2022]
Abstract
Infections with Taenia solium cause significant public health and economic losses worldwide. Despite effective control tools, long-term sustained control/elimination of the parasite has not been demonstrated to date. Success of intervention programs is dependent on their acceptability to local communities. Focus group discussions (FGDs) and questionnaires (QS) were conducted in two study communities in eastern Zambia to assess local perceptions and acceptance of two piloted intervention strategies: one targeting pigs only ('control' study arm), and one integrated human- and pig-based ('elimination') strategy. QS (n = 227) captured data regarding participation in project activities, knowledge and perceptions of T. solium and of the interventional drugs used in the study. FGDs (n = 18) discussed perceived advantages and disadvantages of the interventions and of the project's delivery and value. QS data revealed 67% of respondents participated in at least one educational activity, and 80% correctly identified at least one disease targeted by the education. All elimination study arm respondents (n = 113) had taken the human treatment, and 98% intended to do so next time. Most (70%) indicated willingness to pay for future treatments (median 0.20 USD per dose). Of pig-owning respondents, 11/12 (92%) had allowed their pigs to be treated/vaccinated and all intended to do so again next time. Four pig owners indicated willingness to pay 0.10-0.50 USD per dose of treatment or vaccine. FGD feedback revealed positive perceptions of interventions; people reported improved health in themselves and their pigs, and fewer cysticerci in pork. Latrine use, hand washing, meat inspection and proper cooking of pork had reportedly increased since the program's inception. Preliminary assessment indicates that the piloted intervention methods are generally acceptable to the communities. The reported willingness of many respondents to pay for the medications would contribute to the feasibility of long-term, government-led T. solium intervention programs in future.
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Affiliation(s)
- Emma Clare Hobbs
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Andrew M. Phiri
- School of Veterinary MedicineUniversity of ZambiaLusakaZambia
| | - Moses Mambwe
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | - Richard Mambo
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | - Gideon Zulu
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | | | - Inge Van Damme
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | | | - Jennifer Ketzis
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
| | - Pierre Dorny
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
| | - Sarah Gabriël
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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46
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Lightowlers MW. Diagnosis of Porcine Cysticercosis at Necropsy: When Is Enough, Enough? Trends Parasitol 2020; 36:575-578. [PMID: 32376114 DOI: 10.1016/j.pt.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
Changes in the incidence of porcine cysticercosis is used commonly in the assessment of efforts to control the transmission of Taenia solium, the cause of human neurocysticercosis. Although cysticerci may occasionally occur in tissues other than the striated muscles, particularly the brain, infection in pigs can be diagnosed reliably by assessment of muscle tissue alone.
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Affiliation(s)
- Marshall W Lightowlers
- The University of Melbourne, Faculty of Veterinary and Agricultural Sciences, UVet Clinical Centre, 250 Princes Highway, Werribee, Victoria 3030, Australia.
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47
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Waema MW, Misinzo G, Kagira JM, Agola EL, Ngowi HA. DNA-Detection Based Diagnostics for Taenia solium Cysticercosis in Porcine. J Parasitol Res 2020; 2020:5706981. [PMID: 32395335 PMCID: PMC7199576 DOI: 10.1155/2020/5706981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022] Open
Abstract
Porcine cysticercosis is a neglected and underestimated disease caused by metacestode stage of the tapeworm, Taenia solium (T. solium). Pigs are the intermediate hosts of T. solium while human are the only known definitive host. The disease has an economic consequence because the affected farmers lose 50-100 percent of the value of pigs if they are infected. Lack of affordable, easy to use, sensitive, and specific molecular diagnostic tools for detection of infections at the farm level hinders the control of porcine cysticercosis in endemic areas. A number of DNA based diagnostic assays for the detection of T. solium infections in pigs have been developed and evaluated but none is applicable at low-resource areas where this disease is an endemic. This review focuses mainly on DNA based diagnostic methods, their sensitivity, specificity, and utilization at low-resource areas. We summarized data from 65 studies on the current DNA-detection based diagnostic techniques for T. solium cysticercosis in porcine, published in English between the years 2000-2018, identified through PubMed search engine. Of the different polymerase chain reaction (PCR) assays developed for identification of T. solium, the most sensitive (97-100%) and specific (100%) one is nested PCR. One study utilized loop-mediated isothermal amplification (LAMP) as a diagnostic tool for the detection of T. solium infections though its field use was never determined. Recombinase polymerase amplification (RPA) has been evaluated as a diagnostic tool for a variety of diseases, but has never been exploited for the diagnosis of cysticercosis/taeniasis. In conclusion, several molecular methods have been developed and evaluated in lab settings. However, there is need to validate these methods as a diagnostic tool to diagnose porcine cysticercosis in low-resource areas.
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Affiliation(s)
- Maxwell W. Waema
- Southern African Centre for Infectious Disease Surveillance (SACIDS), Sokoine University of Agriculture, P.O Box 3297, Chuo Kikuu, Morogoro, Tanzania
| | - Gerald Misinzo
- Southern African Centre for Infectious Disease Surveillance (SACIDS), Sokoine University of Agriculture, P.O Box 3297, Chuo Kikuu, Morogoro, Tanzania
| | - John M. Kagira
- Department of Animal Health and Production, Jomo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200, Nairobi, Kenya
| | - Eric L. Agola
- Centre of Biotechnology Research and Development, Kenya Medical Research Institute, P.O Box 3297, Nairobi, Kenya
| | - Helena A. Ngowi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O Box 3021, Chuo Kikuu, Morogoro, Tanzania
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48
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Bustos JA, Ninaquispe BE, Rodriguez S, Castillo Y, Yang SY, Gilman RH, Dorny P, Gabriël S, García HH, Gonzalez AE, For The Cysticercosis Working Group In Peru. Performance of a Sandwich Antigen-Detection ELISA for the Diagnosis of Porcine Taenia solium Cysticercosis. Am J Trop Med Hyg 2020; 100:604-608. [PMID: 30652670 DOI: 10.4269/ajtmh.18-0697] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The pig is the natural intermediate host of Taenia solium, a parasite causing significant burden of disease in both humans and pigs. Porcine cysticercosis is traditionally detected via tongue palpation and slaughterhouse meat inspection, both with limited sensitivity. Serum antibody detection has a better performance; however, it does not discriminate past from present infection. Serum antigen detection can demonstrate viable infection and gives a good estimate of parasitic load. This study evaluated a sandwich antigen-detection ELISA using monoclonal antibodies (MoAbs) 158C11 and 60H8 for the diagnosis of viable cysticercosis in pigs. Serum samples were used from 35 naturally T. solium cysticerci-infected pigs, 31 cysticercosis-negative pigs, and 22 pigs with Taenia hydatigena infection (to assess cross-reactions). Positive cysticercosis samples were subcategorized at necropsy according to parasitic burden as mild (1-10 viable cysts, n = 10), moderate (11-100 cysts, n = 5), or severe infection (more than 100 cysts, n = 20). This Ag-ELISA showed a sensitivity of 82.9% and a specificity of 96.8% when not considering cross-reactions with T. hydatigena. Hundred percentage of severely infected, 80% of moderately infected, and 50% of mildly T. solium-infected pigs tested positive. Twenty of 22 pigs with only T. hydatigena infections were positive, with 13 reaching saturating levels in the ELISA. The Ag-ELISA revealed the presence of live cysts and is, thus, a fairly reliable test to monitor experimental infection, response to treatment, and follow-up in animal models of cysticercosis. It should, however, be carefully interpreted when used in regions where T. hydatigena is endemic in pigs.
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Affiliation(s)
- Javier A Bustos
- Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | | | - Silvia Rodriguez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Yesenia Castillo
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Susan Y Yang
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pierre Dorny
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Héctor H García
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
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49
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Schmidt V, O’Hara MC, Ngowi B, Herbinger KH, Noh J, Wilkins PP, Richter V, Kositz C, Matuja W, Winkler AS. Taenia solium cysticercosis and taeniasis in urban settings: Epidemiological evidence from a health-center based study among people with epilepsy in Dar es Salaam, Tanzania. PLoS Negl Trop Dis 2019; 13:e0007751. [PMID: 31809501 PMCID: PMC6897529 DOI: 10.1371/journal.pntd.0007751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/05/2019] [Indexed: 01/11/2023] Open
Abstract
In Africa, urbanization is happening faster than ever before which results in new implications for transmission of infectious diseases. For the zoonotic parasite Taenia solium, a major cause of acquired epilepsy in endemic countries, the prevalence in urban settings is unknown. The present study investigated epidemiological, neurological, and radiological characteristics of T. solium cysticercosis and taeniasis (TSCT) in people with epilepsy (PWE) living in Dar es Salaam, Tanzania, one of the fastest growing cities worldwide. A total of 302 PWE were recruited from six health centers in the Kinondoni district of Dar es Salaam. Serological testing for T. solium cysticercosis-antigen (Ag) and -antibodies (Abs) and for T. solium taeniasis-Abs was performed in all PWE. In addition, clinical and radiological examinations that included cranial computed tomography (CT) were performed. With questionnaires, demographic data from study populations were collected, and factors associated with TSCT were assessed. Follow-up examinations were conducted in PWE with TSCT. T. solium cysticercosis-Ag was detected in three (0.99%; 95% CI: 0–2.11%), -Abs in eight (2.65%; 95% CI: 0.84–4.46%), and taeniasis-Abs in five (1.66%; 95% CI: 0.22–3.09%) of 302 PWE. Six PWE (1.99%; 95% CI: 0.41–3.56%) were diagnosed with neurocysticercosis (NCC). This study demonstrates the presence of TSCT in Dar es Salaam, however, NCC was only associated with a few cases of epilepsy. The small fraction of PWE with cysticercosis- and taeniasis-Abs may suggest that active transmission of T. solium plays only a minor role in Dar es Salaam. A sufficiently powered risk analysis was hampered by the small number of PWE with TSCT; therefore, further studies are required to determine the exact routes of infection and risk behavior of affected individuals. Taenia solium cysticercosis and taeniasis is a zoonotic disease complex which affects thousands of people in sub-Saharan Africa. This parasite has a human-pig life cycle and has been considered a public health problem mainly in rural areas. As African towns and suburbs grow rapidly and disproportionally, adequate infrastructure such as sewage systems and clean water often lack while population density, trade, and travel increase. This may lead to the appearance of parasitic diseases formerly considered `rural´ in urban settings. In this study, we searched for evidence of T. solium infections in the Kinondoni district of Dar es Salaam, Tanzania. We focused on people with epilepsy (PWE) since epilepsy is one of the most common and severe disorders associated with T. solium neurocysticercosis and tested all of them serologically for T. solium cysticercosis and taeniasis. We further investigated neurological and radiological characteristics. Our findings show that in our study area in Dar es Salaam 2.65% of PWE had contracted T. solium infection at some stage. Neurocysticercosis, as confirmed by neuroimaging, was found only in 1.99% of PWE. This, in combination with the relatively small number of PWE detected with taeniasis antibodies (1.66%), points towards the fact that active transmission of T. solium seems to play only a minor role in this urban setting, suggesting that infections may mainly be contracted in rural areas. Further large-scale studies are required to investigate the infection pathways and risk behavior related to T. solium infections within urban areas of sub-Saharan Africa.
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Affiliation(s)
- Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- * E-mail:
| | - Marie-Claire O’Hara
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Neurology, Elbe Klinikum Stade, Stade, Germany
| | - Bernard Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- College of Health and Allied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Karl-Heinz Herbinger
- Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - John Noh
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Patricia Procell Wilkins
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Vivien Richter
- Department of Neurology and Epileptology, Evangelical Hospital Alsterdorf, Hamburg, Germany
| | - Christian Kositz
- Department of Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Schwitzerland
| | - William Matuja
- Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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50
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Nhancupe N, Noormahomed EV, Afonso S, Svard S, Lindh J. Further evaluation of recombinant Tsol-p27 by enzyme-linked immunoelectrotransfer blot for the serodiagnosis of cysticercosis in pigs from Mozambique. Parasit Vectors 2019; 12:564. [PMID: 31775845 PMCID: PMC6880384 DOI: 10.1186/s13071-019-3816-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 11/20/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Porcine cysticercosis has a negative impact on human health and the meat industry, as it makes infected meat unaproprieted for consuption and it is the main etiology of epileptic seizures in developing countries. There are multiple serological assays that use crude antigens with high sensitivity and specificity for the diagnosis of both porcine and human cysticercosis. Nonetheless, antigen preparation is time-consuming, needs a well-equipped laboratory and trained personnel and places those manipulating the meat at great risk for infection. New serodiagnostic approaches to the diagnosis of porcine and human cysticercosis have been directed towards the development of recombinant deoxyribonucleic acid technology for the generation of synthetic proteins that can serve as simplified, low-cost and harmless substitutes for native antigens. The aim of the present study was to further evaluate the recombinant Tsol-p27 protein as a target molecule in immunoassays for the serodiagnosis of porcine cysticercosis. From these data, we hoped to develop recommendations regarding its use in the serodiagnosis of porcine cysticercosis. RESULTS We studied a panel of 83 naturally infected pig sera from Angónia District, Mozambique, an endemic area for porcine and human cysticercosis. These sera were previously tested by antigen enzyme-linked immunosorbent assay (Ag-ELISA) to detect antigens of T. solium. The serum panel was processed by enzyme-linked immunoelectrotransfer blot (EITB) assay against the recombinant Tsol-p27 protein and the Ag-ELISA assay results were used to compare and evaluate the performance of Tsol-p27 for the diagnosis of cysticercosis. Out of 83 sera, 24 (29.0%) were positive for Tsol-p27 and 59 (71%) were negative in the same assay. From the 37 sera that tested positive to Ag-ELISA, 11 (13.3%) were positive to Tsol-p27, while from 46 sera that tested negative to Ag-ELISA, 33 (39.7%) also tested negative to Tsol-p27. The sensitivity and specificity of Tsol-p27 was 29.7% and 71.7%, respectively, while the positive predictive value and negative predictive value were 45.8% and 55.9%, respectively, as calculated using Medcalc® version 15.0 software (MedCalc Software, Ostend, Belgium). CONCLUSION While Tsol-p27 recombinant protein might be suitable for testing human sera, its performance in pigs is not acceptable, so other recombinant proteins should be evaluated alone or multiplexed.
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Affiliation(s)
- Noemia Nhancupe
- grid.8295.6Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique ,0000 0004 1936 9457grid.8993.bDepartment of Cell and Molecular Biology, BMC, Uppsala University, Uppsala, Sweden
| | - Emilia V. Noormahomed
- grid.8295.6Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique ,0000 0001 2107 4242grid.266100.3Department of Medicine, Infectious Disease Division, University of California, San Diego, USA ,Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
| | - Sonia Afonso
- grid.8295.6Department of Clinics, Veterinary Faculty, Eduardo Mondlane University, Maputo, Mozambique
| | - Staffan Svard
- 0000 0004 1936 9457grid.8993.bDepartment of Cell and Molecular Biology, BMC, Uppsala University, Uppsala, Sweden
| | - Johan Lindh
- 0000 0004 1936 9457grid.8993.bDepartment of Cell and Molecular Biology, BMC, Uppsala University, Uppsala, Sweden
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