1
|
Singh G, Garcia HH, Del Brutto OH, Coyle C, Sander JW. Seizures and Epilepsy in Association With Neurocysticercosis: A Nosologic Proposal. Neurology 2024; 103:e209865. [PMID: 39374469 PMCID: PMC11460340 DOI: 10.1212/wnl.0000000000209865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/17/2024] [Indexed: 10/09/2024] Open
Abstract
Neurocysticercosis is one of the main risk factors of seizures and epilepsy in many regions of the world, which are Taenia solium-endemic but resource-constrained to control the parasite. The nosology of seizures and the classification of epilepsy in the context of neurocysticercosis are somewhat uncertain. Many seizures associated with the infection are customarily referred to as "acute symptomatic seizures." The term, however, seems unsuitable. Neither is the condition acute nor does it allow the avoidance of long-term antiseizure medications, as is the case with acute symptomatic seizures, for instance, associated with traumatic brain injury. We propose that seizures be classified according to the evolutionary stage of parenchymal cysticercosis in addition to the conventional classification of seizures and epilepsy and identification of the epileptogenic zone. An often-ignored aspect is the identification of comorbidities, many of which are specific to neurocysticercosis.
Collapse
Affiliation(s)
- Gagandeep Singh
- From the Department of Neurology (G.S.), Dayanand Medical College & Hospital, Ludhiana, India; Center for Global Health and School of Sciences (H.H.G.), Universidad Peruana Cayetano Heredia; Cysticercosis Unit (H.H.G.), Instituto Nacional de Ciencaia Neurologicas, Lima, Peru; School of Medicine and Research Center (O.H.D.B.), Universidad Espiritu Santo-Ecuador, Samborondón; Albert Einstein College of Medicine (C.C.), Bronx, NY; Department of Clinical & Experimental Epilepsy (J.W.S.), UCL Queen Square Institute of Neurology, London; and Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, United Kingdom
| | - Hector H Garcia
- From the Department of Neurology (G.S.), Dayanand Medical College & Hospital, Ludhiana, India; Center for Global Health and School of Sciences (H.H.G.), Universidad Peruana Cayetano Heredia; Cysticercosis Unit (H.H.G.), Instituto Nacional de Ciencaia Neurologicas, Lima, Peru; School of Medicine and Research Center (O.H.D.B.), Universidad Espiritu Santo-Ecuador, Samborondón; Albert Einstein College of Medicine (C.C.), Bronx, NY; Department of Clinical & Experimental Epilepsy (J.W.S.), UCL Queen Square Institute of Neurology, London; and Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, United Kingdom
| | - Oscar H Del Brutto
- From the Department of Neurology (G.S.), Dayanand Medical College & Hospital, Ludhiana, India; Center for Global Health and School of Sciences (H.H.G.), Universidad Peruana Cayetano Heredia; Cysticercosis Unit (H.H.G.), Instituto Nacional de Ciencaia Neurologicas, Lima, Peru; School of Medicine and Research Center (O.H.D.B.), Universidad Espiritu Santo-Ecuador, Samborondón; Albert Einstein College of Medicine (C.C.), Bronx, NY; Department of Clinical & Experimental Epilepsy (J.W.S.), UCL Queen Square Institute of Neurology, London; and Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, United Kingdom
| | - Christina Coyle
- From the Department of Neurology (G.S.), Dayanand Medical College & Hospital, Ludhiana, India; Center for Global Health and School of Sciences (H.H.G.), Universidad Peruana Cayetano Heredia; Cysticercosis Unit (H.H.G.), Instituto Nacional de Ciencaia Neurologicas, Lima, Peru; School of Medicine and Research Center (O.H.D.B.), Universidad Espiritu Santo-Ecuador, Samborondón; Albert Einstein College of Medicine (C.C.), Bronx, NY; Department of Clinical & Experimental Epilepsy (J.W.S.), UCL Queen Square Institute of Neurology, London; and Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, United Kingdom
| | - Josemir W Sander
- From the Department of Neurology (G.S.), Dayanand Medical College & Hospital, Ludhiana, India; Center for Global Health and School of Sciences (H.H.G.), Universidad Peruana Cayetano Heredia; Cysticercosis Unit (H.H.G.), Instituto Nacional de Ciencaia Neurologicas, Lima, Peru; School of Medicine and Research Center (O.H.D.B.), Universidad Espiritu Santo-Ecuador, Samborondón; Albert Einstein College of Medicine (C.C.), Bronx, NY; Department of Clinical & Experimental Epilepsy (J.W.S.), UCL Queen Square Institute of Neurology, London; and Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, United Kingdom
| |
Collapse
|
2
|
Zulu G, Stelzle D, Gabriël S, Trevisan C, Van Damme I, Mubanga C, Schmidt V, Ngowi BJ, Welte TM, Magnussen P, Ruether C, Fleury A, Dorny P, Bottieau E, Phiri IK, Mwape KE, Winkler AS. Neurocysticercosis Prevalence and Characteristics in Communities of Sinda District in Zambia: A Cross-Sectional Study. J Epidemiol Glob Health 2024; 14:1180-1190. [PMID: 38980629 PMCID: PMC11444043 DOI: 10.1007/s44197-024-00271-z] [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: 04/19/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND This study aimed at describing the epidemiology of (neuro)cysticercosis as well as its clinical and radiological characteristics in a Taenia solium endemic district of Zambia. METHODS This was part of a cross-sectional community-based study conducted in Sinda district to evaluate an antibody-detecting T. solium point-of-care (TS POC) test for taeniosis and (neuro)cysticercosis. All TS POC cysticercosis positive (CC+) participants and a subset of the TS POC cysticercosis negative (CC-) received a clinical evaluation and cerebral computed tomography (CT) examination for neurocysticercosis (NCC) diagnosis and staging. RESULTS Of the 1249 participants with a valid TS POC test result, 177 (14%) were TS POC CC+ . Cysticercosis sero-prevalence was estimated to be 20.1% (95% confidence intervals [CI] 14.6-27.0%). In total, 233 participants received a CT examination (151 TS POC CC+ , 82 TS POC CC-). Typical NCC lesions were present in 35/151 (23%) TS POC CC+ , and in 10/82 (12%) TS POC CC- participants. NCC prevalence was 13.5% (95% CI 8.4-21.1%) in the study population and 38.0% (95% CI 5.2-87.4%) among people reporting epileptic seizures. Participants with NCC were more likely to experience epileptic seizures (OR = 3.98, 95% CI 1.34-11.78, p = 0.01) than those without NCC, although only 7/45 (16%) people with NCC ever experienced epileptic seizures. The number of lesions did not differ by TS POC CC status (median: 3 [IQR 1-6] versus 2.5 [IQR 1-5.3], p = 0.64). Eight (23%) of the 35 TS POC CC+ participants with NCC had active stage lesions; in contrast none of the TS POC CC- participants was diagnosed with active NCC. CONCLUSION NCC is common in communities in the Eastern province of Zambia, but a large proportion of people remain asymptomatic.
Collapse
Affiliation(s)
- Gideon Zulu
- Ministry of Health, Lusaka, Zambia.
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
| | - Dominik Stelzle
- Department of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Centre for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Sarah Gabriël
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Chiara Trevisan
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Inge Van Damme
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Veronika Schmidt
- Department of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Centre for Global Health, School of Medicine and Health, 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
| | - Tamara M Welte
- Department of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Centre for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Neurology, Epilepsy Center, University Hospital Erlangen, Erlangen, Germany
| | - Pascal Magnussen
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ruether
- Department of Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Agnes Fleury
- Instituto de Investigaciones Biomédicas-UNAM/Instituto Nacional de Neurología y Neurocirugía/Facultad de Medicina-UNAM, Mexico City, Mexico
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Andrea S Winkler
- Department of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Centre for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Tellez-Arellano CA, Kuschick-Fehér J, Romero-Gonzalez FG, Fleury A. Neurocysticercosis: The duration of its preclinical phase relies on the parasite location. Trop Med Int Health 2024; 29:226-232. [PMID: 38200673 DOI: 10.1111/tmi.13964] [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] [Indexed: 01/12/2024]
Abstract
OBJECTIVES Neurocysticercosis (NC) is a heterogeneous disease particularly in terms of response to treatment and prognosis. Parasite localization is one of the main factors involved in this heterogeneity. In this study we aim to determine whether differences in the duration of the preclinical phase associated with parasite location, could contribute to said heterogeneity. METHODS Ninety-nine patients were included, 24 with parasites in the parenchyma (PAR), 56 in the subarachnoid (SA) space and 19 in the ventricular system (IV). A questionnaire designed to assess exposure to classic NC risk factors 5, 10, 15, 20 and more than 20 years prior to diagnosis was applied. The results were compared between the three groups. Also, asymptomatic relatives of patients who had shared their living conditions in childhood or more recently were included and underwent brain scan and blood testing for specific antibodies. RESULTS Over the course of their lives, exposure to risk factors decreased significantly for all patients, although the decrease was more evident in patients with parasites in the SA space (p < 0.001) compared to patients with PAR (p = 0.011) or IV cysts (p = 0.020). Five years prior to diagnosis, exposure to risk factors was significantly higher in patients with PAR or IV NC than in patients with SA NC (p = 0.04). Furthermore, individuals in close contact with PAR or IV patients in the years preceding diagnosis were more likely to have asymptomatic NC, specific antibodies in sera, particularly IgM, compared to individuals in close contact with SA patients during the same period. CONCLUSIONS All these findings are highly suggestive of the possibility of a more recent infection of patients affected by parenchymal and ventricular NC than of patients with subarachnoid NC. Consequently, subarachnoid disease could be considered a chronic disease, which, probably contributes to the severity of the disease as well as the minimal response to medical treatment.
Collapse
Affiliation(s)
| | - Jan Kuschick-Fehér
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- Departamento de Neurología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - Franco Gabriel Romero-Gonzalez
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- University of Bern, ISPM, Bern, Switzerland
| | - Agnès Fleury
- Clínica de neurocisticercosis, Instituto Nacional de Neurologia y Neurocirugía Manuel Velasco Suarez, Ciudad de México, Mexico
- Unidad de Neuro Inflamación, Departamento de Medicina Genómica y Toxicología ambiental, Instituto de Investigación Biomédicas, UNAM/Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN-MVS), México City, Mexico
| |
Collapse
|
4
|
Norcia LF, Zanini MA, Hamamoto Filho PT. Letter to the Editor Regarding: "Is Antihelminthics Necessary in Postoperative Treatment of Intraventricular Neurocysticercosis? A Systematic Review". World Neurosurg 2024; 182:229. [PMID: 38390886 DOI: 10.1016/j.wneu.2023.11.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Luiz Fernando Norcia
- UNESP - Department of Neurology, Psychology and Psychiatry, University, Estadual Paulista, Botucatu Medical School, Botucatu, Brazil
| | - Marco Antônio Zanini
- UNESP - Department of Neurology, Psychology and Psychiatry, University, Estadual Paulista, Botucatu Medical School, Botucatu, Brazil
| | - Pedro Tadao Hamamoto Filho
- UNESP - Department of Neurology, Psychology and Psychiatry, University, Estadual Paulista, Botucatu Medical School, Botucatu, Brazil.
| |
Collapse
|
5
|
Xiao G, Shu M. Massive neurocysticercosis in a ten-year-old girl: a case report. BMC Pediatr 2024; 24:79. [PMID: 38267910 PMCID: PMC10807077 DOI: 10.1186/s12887-024-04530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Massive neurocysticercosis is a rare form of neurocysticercosis, and can lead to serious conditions and even death. CASE PRESENTATION Here we present a case of ten-year-old Tibetan girl who developed headache and vomiting. Her brain magnetic resonance imaging (MRI) illustrated lots of intracranial cystic lesions, and no obvious extracranial lesions were found. Serum immunoglobulin G antibodies against cysticerci were positive by the use of an enzyme-linked immunosorbent assay (ELISA). These results in combination with her medical history were in line with massive neurocysticercosis. The patients recovered well after supportive management and antiparasitic treatment. CONCLUSIONS This case provides insights on the diagnosis and treatment of massive neurocysticercosis. The treatment of patients with massive neurocysticercosis should be in an individualized fashion, and the use of antiparasitic drugs in these patients must be decided after carefully weighing the risks and benefits.
Collapse
Affiliation(s)
- Guoguang Xiao
- Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan Province, P. R. China
- West China Xiamen Hospital of Sichuan University, Xiamen, 361022, China
| | - Min Shu
- Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan Province, P. R. China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China.
- West China Xiamen Hospital of Sichuan University, Xiamen, 361022, China.
| |
Collapse
|
6
|
Toledo A, Fragoso G, Carrillo-Mezo R, Romo ML, Sciutto E, Fleury A. Can sPD-1 and sPD-L1 Plasma Concentrations Predict Treatment Response among Patients with Extraparenchymal Neurocysticercosis? Pathogens 2023; 12:1116. [PMID: 37764924 PMCID: PMC10535301 DOI: 10.3390/pathogens12091116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/14/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Extraparenchymal neurocysticercosis (EP-NC) is a chronic, potentially life-threatening disease that responds poorly to initial anthelmintic drug therapy. A depressed specific reactivity of peripheral lymphocytes and an increased level of specific Tregs accompanies EP-NC. The immune checkpoint pathway PD-1 and its ligand PD-L1 downregulates effector T cells, causing specific immune suppression in chronic diseases. This study explored whether their soluble forms, sPD-1/sPD-L1, are present in plasma among patients with EP-NC and if their levels could be associated with treatment response. A total of 21 patients with vesicular EP-NC and 22 healthy controls were included. Patients received standard treatment and were followed for six months to assess treatment response by assessing changes in cyst volume determined with 3D MRI. The presence of both sPD-1 and sPD-L1 was more frequently detected among patients with EP-NC than in healthy controls and had higher concentrations. Among patients, higher pre-treatment levels of both markers were associated with a poor treatment response, and the sensitivity and specificity of the sPD-1/sPD-L1 ratio for predicting any response to treatment were high. Our results are consistent with the presence of lymphocyte exhaustion and open new research perspectives to improve the prognosis of patients with this severe disease.
Collapse
Affiliation(s)
- Andrea Toledo
- Unidad de Neuro Inflamación, Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigación Biomédicas, Universidad Nacional Autónoma de México (UNAM)/Instituto Nacional de Neurología y Neurocirugía, Ciudad de México 14269, Mexico
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico
| | - Gladis Fragoso
- Departamento de Inmunología, Instituto de Investigación Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico
| | - Roger Carrillo-Mezo
- Departamento de Neurorradiología, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México 14269, Mexico
| | - Matthew L Romo
- Department of Epidemiology & Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA
| | - Edda Sciutto
- Departamento de Inmunología, Instituto de Investigación Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico
| | - Agnès Fleury
- Unidad de Neuro Inflamación, Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigación Biomédicas, Universidad Nacional Autónoma de México (UNAM)/Instituto Nacional de Neurología y Neurocirugía, Ciudad de México 14269, Mexico
- Clínica de Neurocisticercosis, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México 14269, Mexico
| |
Collapse
|
7
|
Moreira CAA, Murayama LHV, Martins TDC, Oliveira VT, Generoso D, Machado VMDV, Batah SS, Fabro AT, Bazan R, Zanini MA, Sciutto E, Fleury A, Hamamoto Filho PT. Sexual dimorphism in the murine model of extraparenchymal neurocysticercosis. Parasitol Res 2023; 122:2147-2154. [PMID: 37428312 DOI: 10.1007/s00436-023-07913-4] [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: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
Neurocysticercosis is a heterogeneous disease, and the patient's sex seems to play a role in this heterogeneity. Hosts' sexual dimorphism in cysticercosis has been largely explored in the murine model of intraperitoneal Taenia crassiceps cysticercosis. In this study, we investigated the sexual dimorphism of inflammatory responses in a rat model of extraparenchymal neurocysticercosis caused by T. crassiceps. T. crassiceps cysticerci were inoculated in the subarachnoid space of Wistar rats (25 females, 22 males). Ninety days later, the rats were euthanized for histologic, immunohistochemistry, and cytokines studies. Ten animals also underwent a 7-T magnetic resonance imaging (MRI). Female rats presented a higher concentration of immune cells in the arachnoid-brain interface, reactive astrogliosis in the periventricular region, in situ pro-inflammatory cytokine (interleukin [IL]-6) and anti-inflammatory cytokine (IL-10), and more intense hydrocephalus on MRI than males. Intracranial hypertension signals were not observed during the observational period. Overall, these results suggest sexual dimorphism in the intracranial inflammatory response that accompanied T. crassiceps extraparenchymal neurocysticercosis.
Collapse
Affiliation(s)
- Carlos Alexandre Aguiar Moreira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Luis Henrique Vallesquino Murayama
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Tatiane de Camargo Martins
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Vinicius Tadeu Oliveira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Diego Generoso
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | | | | | | | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Marco Antônio Zanini
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Edda Sciutto
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
| | - Agnès Fleury
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
- Instituto Nacional de Neurología y Neurocirurgía, Mexico City, Mexico
| | - Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil.
| |
Collapse
|
8
|
Stelzle D, Makasi C, Welte TM, Ruether C, Schmidt V, Gabriel S, Bottieau E, Fleury A, Ngowi BJ, Winkler AS. Report of three patients with extensive neurocysticercosis in rural southern Tanzania: neurological, serological and neuroradiological findings. J Med Case Rep 2023; 17:311. [PMID: 37408061 DOI: 10.1186/s13256-023-03974-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Neurocysticercosis (NCC) is common in eastern Africa, but disease presentation varies considerably. Most patients have single or few NCC-typical lesions in their brain but some present with a large number of lesions. We present three patients with positive antibody-based serology for Taenia solium cysticercosis screened at the Vwawa district hospital, Mbozi district, southern Tanzania, in whom extensive NCC was confirmed by neuroimaging. CASE PRESENTATIONS Patient 1 was a 55-year-old female from the tribe Malila smallholder farmer who has had four generalized tonic-clonic epileptic seizures over a period of 11 years and one episode of transient left hemiparesis one year before seizure onset. The patient also reported monthly to weekly episodes of severe, progressive, unilateral headache. The computed tomography (CT) scan of the brain showed 25 NCC lesions of which 15 were in the vesicular stage. Patient 2 was a 30-year-old male from tribe Nyha mechanic who reported monthly episodes of moderate to severe, progressive, bilateral headache, but no epileptic seizures. The CT scan showed 63 NCC lesions of which 50 were in the vesicular stage. Patient 3 was a 54-year-old female from the tribe Malila smallholder farmer who suffered from frequent generalized tonic-clonic epileptic seizures with potential signs of focal seizure onset. She also reported weekly to daily episodes of severe, progressive, unilateral headache. The CT scan showed 29 NCC lesions of which 28 were in the vesicular stage. CONCLUSIONS Clinical presentation of NCC with multiple brain lesions varies considerably ranging from few epileptic seizures and severe headache to severe epilepsy with frequent epileptic seizures. Individuals with neurological signs/symptoms that may be due to NCC, based for example on epidemiological criteria or serological evidence of cysticercosis, are recommended to undergo neuroimaging before anthelminthic treatment is considered.
Collapse
Affiliation(s)
- D Stelzle
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany.
| | - C Makasi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - T M Welte
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - C Ruether
- Department of Neuroradiology, RoMed Clinic Rosenheim, Rosenheim, Germany
| | - V Schmidt
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - S Gabriel
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - E Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - A Fleury
- Departamento de Medicina Genómica y Toxicología ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Ciudad de Mexico, Mexico
| | - B J Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania
- University of Dar Es Salaam, Mbeya College of Health and Allies Sciences, Mbeya, Tanzania
| | - A S Winkler
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
9
|
Stelzle D, Abraham A, Kaminski M, Schmidt V, De Meijere R, Bustos JA, Garcia HH, Sahu PS, Bobić B, Cretu C, Chiodini P, Dermauw V, Devleesschauwer B, Dorny P, Fonseca A, Gabriël S, Morales MÁG, Laranjo-González M, Hoerauf A, Hunter E, Jambou R, Jurhar-Pavlova M, Reiter-Owona I, Sotiraki S, Trevisan C, Vilhena M, Walker NF, Zammarchi L, Winkler AS. Clinical characteristics and management of neurocysticercosis patients: a retrospective assessment of case reports from Europe. J Travel Med 2023; 30:6759132. [PMID: 36222148 DOI: 10.1093/jtm/taac102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/15/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe. METHODS We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000-2019) and extracted demographic, clinical and radiological information on each case, if available. RESULTS Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases. CONCLUSIONS Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.
Collapse
Affiliation(s)
- Dominik Stelzle
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Annette Abraham
- 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
| | - Miriam Kaminski
- Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, 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
| | - Robert De Meijere
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Javier A Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Hector Hugo Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Branko Bobić
- Centre of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Carmen Cretu
- Department of Parasitology, Carol Davila University of Medicine, Bucharest, Romania
| | - Peter Chiodini
- Hospital for Tropical Diseases, University College London Hospitals, London, UK
- Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, London, UK
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ana Fonseca
- Public Health Department, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Sarah Gabriël
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Maria Ángeles Gómez Morales
- Department of Infectious Diseases, European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Minerva Laranjo-González
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la UAB, Bellaterra (Cerdanyola del Vallès), Spain
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ewan Hunter
- Department of Infection and Tropical Medicine, The Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ronan Jambou
- Global Health Department, Institut Pasteur, Paris, France
| | - Maja Jurhar-Pavlova
- Institute for Microbiology and Parasitology, Medical faculty, University "Ss. Cyril and Methodius", Skopje, Republic of North Macedonia
| | - Ingrid Reiter-Owona
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Smaragda Sotiraki
- Veterinary Research Institute, Hellenic Agricultural Organisation DIMITRA, Thessaloniki, Greece
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Manuela Vilhena
- MED-Instituto Mediterrâneo para a Agricultura, Ambiente e Desenvolvimento, Universidade de Évora, Évora, Portugal
| | - Naomi F Walker
- Hospital for Tropical Diseases, University College London Hospitals, London, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - 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
| |
Collapse
|
10
|
Hamamoto Filho PT, Rodríguez-Rivas R, Fleury A. Neurocysticercosis: A Review into Treatment Options, Indications, and Their Efficacy. Res Rep Trop Med 2022; 13:67-79. [PMID: 36601353 PMCID: PMC9807125 DOI: 10.2147/rrtm.s375650] [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: 11/01/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022] Open
Abstract
Neurocysticercosis, due to the localization of Taenia solium larvae in the Central Nervous System, is a neglected tropical disease still endemic in much of Latin America, Asia and sub-Saharan Africa. The therapeutic management of NC has gradually improved with the establishment of neuroimaging studies (CT and MRI) in endemic countries and with the demonstration of the efficacy of albendazole and praziquantel in the 1980s. But the morbidity and mortality of this preventable disease remain an unacceptable fact. In this scoping review, we will revise the different treatment options and their indications.
Collapse
Affiliation(s)
- Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP –Universidad de Estadual Paulista, Botucatu, Brazil
| | - Roberto Rodríguez-Rivas
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México
| | - Agnès Fleury
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México,Clínica de Neurocisticercosis, Instituto Nacional de Neurología Y Neurocirugía Manuel Velasco Suarez, Ciudad de México, México,Correspondence: Agnès Fleury, Insurgentes Sur 3877 CP 14269 Barrio La Fama, Tlalpan, Ciudad de México, México, Tel +52 5556063822, Email
| |
Collapse
|
11
|
Epidemiological, clinical and radiological characteristics of people with neurocysticercosis in Tanzania-A cross-sectional study. PLoS Negl Trop Dis 2022; 16:e0010911. [PMID: 36441777 PMCID: PMC9704569 DOI: 10.1371/journal.pntd.0010911] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/26/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Neurocysticercosis (NCC) is common among people with epilepsy in low-resource settings. Prevalence of NCC and radiological characteristics of patients with NCC vary considerably even within small areas but differences have been poorly characterized so far. METHODS We conducted a cross-sectional study between August 2018 and April 2020 in three district hospitals in southern Tanzania (Ifisi, Tukuyu and Vwawa). Patients with and without epileptic seizures were included in this study. All patients were tested with a novel antibody-detecting point-of-care test for the diagnosis of Taenia solium cysticercosis. All test positives and a subset of test negatives had a further clinical work-up including medical examination and computed tomography of the brain. NCC was defined according to the Del Brutto criteria. We assessed epidemiological, clinical and radiological characteristics of patients with NCC by presence of epileptic seizures and by serology status. RESULTS In all three district hospitals, more than 30% of all people with epileptic seizures (PWE) had NCC lesions in their brain (38% in Vwawa, 32% in Tukuyu and 31% in Ifisi). Most PWE with NCC had multiple lesions and mostly parenchymal lesions (at least 85%). If patients were serologically positive, they had in the median more lesions than serologically negative patients (15 [interquartile range 8-29] versus 5 [1.8-11]), and only serologically positive patients had active stage lesions. Furthermore, serologically positive PWE had more lesions than serologically positive people without epileptic seizures (10.5 [7-23]), and more often had active lesions. PWE diagnosed with NCC (n = 53) were older, and more commonly had focal onset seizures (68% versus 44%, p = 0.03) and headache episodes (34% versus 14%, p = 0.06), which were also stronger than in PWE without NCC (p = 0.04). CONCLUSION NCC is common among PWE. A combination of clinical and serological factors could help to establish an algorithm to identify patients potentially suffering from active NCC, who benefit from further clinical investigation including neuroimaging.
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries. PLoS Negl Trop Dis 2022; 16:e0010652. [PMID: 36037251 PMCID: PMC9462807 DOI: 10.1371/journal.pntd.0010652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 09/09/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Neurocysticercosis (NC) is one of the major parasitic diseases affecting the central nervous system and is endemic in much of Asia, sub-Saharan Africa, and Latin America. Its epidemiology is difficult to assess, although official registries are available in Brazil, Colombia, Ecuador, and Mexico. Methodology/Principal findings Using official statistics, we assessed trends in NC hospitalization rates during 1998–2019 in Brazil and Ecuador, during 2004–2019 in Mexico, and during 2009–2019 in Colombia. We also assessed the trend in NC mortality in Brazil (1998–2019), the trend in hospitalizations for NC in a Mexican tertiary-level hospital (Instituto Nacional de Neurología y Neurocirugía [INNN]; 1995–2019), and in Mexican primary care ambulatory clinics (1995–2019). Associations between NC hospitalization rates and the human development index (HDI) were also examined. In Brazil, Ecuador, and Mexico, statistically significant decreases in NC hospitalization rates were observed. In Mexico, a significant increase in the age of patients at INNN was observed, suggesting a decreasing incidence of recent infection. Conversely, a significant increase in NC hospitalization rate was observed in Colombia. HDI was not significantly associated with NC hospitalization rates when adjusting for time. Conclusions The downward trends in NC cases in Brazil, Ecuador, and Mexico are encouraging, especially in the context of the PAHO/WHO plan of action to eliminate neglected tropical diseases from the region. On the other hand, in Colombia, the increased NC hospitalization rate is concerning and needs further evaluation so that the authorities can take specific measures. These results should encourage health authorities in other endemic countries to establish a system of official registries to identify where the need for a control program is most urgent. However, it is also important to remember that NC persists, although less frequently in some Latin American countries, and efforts to achieve its control must continue. The present work shows the current trends in the frequency of neurocysticercosis hospitalizations in four endemic Latin American countries. Neurocysticercosis is a parasitic disease of the central nervous system that has been historically linked to poverty and poor sanitation. It is one of the neglected tropical diseases included in the PAHO/WHO action plan for their elimination. We compiled official data available from Brazil, Colombia, Ecuador, and Mexico. Our results show a clear and significant reduction in the disease burden in 3 of the 4 countries included. On the other hand, in Colombia, an increase in incidence was observed. These mixed results are of great relevance. They allow us to be optimistic about the possibility of eliminating this disease in some countries, but also allow us to consider why the disease does not seem to be controlled in other countries and direct public health measures aimed at eliminating this parasite in the countries that need it most.
Collapse
|
14
|
Zhang D, Qi Y, Cui Y, Song W, Wang X, Liu M, Cai X, Luo X, Liu X, Sun S. Rapid Detection of Cysticercus cellulosae by an Up-Converting Phosphor Technology-Based Lateral-Flow Assay. Front Cell Infect Microbiol 2021; 11:762472. [PMID: 34858877 PMCID: PMC8631268 DOI: 10.3389/fcimb.2021.762472] [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: 08/22/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Cysticercosis is a neglected tropical disease caused by the larvae of Taenia solium in pigs and humans. The current diagnosis of porcine cysticercosis is difficult, and traditional pathological tests cannot meet the needs of detection. This study established a UPT-LF assay for the detection of Cysticercus cellulosae. UCP particles were bound to two antigens, TSOL18 and GP50; samples were captured, and the signal from the UCP particles was converted into a detectable signal for analysis using a biosensor. Compared to ELISA, UPT-LF has higher sensitivity and specificity, with a sensitivity of 93.59% and 97.44%, respectively, in the case of TSOL18 and GP50 antigens and a specificity of 100% for both. Given its rapidness, small volume, high sensitivity and specificity, and good stability and reproducibility, this method could be used in the diagnosis of cysticercosis.
Collapse
Affiliation(s)
- Dejia Zhang
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China
| | - Yu Qi
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China
| | - Yaxuan Cui
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China
| | - Weiyi Song
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China
| | - Xinrui Wang
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China
| | - Mingyuan Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis/College of Veterinary Medicine, Jilin University, Changchun, China
| | - Xuepeng Cai
- Key Laboratory of Veterinary Parasitology of Gansu Province, State Key Laboratory of Veterinary Etioloical Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricuitural Sciences, Lanzhou, China
| | - Xuenong Luo
- Key Laboratory of Veterinary Parasitology of Gansu Province, State Key Laboratory of Veterinary Etioloical Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricuitural Sciences, Lanzhou, China
| | - Xiaolei Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis/College of Veterinary Medicine, Jilin University, Changchun, China
| | - Shumin Sun
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao, China.,College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
| |
Collapse
|
15
|
Abstract
Ecuador has shown a growth in its scientific production since 2011, representing 85% of the total historical production. These investigations are reflected in scientific publications, which address world interest topics and serve as a link for the university, business, and society. This work aims to analyze the scientific production generated by Ecuador in the period of 1920–2020 using bibliometric methods to evaluate its intellectual structure and performance. The methodology applied in this study includes: (i) terms definition and search criteria; (ii) database selection, initial search, and document compilation; (iii) data extraction and software selection; and finally, (iv) analysis of results. The results show that scientific production has been consolidated in 30,205 documents, developed in 27 subject areas, in 13 languages under the contribution of 84 countries. This intellectual structure is in harmony with the global context when presenting research topics related to “Biology and regional climate change”, “Higher education and its various approaches”, “Technology and Computer Science”, “Medicine”, “Energy, food and water”, and ”Development and applications on the Web”. Topics framed in the Sustainable Development Goals (SDGs), sustainability, climate change, and others. This study contributes to the academic community, considering current re-search issues and global concerns, the collaboration between universities and countries that allow establishing future collaboration links.
Collapse
|
16
|
Ito A, Budke CM. Genetic Diversity of Taenia solium and its Relation to Clinical Presentation of Cysticercosis. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:343-349. [PMID: 34211353 PMCID: PMC8223547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
In this perspectives paper, we discuss fertilization strategies for Taenia saginata and Taenia saginata asiatica as well as heterogeneity in Taenia solium, the causative agent of human cysticercosis. Two different genotypes of T. solium (Asian and Afro/American) were confirmed by mitochondrial DNA analysis approximately two decades ago. Since then, outcrossings of the two genotypes have been identified in Madagascar where the two genotypes are distributed sympatrically. Outcrossings were confirmed by the presence of discordance between mitochondrial and nuclear DNA. Since multiple tapeworm infections are common in endemic areas, outcrossing events likely occur quite frequently. Therefore, mitochondrial DNA from T. solium specimens collected from humans and pigs in endemic areas should be analyzed. If variations are found between specimens, nuclear DNA analysis should be performed to confirm the presence of discordance between mitochondrial and nuclear genes. Additional outcrossings likely add complexity to understanding the existing genetic diversity. Serological surveys are also recommended since serodiagnostic glycoprotein can also differentiate between the two genotypes. Viable eggs from different genotypes or from hybrids of two different genotypes should be used for experimental infection of pigs or dogs in order to observe any pathological heterogeneity in cysticercosis development. Although genetic diversity of T. solium is expected to result in clinical heterogeneity of cysticercosis in humans and pigs, there is currently no evidence showing that this occurs. There are also no comparative experimental studies on this topic. Therefore, studies evaluating the link between parasite heterogeneity and clinical outcome are warranted.
Collapse
Affiliation(s)
- Akira Ito
- Department of Parasitology, Asahikawa Medical
University, Asahikawa, Japan
| | - Christine M. Budke
- Department of Veterinary Integrative Biosciences,
College of Veterinary Medicine & Biomedical Sciences, Texas A & M
University, College Station, TX, USA
| |
Collapse
|
17
|
Hamamoto Filho PT, Fragoso G, Sciutto E, Fleury A. Inflammation in neurocysticercosis: clinical relevance and impact on treatment decisions. Expert Rev Anti Infect Ther 2021; 19:1503-1518. [PMID: 33794119 DOI: 10.1080/14787210.2021.1912592] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Neurocysticercosis is caused by the localization of Taenia solium larvae in the central nervous system. The disease remains endemic in most countries of Latin America, Asia and Africa. While major improvements have been made in its diagnosis and treatment, uncertainties persist regarding the clinical implications and treatment of the inflammatory reaction associated with the disease. AREAS COVERED In this review, based on PubMed searches, the authors describe the characteristics of the immune-inflammatory response in patients with neurocysticercosis, its clinical implications and the treatment currently administered. The dual role of inflammation (participating in both, the death of the parasite, and the precipitation of serious complications) is discussed. New therapeutic strategies of potential interest are presented. EXPERT OPINION Inflammatory reaction is the main pathogenic mechanism associated to neurocysticercosis. Its management is mainly based on corticosteroids administration. This strategy had improved prognostic of patients as it allows for the control of most of the inflammatory complications. On the other side, it might be involved in the persistence of parasites in some patients, despite cysticidal treatment, due to its immunosuppressive properties. New strategies are needed to improve therapeutical management, particularly in the severest presentations.
Collapse
Affiliation(s)
- Pedro T Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, UNESP-Univ Estadual Paulista, Botucatu Medical School, Botucatu, Brazil
| | - Gladis Fragoso
- Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Edda Sciutto
- Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Agnès Fleury
- Department of Genomic Medicine and Environmental Toxicology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.,Neurocysticercosis Clinic, Instituto Nacional de Neurología Y Neurocirugía, Ciudad de México, Mexico, mexico.,Neuroinflammation Unit, Instituto de Investigaciones Biomédicas-Universidad Nacional Autónoma de México/INNN/Facultad de Medicina-UNAM, Ciudad de México, Mexico
| |
Collapse
|
18
|
Mendlovic F, Fleury A, Flisser A. Zoonotic Taenia infections with focus on cysticercosis due to Taenia solium in swine and humans. Res Vet Sci 2020; 134:69-77. [PMID: 33321377 DOI: 10.1016/j.rvsc.2020.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 01/12/2023]
Abstract
Zoonotic taeniasis caused by the adult stage of Taenia solium, Taenia saginata or Taenia asiatica are considered neglected tropical diseases by the World Health Organization. The life cycle of these 3 metazoan species is very similar and includes an intermediate host: pigs in the case of T. solium and T. asiatica, and cattle in the case of T. saginata. By eating meat (pork/T. solium, T. asiatica; beef/T. saginata) containing live cysticerci, humans develop taeniasis, which is practically asymptomatic but is the main risk factor for intermediate hosts to become infected. T. saginata causes bovine cysticercosis, while T. solium and T. asiatica cause swine cysticercosis, of veterinary and economic importance. T. solium cysticerci cause neurological disease in humans: neurocysticercosis. Cysticerci develop after ingesting microscopic eggs released from a human tapeworm carrier. Here we describe the life stages of the parasites, diagnosis, pathogenesis, symptomatology of neurocysticercosis, and prevention and control measures. Highlighting the need to validate diagnostic tools, treatments and vaccination in endemic areas, with the challenge of addressing the most vulnerable populations that lack resources. If people understand the transmission route, avoid eating uncooked or insufficiently cooked meat and have adequate hygienic habits, the life cycle of the 3 zoonotic Taenia species may be interrupted. In addition, we describe the growing field of immune response and immunomodulation elicited by the parasites, which may provide essential tools for diagnosis, treatment, control of taeniasis/cysticercosis, as well as for identification of parasite-derived immunomodulators that could aid in the treatment of emerging inflammatory diseases worldwide.
Collapse
Affiliation(s)
- Fela Mendlovic
- Facultad de Medicina, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico; Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, Estado de México, Mexico
| | - Agnes Fleury
- Instituto Nacional de Neurología y Neurocirugia "Manuel Velasco Suárez", SSA, Av. Insurgentes sur 3877, Col. La Fama, Tlalpan, Ciudad de México 14269, Mexico; Instituto de Investigaciones Biomédicas, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico
| | - Ana Flisser
- Facultad de Medicina, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico.
| |
Collapse
|