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Rasoamanamihaja CF, Rakotoarivelo RA, Edosoa G, Rasamoelina T, Montresor A, Marchese V, Fusco D. Schistosomiasis elimination in Madagascar: challenges and opportunities for implementing the new WHO guidelines. BMJ Glob Health 2023; 8:e012598. [PMID: 37580102 PMCID: PMC10432657 DOI: 10.1136/bmjgh-2023-012598] [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: 04/17/2023] [Accepted: 07/01/2023] [Indexed: 08/16/2023] Open
Abstract
Madagascar is one of the countries with the highest burden of schistosomiasis worldwide. The release from the WHO of the new 2021-2030 neglected tropical disease (NTD) roadmap alongside with the schistosomiasis guidelines sets the ambitious goal of eliminating schistosomiasis as a public health problem worldwide. In Madagascar, implementation barriers exist. This paper has the objective of identifying strengths, weaknesses, opportunities and threats in order to build on their basis practices and policies that can help the country to align with the international global health agenda and reach the ambitious goal set by the WHO.
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Affiliation(s)
| | | | - Glenn Edosoa
- World Health Organization, Antananarivo, Madagascar
| | | | | | - Valentina Marchese
- Infectious Diseases Epidemiology, Bernhard-Nocht-Institut fur Tropenmedizin, Hamburg, Germany
- German Center for Infection Research Hamburg-Lübeck-Borstel-Riems Site, Hamburg, Germany
| | - Daniela Fusco
- Infectious Diseases Epidemiology, Bernhard-Nocht-Institut fur Tropenmedizin, Hamburg, Germany
- German Center for Infection Research Hamburg-Lübeck-Borstel-Riems Site, Hamburg, Germany
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Rueda RG, Ospina RAK, Másmela LAO, López NG, Calambas AIO, Díaz LFN, Ippolito NGA, Fernández-Niño JA, Páez MCL. Knowledge and practices about taeniasis/cysticercosis complex within the framework of the national plan for its elimination in Colombia, 2019. Acta Trop 2023; 242:106907. [PMID: 36963599 DOI: 10.1016/j.actatropica.2023.106907] [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: 01/28/2022] [Revised: 06/08/2022] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination. OBJECTIVES To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia. METHODS A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n=152) (Atlantic Region) and Mercaderes, Cauca (n=152) (Andean Region). RESULTS Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities. CONCLUSION Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes.
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Affiliation(s)
| | | | | | - Natalia Gómez López
- Departamento de Historia, Facultad de Ciencias Sociales, Universidad de los Andes. Bogotá, Colombia
| | | | | | - Norman Giovanni Apráez Ippolito
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Secretaría Departamental de Salud del Cauca, Popayán, Colombia
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Talebzadeh AT, Talebzadeh N. Neurocysticercosis Infection: A Case Report. Cureus 2023; 15:e36133. [PMID: 37065366 PMCID: PMC10100599 DOI: 10.7759/cureus.36133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/15/2023] Open
Abstract
Neurocysticercosis is a condition affecting a significant number of people around the world. The etiology of this condition is a helminth parasite Taenia solium, which has a cycle eventually affecting the human host. This condition follows a cycle of human-to-human fecal-oral route and pigs as an intermediate host with transmission to humans. Infected humans can get dissemination of the larva through circulation and spread throughout the body. In this case, the neural tissue was affected. This article will review the neurocysticercosis condition, pathophysiology, mode of transmission, treatment, and complications.
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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] [MESH Headings] [Grants] [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
| | - 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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5
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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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Mubanga C, Trevisan C, Van Damme I, Schmidt V, Phiri IK, Zulu G, Noh J, Handali S, Mambo R, Chembensofu M, Masuku M, Reynders D, Jansen F, Bottieau E, Magnussen P, Winkler AS, Dorny P, Mwape KE, Gabriel S. Challenges Encountered When Evaluating an Antibody-Detecting Point-of-Care Test for Taeniosis in an Endemic Community in Zambia: A Prospective Diagnostic Accuracy Study. Diagnostics (Basel) 2021; 11:diagnostics11112039. [PMID: 34829386 PMCID: PMC8625551 DOI: 10.3390/diagnostics11112039] [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: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
Taenia solium taeniosis diagnosis is challenging because current tests perform sub-optimally and/or are expensive, require sophisticated equipment, infrastructure and trained manpower, and therefore are not community deployable. A recently-developed, multi-strip, T. solium point-of-care test (TS POC) for simultaneous detection of tapeworm (TS POC T) and cysticercus (TS POC CC) human antibodies was evaluated for diagnostic accuracy on consecutively recruited community participants in Sinda district, Zambia. All participants were tested using the TS POC test. All test-positives and 20% of the test-negative participants were invited to give a blood and stool sample for reference testing. Three different reference tests were used for taeniosis diagnosis: recombinant rES33 enzyme-linked immunoelectrotransfer blot (rES33 EITB), copro PCR and copro Ag ELISA. Bayesian analysis with probabilistic constraints was used to estimate sensitivity and specificity. In total, 1254 participants were tested with the TS POC test, of whom 13 tested positive using the TS POC T. Based on 161 participants with complete data, the estimated sensitivity and specificity for the TS POC T test were 38% (95% CI: 5–93%) and 99% (95% CI: 98–100%), respectively. The challenge of highly variable inter-assay performance is highlighted. We recommend either increasing the sensitivity or redesigning the test.
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Affiliation(s)
- Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (I.V.D.)
| | - Chiara Trevisan
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (I.V.D.)
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (F.J.); (P.D.)
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (I.V.D.)
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Isaac K. Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
- Eastern Provincial Health Office, Ministry of Health, Chipata 510023, Zambia
| | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.N.); (S.H.)
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.N.); (S.H.)
| | - Richard Mambo
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
- Eastern Provincial Health Office, Ministry of Health, Chipata 510023, Zambia
| | - Mwelwa Chembensofu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
| | - Maxwell Masuku
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
| | - Dries Reynders
- Department of Applied Mathematics, Computer Science and Statistics, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Famke Jansen
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (F.J.); (P.D.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, 81675 Munich, Germany; (V.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; (F.J.); (P.D.)
| | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia or (C.M.); (I.K.P.); (G.Z.); (R.M.); (M.C.); (M.M.); (K.E.M.)
| | - Sarah Gabriel
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (I.V.D.)
- Correspondence:
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Lightowlers MW, Gasser RB, Hemphill A, Romig T, Tamarozzi F, Deplazes P, Torgerson PR, Garcia HH, Kern P. Advances in the treatment, diagnosis, control and scientific understanding of taeniid cestode parasite infections over the past 50 years. Int J Parasitol 2021; 51:1167-1192. [PMID: 34757089 DOI: 10.1016/j.ijpara.2021.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023]
Abstract
In the past 50 years, enormous progress has been made in the diagnosis, treatment and control of taeniid cestode infections/diseases and in the scientific understanding thereof. Most interest in this group of parasites stems from the serious diseases that they cause in humans. It is through this lens that we summarize here the most important breakthroughs that have made a difference to the treatment of human diseases caused by these parasites, reduction in transmission of the taeniid species associated with human disease, or understanding of the parasites' biology likely to impact diagnosis or treatment in the foreseeable future. Key topics discussed are the introduction of anti-cestode drugs, including benzimidazoles and praziquantel, and the development of new imaging modalities that have transformed the diagnosis and post-treatment monitoring of human echinococcoses and neurocysticercosis. The availability of new anti-cestode drugs for use in dogs and a detailed understanding of the transmission dynamics of Echinococcus granulosus sensu lato have underpinned successful programs that have eliminated cystic echinococcosis in some areas of the world and greatly reduced the incidence of infection in others. Despite these successes, cystic and alveolar echinococcosis and neurocysticercosis continue to be prevalent in many parts of the world, requiring new or renewed efforts to prevent the associated taeniid infections. Major advances made in the development of practical vaccines against E. granulosus and Taenia solium will hopefully assist in this endeavour, as might the understanding of the parasites' biology that have come from an elucidation of the nuclear genomes of each of the most important taeniid species causing human diseases.
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Affiliation(s)
- Marshall W Lightowlers
- Department of Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, 250 Princes Highway, Werribee, Victoria 3030, Australia.
| | - Robin B Gasser
- Department of Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew Hemphill
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland
| | - Thomas Romig
- University of Hohenheim, Parasitology Unit, Emil-Wolff-Strasse 34, 70599 Stuttgart, Germany
| | - Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse, and Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Hector H Garcia
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Peter Kern
- Ulm University Hospital, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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Pray IW, Pizzitutti F, Bonnet G, Gonzales-Gustavson E, Wakeland W, Pan WK, Lambert WE, Gonzalez AE, Garcia HH, O’Neal SE. Validation of a spatial agent-based model for Taenia solium transmission ("CystiAgent") against a large prospective trial of control strategies in northern Peru. PLoS Negl Trop Dis 2021; 15:e0009885. [PMID: 34705827 PMCID: PMC8575314 DOI: 10.1371/journal.pntd.0009885] [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: 01/12/2021] [Revised: 11/08/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pork tapeworm (Taenia solium) is a parasitic helminth that imposes a major health and economic burden on poor rural populations around the world. As recognized by the World Health Organization, a key barrier for achieving control of T. solium is the lack of an accurate and validated simulation model with which to study transmission and evaluate available control and elimination strategies. CystiAgent is a spatially-explicit agent based model for T. solium that is unique among T. solium models in its ability to represent key spatial and environmental features of transmission and simulate spatially targeted interventions, such as ring strategy. METHODS/PRINCIPAL FINDINGS We validated CystiAgent against results from the Ring Strategy Trial (RST)-a large cluster-randomized trial conducted in northern Peru that evaluated six unique interventions for T. solium control in 23 villages. For the validation, each intervention strategy was replicated in CystiAgent, and the simulated prevalences of human taeniasis, porcine cysticercosis, and porcine seroincidence were compared against prevalence estimates from the trial. Results showed that CystiAgent produced declines in transmission in response to each of the six intervention strategies, but overestimated the effect of interventions in the majority of villages; simulated prevalences for human taenasis and porcine cysticercosis at the end of the trial were a median of 0.53 and 5.0 percentages points less than prevalence observed at the end of the trial, respectively. CONCLUSIONS/SIGNIFICANCE The validation of CystiAgent represented an important step towards developing an accurate and reliable T. solium transmission model that can be deployed to fill critical gaps in our understanding of T. solium transmission and control. To improve model accuracy, future versions would benefit from improved data on pig immunity and resistance, field effectiveness of anti-helminthic treatment, and factors driving spatial clustering of T. solium infections including dispersion and contact with T. solium eggs in the environment.
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Affiliation(s)
- Ian W. Pray
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Francesco Pizzitutti
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Gabrielle Bonnet
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Eloy Gonzales-Gustavson
- Tropical and Highlands Veterinary Research Institute, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, EL Mantaro, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Wayne Wakeland
- Systems Science Program, Portland State University, Portland, Oregon, United States of America
| | - William K. Pan
- Duke Global Health Institute & Nicholas School of Environment, Duke University, Durham, North Carolina, United States of America
| | - William E. Lambert
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
| | - Armando E. Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H. Garcia
- School of Sciences, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
| | - Seth E. O’Neal
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
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O'Neal SE, Pray IW, Vilchez P, Gamboa R, Muro C, Moyano LM, Ayvar V, Gavidia CM, Gilman RH, Gonzalez AE, Garcia HH. Geographically Targeted Interventions versus Mass Drug Administration to Control Taenia solium Cysticercosis, Peru. Emerg Infect Dis 2021; 27:2389-2398. [PMID: 34424165 PMCID: PMC8386790 DOI: 10.3201/eid2709.203349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Optimal control strategies for Taenia solium taeniasis and cysticercosis have not been determined. We conducted a 2-year cluster randomized trial in Peru by assigning 23 villages to 1 of 3 geographically targeted intervention approaches. For ring screening (RS), participants living near pigs with cysticercosis were screened for taeniasis; identified cases were treated with niclosamide. In ring treatment (RT), participants living near pigs with cysticercosis received presumptive treatment with niclosamide. In mass treatment (MT), participants received niclosamide treatment every 6 months regardless of location. In each approach, half the villages received targeted or mass oxfendazole for pigs (6 total study arms). We noted significant reductions in seroincidence among pigs in all approaches (67.1% decrease in RS, 69.3% in RT, 64.7% in MT; p<0.001), despite a smaller proportion of population treated by targeted approaches (RS 1.4%, RT 19.3%, MT 88.5%). Our findings suggest multiple approaches can achieve rapid control of T. solium transmission.
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Bustos J, Gonzales I, Saavedra H, Handali S, Garcia HH. Neurocysticercosis. A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world. J Neurol Sci 2021; 427:117527. [PMID: 34147957 PMCID: PMC8800347 DOI: 10.1016/j.jns.2021.117527] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 12/07/2022]
Abstract
Neurocysticercosis is endemic in most of the world and in endemic areas it accounts for approximately 30% of cases of epilepsy. Appropriate diagnosis and management of neurocysticercosis requires understanding the diverse presentations of the disease since these will vary in regards to clinical manifestation, sensitivity of diagnostic tests, and most importantly, therapeutic approach. This review attempts to familiarize tropical neurology practitioners with the diverse types of neurocysticercosis and the more appropriate management approaches for each.
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Affiliation(s)
- J Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - I Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - H Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - S Handali
- Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - H H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Ngwili N, Johnson N, Wahome R, Githigia S, Roesel K, Thomas L. A qualitative assessment of the context and enabling environment for the control of Taenia solium infections in endemic settings. PLoS Negl Trop Dis 2021; 15:e0009470. [PMID: 34115758 PMCID: PMC8221787 DOI: 10.1371/journal.pntd.0009470] [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: 11/02/2020] [Revised: 06/23/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Taenia solium (T. solium), is a zoonotic helminth causing three diseases namely; taeniasis (in humans), neurocysticercosis (NCC, in humans) and porcine cysticercosis (PCC, in pigs) and is one of the major foodborne diseases by burden. The success or failure of control options against this parasite in terms of reduced prevalence or incidence of the diseases may be attributed to the contextual factors which underpin the design, implementation, and evaluation of control programmes. METHODOLOGY/PRINCIPAL FINDINGS The study used a mixed method approach combining systematic literature review (SLR) and key informant interviews (KII). The SLR focused on studies which implemented T. solium control programmes and was used to identify the contextual factors and enabling environment relevant to successful inception, planning and implementation of the interventions. The SLR used a protocol pre-registered at the International prospective register of systematic reviews (PROSPERO) number CRD42019138107 and followed PRISMA guidelines on reporting of SLR. To further highlight the importance and interlinkage of these contextual factors, KII were conducted with researchers/implementers of the studies included in the SLR. The SLR identified 41 publications that had considerations of the contextual factors. They were grouped into efficacy (10), effectiveness (28) and scale up or implementation (3) research studies. The identified contextual factors included epidemiological, socioeconomic, cultural, geographical and environmental, service and organizational, historical and financial factors. The enabling environment was mainly defined by policy and strategies supporting T. solium control. CONCLUSION/SIGNIFICANCE Failure to consider the contextual factors operating in target study sites was shown to later present challenges in project implementation and evaluation that negatively affected expected outcomes. This study highlights the importance of fully considering the various domains of the context and integrating these explicitly into the plan for implementation and evaluation of control programmes. Explicit reporting of these aspects in the resultant publication is also important to guide future work. The contextual factors highlighted in this study may be useful to guide future research and scale up of disease control programmes and demonstrates the importance of close multi-sectoral collaboration in a One Health approach.
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Affiliation(s)
- Nicholas Ngwili
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Nancy Johnson
- CGIAR Research program on Agriculture for Nutrition and Health, IFPRI, Washington, DC, United States of America
| | - Raphael Wahome
- College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Samuel Githigia
- College of Agriculture and Veterinary Sciences, 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
| | - Lian Thomas
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Lea Hurst Campus, Neston, United Kingdom
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12
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Li T, Chen X, Budke CM, Zhou Y, Duan M, Wang C, Zhong B, Liu Y, Luo J, He W, Shang J, Ito A. New insights on the Taenia solium tapeworm using molecular tools: age-based human definitive host prevalence and deliberation on parasite life span. Pathog Glob Health 2021; 116:99-106. [PMID: 34029172 PMCID: PMC8933036 DOI: 10.1080/20477724.2021.1928869] [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] [Indexed: 11/30/2022] Open
Abstract
Information on age-based Taenia solium taeniasis prevalence is crucial for control of cysticercosis. T. solium taeniasis prevalence was determined for a village in Liangshan Prefecture, Sichuan Province, China that was co-endemic for T. solium, Taenia saginata asiatica, and Taenia saginata. Individuals who were Taenia egg-positive by stool microscopy and/or expelled tapeworms or proglottids post-treatment were diagnosed as having taeniasis. Infecting species was identified via multiplex PCR on tapeworm specimens or coproPCR followed by sequencing. In addition, initial stool samples from 10 children with taeniasis suspected of having spontaneous expulsion of tapeworms within the period between diagnosis and treatment were subject to species confirmation via coproPCR and sequencing. Of the 389 study subjects, 194 (49.9%) were diagnosed with taeniasis. Children (< 16 years of age) had a higher T. solium taeniasis prevalence (8.8%) than older individuals (2.5%) (P = 0.0127). Molecular analysis of initial stool samples from 7 of 10 children suspected of spontaneously passing tapeworms indicated 6 infections due to T. solium and 1 infection due to T. saginata. This study found that young children had a higher T. solium taeniasis prevalence than older individuals, providing additional support for the belief that adult T. solium likely has a relatively short lifespan compared to other Taenia species with human definitive hosts.
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Affiliation(s)
- Tiaoying Li
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Xingwang Chen
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Yuangui Zhou
- Department of Endemic Diseases, Muli County Center for Disease Control and Prevention, Muli, China
| | - Mianchuan Duan
- Department of Endemic Diseases, Muli County Center for Disease Control and Prevention, Muli, China
| | - Celine Wang
- Williamsville School District, Buffalo, NY, USA
| | - Bo Zhong
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yang Liu
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Jianying Luo
- Department of Endemic Diseases, Muli County Center for Disease Control and Prevention, Muli, China
| | - Wei He
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Jingye Shang
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Akira Ito
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan
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13
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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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14
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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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15
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Pray IW, Wakeland W, Pan W, Lambert WE, Garcia HH, Gonzalez AE, O'Neal SE. Understanding transmission and control of the pork tapeworm with CystiAgent: a spatially explicit agent-based model. Parasit Vectors 2020; 13:372. [PMID: 32709250 PMCID: PMC7379812 DOI: 10.1186/s13071-020-04226-8] [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: 01/27/2020] [Accepted: 07/14/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The pork tapeworm, Taenia solium, is a serious public health problem in rural low-resource areas of Latin America, Africa and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts. METHODS We developed a spatially-explicit agent-based model (ABM) for T. solium ("CystiAgent") that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters. RESULTS LHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of "tuning" parameters defining the probabilities of infection in humans and pigs given exposure to T. solium. CONCLUSIONS CystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium.
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Affiliation(s)
- Ian W Pray
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA.
| | - Wayne Wakeland
- Systems Science Program, Portland State University, Portland, OR, USA
| | - William Pan
- Global Health Institute, Duke University, Durham, NC, USA
| | - William E Lambert
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA
| | - Hector H Garcia
- School of Sciences, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Seth E O'Neal
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA
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16
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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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17
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Garcia HH, Gonzalez AE, Gilman RH. Taenia solium Cysticercosis and Its Impact in Neurological Disease. Clin Microbiol Rev 2020; 33:e00085-19. [PMID: 32461308 PMCID: PMC7254859 DOI: 10.1128/cmr.00085-19] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
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Affiliation(s)
- Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E Gonzalez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Haby MM, Sosa Leon LA, Luciañez A, Nicholls RS, Reveiz L, Donadeu M. Systematic review of the effectiveness of selected drugs for preventive chemotherapy for Taenia solium taeniasis. PLoS Negl Trop Dis 2020; 14:e0007873. [PMID: 31945055 PMCID: PMC6964831 DOI: 10.1371/journal.pntd.0007873] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/25/2019] [Indexed: 01/21/2023] Open
Abstract
Background Preventive chemotherapy is a useful tool for the control of Taenia solium taeniasis and cysticercosis. The aim of this systematic review is to assess the scientific evidence concerning the effectiveness and safety of different drugs in preventive chemotherapy for T. solium taeniasis in endemic populations. Methods A systematic review was conducted of controlled and uncontrolled studies, assessing the efficacy and adverse effects (among other outcomes) of albendazole, niclosamide and/or praziquantel for preventive chemotherapy of T. solium taeniasis. A comprehensive search was conducted for published and unpublished studies. Two reviewers screened articles, completed the data extraction and assessment of risk of bias. A meta-analysis of cure rate and relative reduction in prevalence was performed. The protocol for this review was registered on the International prospective register of systematic reviews (PROSPERO), number CRD42018112533. Results We identified 3555 records, of which we included 20 primary studies reported across 33 articles. Meta-analyses of drug and dose showed that a single dose of praziquantel 10mg/kg, albendazole 400mg per day for three consecutive days, or niclosamide 2g, resulted in better cure rates for T. solium taeniasis (99.5%, 96.4% and 84.3%, respectively) than praziquantel 5mg/kg or single dose albendazole 400mg (89.0% and 52.0%, respectively). These findings have a low certainty of evidence due to high risk of bias in individual studies and heterogeneity in combined estimates. In relation to side-effects, most studies reported either no or only mild and transient side-effects within the first three days following drug administration for all drugs and doses. Conclusion Evidence indicated that praziquantel 10mg/kg, niclosamide 2g, and triple dose albendazole 400mg were effective as taenicides and could be considered for use in mass drug administration programs for the control of T. solium taeniasis. Evidence was not found that any of these drugs caused severe side effects at the indicated doses, although the extent of the available evidence was limited. Taeniasis and cysticercosis caused by Taenia solium are considered, by the WHO, to be neglected tropical diseases. Preventive chemotherapy for taeniasis in endemic populations is a useful tool for control of the parasite. Preventive chemotherapy can be implemented by treating the whole population in endemic areas at regular intervals (known as mass drug administration). While different drugs, doses and regimes have been used there were still uncertainties about which drugs and dose have the best efficacy while considering adverse effects. We conducted a systematic review of the best available literature to inform a WHO guideline for preventive chemotherapy. We found that praziquantel 10mg/kg, niclosamide 2g, and triple dose albendazole 400mg (400mg per day for three consecutive days) are all effective. Proven side-effects were mild and short-lived, when they did occur.
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Affiliation(s)
- Michelle M. Haby
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Sonora, Mexico
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | | | - Ana Luciañez
- Neglected Infectious Diseases, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Ruben Santiago Nicholls
- Neglected Infectious Diseases, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Ludovic Reveiz
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Meritxell Donadeu
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Initiative for Neglected Animal Diseases (INAND), Midrand, South Africa
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Li T, Chen X, Wang H, Openshaw JJ, Zhong B, Felt SA, Ito A, Luby SP. High prevalence of taeniasis and Taenia solium cysticercosis in children in western Sichuan, China. Acta Trop 2019; 199:105133. [PMID: 31415736 DOI: 10.1016/j.actatropica.2019.105133] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 12/27/2022]
Abstract
Data in China on human Taenia infections, including Taenia solium cysticercosis, is largely lacking. We aimed to determine the prevalence of taeniasis with all three human Taenia species as well as T. solium cysticercosis in primary school-aged children in minority areas of western Sichuan, China. During April 2016 to December 2017, we did a cross-sectional study in five western Sichuan Province primary schools in Liangshan (3 schools), Ganzi (1 school) and Aba (1 school) prefectures. Diagnosis of taeniasis was made by stool microscopy for presence of Taenia eggs, as well as recovery of taeniid tapeworms or proglottids by medicinal treatment followed by species identification using multiplex PCR. Diagnosis of T. solium cysticercosis was made serologically using an ELISA with low-molecular-weight antigens purified from T. solium cyst fluid to detect specific IgG antibodies. A total of 1672 children were screened for taeniasis and 1639 were evaluated for cysticercosis antibodies. Overall prevalence of taeniasis was 7.5% but was as high as 15.6% at one school site (e.g., Shuiluo). Of the three known human Taenia species, adult T. solium tapeworms were detected in 42 children from four of the five schools (all three schools in Liangshan and one in Aba), giving a prevalence of T. solium taeniasis of 2.5% (95% confidence interval 0-6.7%). Cysticercosis antibody seropositivity by school varied from 2.3% to 15.6% (overall 7.5%). T. solium taeniasis carriers were more likely to have cysticercosis antibodies than children without T. solium taeniasis (43.6% vs 6.6%). Schools with higher prevalences of T. solium taeniasis were more likely to have children with human cysticercosis IgG antibodies. This study shows a high prevalence of taeniasis and T. solium cysticercosis in primary school-aged children in minority areas of western Sichuan, suggesting an urgent necessity for school-based disease control.
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Affiliation(s)
- Tiaoying Li
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Sichuan Province, Chengdu, Sichuan, People's Republic of China.
| | - Xingwang Chen
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Hao Wang
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - John J Openshaw
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Bo Zhong
- Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Stephen A Felt
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Akira Ito
- Department of Parasitology and Laboratory of NTDs, Asahikawa Medical University, Asahikawa, Japan
| | - Stephen P Luby
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
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KRISHNAMOORTHY P, KURLI RASHMI, PATIL SS, ROY PARIMAL, SURESH KP. Trends and future prediction of livestock diseases outbreaks by periodic regression analysis. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2019. [DOI: 10.56093/ijans.v89i4.89091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Livestock disease outbreaks become a burden to the animal husbandry farmers and cause great economic loss in India. Period regression analysis is used to find the periodic or cyclic character of livestock disease outbreaks in animals, as many other natural phenomena in environment is periodic or cyclic in nature. In present study, livestock disease outbreaks of anthrax (AX), black quarter (BQ), enterotoxaemia (ET), haemorrahgic septicemia (HS), bluetongue (BT), foot-and-mouth disease (FMD), peste des petits ruminants (PPR), sheep and goat pox (SGP), babesiosis (BA), fasciolosis (FA), theileriosis (TH) and trypanosomosis (TR) were analyzed using periodic regression to know the trend and future prediction of outbreaks. Time series data on disease outbreaks, month and year was collected from National Animal Disease Referral Expert System database for 2001–2016. The regression curves were prepared with baseline, observed outbreaks and upper bound curves for 12 livestock diseases. The analysis revealed decreasing trend for AX, BQ, ET, HS, FMD, PPR, SGP and a cyclical trend of peak occurrence for every 4–5 years was observed in BQ, PPR, SGP, FA and TR. However, TR showed increasing trend and BT, BA, FA, TH outbreaks were maintained at the same trend in the past and future also. Further, BQ in 2026, ET in 2020, HS in 2022, FMD in 2023, outbreak numbers may touch the zero point, if the preventive measures are continued for these diseases effectively. Thus, continuous and constant efforts are needed for prevention of livestock diseases outbreaks from all stakeholders, which will improve the economy of farmers in India.
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WAVHAL NILAM, PATURKAR ASHISH, VAIDYA VILAS, WAGHMARE RUPESH, ZENDE RAVINDRA, MOON SHILPA. Seroprevalence of porcine cysticercosis in Maharashtra. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2019. [DOI: 10.56093/ijans.v89i4.89090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Porcine cysticercosis is caused by Cysticercus cellulosae, a larval stage of parasite Taenia solium. Humans get infected by consuming eggs of T. solium through contamination of food and water. Owing to economic and zoonotic importance of porcine cysticercosis in India, a research plan was designed to study seroprevalence of cysticercosis in Maharashtra. Blood samples (172) were collected from different regions. The seroprevalence of cysticercosis by ELISA, FTA and western blot was 8.5%, 7.5% and 6.98%, respectively. Cohen’s kappa coefficient was used to analyse for the percentage of agreement with meat inspection test. The sensitivity and specificity between ELISA and FTA (k=0.958) showed no significant difference. The study indicates that ELISA and FTA were more sensitive than western blot. Western blot of whole cyst antigen revealed immunoreactivity at 42 to 250 kDa bands. The seroprevalence of porcine cysticercosis in Maharashtra had increased significantly. FTA is easier to perform and faster than ELISA test. This simple test appears to be suitable for practical use at field level, especially for largescale ante-mortem screening of pigs against cysticercosis.
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Braae UC, Thomas LF, Robertson LJ, Dermauw V, Dorny P, Willingham AL, Saratsis A, Devleesschauwer B. Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in the Americas. Parasit Vectors 2018; 11:518. [PMID: 30236143 PMCID: PMC6149206 DOI: 10.1186/s13071-018-3079-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/27/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The distribution of Taenia saginata in the Americas is unclear. Establishing the distribution, economic burden, and potentials for control of bovine cysticercosis is increasingly important due to the growing demand for beef. This paper aims to take the first step and reviews the recent distribution of T. saginata taeniosis and bovine cysticercosis on a national level within the Americas. METHODS We undertook a systematic review of published and grey literature for information on the occurrence, prevalence, and geographical distribution of bovine cysticercosis and human taeniosis in the 54 countries and territories of the Americas between January 1st, 1990 and December 31st, 2017. Data on bovine cysticercosis from OIE reports from 1994 to 2005 were also included. RESULTS We identified 66 papers from the Americas with data on the occurrence of taeniosis or bovine cysticercosis and an additional 19 OIE country reports on bovine cysticercosis. Taeniosis was reported from 13 countries, with nine of these countries reporting specifically T. saginata taeniosis, and four countries reporting non-species specific taeniosis. The reported prevalence of taeniosis ranged between 0.04-8.8%. Bovine cysticercosis was reported from 19 countries, nine identified through the literature search, and an additional 10 identified through the OIE country reports for notifiable diseases. The reported prevalence of bovine cysticercosis ranged between 0.1-19%. Disease occurrence was restricted to 21 countries within the Americas, the majority from the mainland, with the only island nations reporting either bovine cysticercosis or taeniosis being Cuba, Haiti, and the US Virgin Islands. CONCLUSIONS Taenia saginata is widely distributed across 21 of the 54 countries in the Americas, but insufficient epidemiological data are available to estimate the subnational spatial distribution, prevalence, incidence and intensity of infections. This needs to be addressed through active surveillance and disease detection programmes. Such programmes would improve the data quantity and quality, and may enable estimation of the economic burden due to bovine cysticercosis in the region in turn determining the requirement for and cost-effectiveness of control measures.
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Affiliation(s)
- Uffe Christian Braae
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, Saint Kitts and Nevis
| | - Lian F. Thomas
- International Livestock Research Institute (ILRI), P.O. Box 30709, Nairobi, Kenya
- Institute for Infection & Global Health, University of Liverpool, Neston, UK
| | - Lucy J. Robertson
- Parasitology, Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, Oslo, Norway
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, Saint Kitts and Nevis
| | - Anastasios Saratsis
- Veterinary Research Institute, Hellenic Agricultural Organization Demeter, 57001 Thermi, Greece
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Melki J, Koffi E, Boka M, Touré A, Soumahoro MK, Jambou R. Taenia solium cysticercosis in West Africa: status update. ACTA ACUST UNITED AC 2018; 25:49. [PMID: 30230445 PMCID: PMC6144651 DOI: 10.1051/parasite/2018048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/06/2018] [Indexed: 11/22/2022]
Abstract
Cysticercosis is caused by the larvae of the cestode Taenia solium. Few data are available on the prevalence of this disease in pigs and humans in West African countries. The aim of this study was to provide an overview of existing data concerning the spread of this parasitosis in the countries of the Economic Community of West African States (ECOWAS) on the basis of the literature published over the last five decades. Systematic searches for publications were carried out on PubMed and Google Scholar, as well as in certain regional and local journals. From a total of 501 articles initially retrieved concerning T. solium cysticercosis in West African countries, only 120 articles were relevant for this review and therefore finally retained. For pigs, only eight out of sixteen countries of the region have reported porcine cysticercosis. Post-mortem examination of carcasses at slaughterhouses, meat inspection at butcheries or tongue inspection in herds have been the main source of data, but may not entirely reflect actual parasite distribution. For humans, only five out of sixteen countries reported epidemiological data on neurocysticercosis. Most data referred to neurocysticercosis prevalence among epileptic patients or isolated clinical cases. Furthermore, existing data are often old. Overall, T. solium cysticercosis remains largely neglected in West Africa, and its prevalence appears not to be affected by any religion in particular. There is an urgent need to promote and implement health partnerships and programs on this disease in order to collect more data and identify sensitive populations in the countries of the ECOWAS area.
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Affiliation(s)
- Jihen Melki
- Institut Pasteur de Côte d'Ivoire, B.P. 490, Abidjan 01, Côte d'Ivoire
| | - Eugène Koffi
- Institut Pasteur de Côte d'Ivoire, B.P. 490, Abidjan 01, Côte d'Ivoire
| | - Marcel Boka
- Direction des Services Vétérinaires, Ministère des Ressources Animales et Halieutiques, B.P. V84, Abidjan 01, Côte d'Ivoire - Université Alassane Ouattara, Ministère de l'Enseignement Supérieur et de la Recherche Scientifique, B.P. V18, Bouaké 01, Côte d'Ivoire
| | - André Touré
- Institut Pasteur de Côte d'Ivoire, B.P. 490, Abidjan 01, Côte d'Ivoire
| | | | - Ronan Jambou
- Institut Pasteur de Côte d'Ivoire, B.P. 490, Abidjan 01, Côte d'Ivoire - Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
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Beam M, Spencer A, Fernandez L, Atto R, Muro C, Vilchez P, Gamboa R, Olaya S, Ayvar V, Gonzalez AE, Garcia HH, O'Neal SE, For The Cysticercosis Working Group In Peru. Barriers to Participation in a Community-Based Program to Control Transmission of Taenia solium in Peru. Am J Trop Med Hyg 2018; 98:1748-1754. [PMID: 29663901 DOI: 10.4269/ajtmh.17-0929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Infection of the brain with Taenia solium larvae (neurocysticercosis) is a leading cause of preventable epilepsy worldwide. Effective and sustainable strategies to control parasite transmission in rural endemic communities are needed to prevent the disease. Surveillance and targeted intervention around infected pigs (ring control strategy) have been shown to be effective when carried out by research teams. However, this strategy has not been implemented or tested as a community-based program. In this small trial in northern Peru, eight villages were randomly assigned to community-led surveillance and treatment (five villages, 997 residents) or control (three villages, 1,192 residents). In intervention villages, community-led surveillance and reporting were promoted by community health workers, radio advertisement, and school and household education. Each suspected pig infection was verified, with confirmed cases resulting in treatment with niclosamide for taeniasis and oxfendazole for pigs in clusters of homes nearby. No incentives beyond human and pig treatment were offered. Control villages received basic disease education but no treatment intervention in response to reports. Despite 14 case reports, community-based replication of ring control strategy did not replicate prior results. After 12 months, there was no change in seroincidence in intervention villages between the baseline and study end, and no difference compared with control villages. There was no difference in prevalence of taeniasis or porcine cysticercosis at study end. Community members described lack of knowledge as the main reason for not reporting infected pigs. Further exploration of methods to transfer ring strategy and other control interventions for cysticercosis to the community is needed.
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Affiliation(s)
- Michelle Beam
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Angela Spencer
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Lauralee Fernandez
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Ruth Atto
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudio Muro
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Gamboa
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sandra Olaya
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Viterbo Ayvar
- 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
| | - Hector H Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E O'Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
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Hobbs EC, Mwape KE, Van Damme I, Berkvens D, Zulu G, Mambwe M, Chembensofu M, Phiri IK, Masuku M, Bottieau E, Devleesschauwer B, Speybroeck N, Colston A, Dorny P, Willingham AL, Gabriël S. Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia. Trop Med Int Health 2018; 23:306-314. [PMID: 29314480 PMCID: PMC5888122 DOI: 10.1111/tmi.13029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. METHODS Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. RESULTS In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. CONCLUSION Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa.
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Affiliation(s)
- Emma C. Hobbs
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineBasseterreSt Kitts, West Indies
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Inge Van Damme
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Gideon Zulu
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | - Moses Mambwe
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | | | - Maxwell Masuku
- School of Veterinary MedicineUniversity of ZambiaLusakaZambia
| | | | | | - Niko Speybroeck
- Institute of Health and SocietyUniversité Catholique de LouvainBrusselsBelgium
| | - Angela Colston
- Global Alliance for Livestock Veterinary Medicines (GALVmed)NairobiKenya
| | - 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 MedicineBasseterreSt Kitts, West Indies
| | - Sarah Gabriël
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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Okello AL, Thomas LF. Human taeniasis: current insights into prevention and management strategies in endemic countries. Risk Manag Healthc Policy 2017; 10:107-116. [PMID: 28615981 PMCID: PMC5461055 DOI: 10.2147/rmhp.s116545] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Human taeniasis is a zoonotic condition resulting from infection with the adult stages of Taenia saginata ("beef tapeworm"), Taenia solium ("pork tapeworm") or Taenia asiatica ("Asian tapeworm"). Although these parasites have a worldwide distribution, the overwhelming burden is felt by communities in low- and middle-income countries. This is particularly true for T. solium, whereby infection of the central nervous system with the larval stage of the parasite (neurocysticercosis) is a major cause of acquired epilepsy in low-resource settings. With a focus on endemic countries, this review provides an insight into the prevention and management of human taeniasis, concluding with some recent case studies describing their implementation. Discussion of the opportunities and challenges regarding current fecal and serological diagnostic assays for detecting Taenia spp. highlights the importance of accurate and accessible diagnostic options for the field situation. The lack of long-term impact on the parasites' lifecycle from human anthelmintic treatment, coupled with the propensity for adverse reactions, highlights the importance of a "two-pronged" approach that considers the relevant animal hosts, particularly in the case of T. solium. Aside from the therapeutic options, this review reiterates the importance of adequate assessment and consideration of the associated behavioral and policy aspects around sanitation, hygiene and meat inspection that have been shown to support parasite control, and potential elimination, in endemic regions.
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Affiliation(s)
- Anna L Okello
- Division of Infection and Pathway Medicine, Edinburgh Medical School, Biomedical Sciences College of Medicine and Veterinary Medicine, University of Edinburgh, Scotland
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Winskill P, Harrison WE, French MD, Dixon MA, Abela-Ridder B, Basáñez MG. Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model. Parasit Vectors 2017; 10:73. [PMID: 28183336 PMCID: PMC5301381 DOI: 10.1186/s13071-017-1988-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pork tapeworm, Taenia solium, and associated human infections, taeniasis, cysticercosis and neurocysticercosis, are serious public health problems, especially in developing countries. The World Health Organization (WHO) has set goals for having a validated strategy for control and elimination of T. solium taeniasis/cysticercosis by 2015 and interventions scaled-up in selected countries by 2020. Timely achievement of these internationally-endorsed targets requires that the relative benefits and effectiveness of potential interventions be explored rigorously within a quantitative framework. METHODS A deterministic, compartmental transmission model (EPICYST) was developed to capture the dynamics of the taeniasis/cysticercosis disease system in the human and pig hosts. Cysticercosis prevalence in humans, an outcome of high epidemiological and clinical importance, was explicitly modelled. A next generation matrix approach was used to derive an expression for the basic reproduction number, R 0. A full sensitivity analysis was performed using a methodology based on Latin-hypercube sampling partial rank correlation coefficient index. RESULTS EPICYST outputs indicate that chemotherapeutic intervention targeted at humans or pigs would be highly effective at reducing taeniasis and cysticercosis prevalence when applied singly, with annual chemotherapy of humans and pigs resulting, respectively, in 94 and 74% of human cysticercosis cases averted. Improved sanitation, meat inspection and animal husbandry are less effective but are still able to reduce prevalence singly or in combination. The value of R 0 for taeniasis was estimated at 1.4 (95% Credible Interval: 0.5-3.6). CONCLUSIONS Human- and pig-targeted drug-focussed interventions appear to be the most efficacious approach from the options currently available. The model presented is a forward step towards developing an informed control and elimination strategy for cysticercosis. Together with its validation against field data, EPICYST will be a valuable tool to help reach the WHO goals and to conduct economic evaluations of interventions in varying epidemiological settings.
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Affiliation(s)
- Peter Winskill
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
| | - Wendy E. Harrison
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
| | - Michael D. French
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- Current address: Research Triangle Institute, 701 13st Street NW, Washington D.C., 20005 USA
| | - Matthew A. Dixon
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
| | - Bernadette Abela-Ridder
- Neglected Zoonotic Diseases Team, Department of Neglected Tropical Diseases (NTD), World Health Organization (WHO), 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - María-Gloria Basáñez
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, London, W2 1PG UK
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Madinga J, Kanobana K, Lukanu P, Abatih E, Baloji S, Linsuke S, Praet N, Kapinga S, Polman K, Lutumba P, Speybroeck N, Dorny P, Harrison W, Gabriel S. Geospatial and age-related patterns of Taenia solium taeniasis in the rural health zone of Kimpese, Democratic Republic of Congo. Acta Trop 2017; 165:100-109. [PMID: 26996821 PMCID: PMC5178865 DOI: 10.1016/j.actatropica.2016.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 02/19/2016] [Accepted: 03/14/2016] [Indexed: 11/27/2022]
Abstract
We assessed patterns of taeniasis in 24 village communities of Kimpese health zone. Prevalence of taeniasis was very high and varied between households and villages. Children of five to ten years were the most infected age group. Taeniasis was not spatially correlated with porcine cysticercosis.
Background Taenia solium infections are mostly endemic in less developed countries where poor hygiene conditions and free-range pig management favor their transmission. Knowledge on patterns of infections in both human and pig is crucial to design effective control strategies. The aim of this study was to assess the prevalence, risk factors and spatial distribution of taeniasis in a rural area of the Democratic Republic of Congo (DRC), in the prospect of upcoming control activities. Methods A cross-sectional study was conducted in 24 villages of the health zone of Kimpese, Bas Congo Province. Individual and household characteristics, including geographical coordinates were recorded. Stool samples were collected from willing participants and analyzed using the copro-antigen enzyme-linked immunosorbent assay (copro-Ag ELISA) for the detection of taeniasis. Blood samples were collected from pigs and analyzed using the B158/B60 monoclonal antibody-based antigen ELISA (sero-Ag ELISA) to detect porcine cysticercosis. Logistic regression and multilevel analysis were applied to identify risk factors. Global clustering and spatial correlation of taeniasis and porcine cysticercosis were assessed using K functions. Local clusters of both infections were identified using the Kulldorff’s scan statistic. Results A total of 4751 participants above 5 years of age (median: 23 years; IQR: 11–41) were included. The overall proportion of taeniasis positivity was 23.4% (95% CI: 22.2–24.6), ranging from 1 to 60% between villages, with a significant between-household variance of 2.43 (SE = 0.29, p < 0.05). Taeniasis was significantly associated with age (p < 0.05) and the highest positivity was found in the 5–10 years age group (27.0% (95% CI: 24.4–29.7)). Overall, 45.6% (95% CI: 40.2–51) of sampled pigs were sero-positive. The K functions revealed a significant overall clustering of human and pig infections but no spatial dependence between them. Two significant clusters of taeniasis (p<0.001; n = 276 and n = 9) and one cluster of porcine cysticercosis (p<0.001; n = 24) were found. Conclusion This study confirms high endemicity and geographical dispersal of taeniasis in the study area. The role of age in taeniasis patterns and significant spatial clusters of both taeniasis and porcine cysticercosis were evidenced, though no spatial correlation was found between human and pig infections. Urgent control activities are needed for this endemic area.
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Braae UC, Magnussen P, Ndawi B, Harrison W, Lekule F, Johansen MV. Effect of repeated mass drug administration with praziquantel and track and treat of taeniosis cases on the prevalence of taeniosis in Taenia solium endemic rural communities of Tanzania. Acta Trop 2017; 165:246-251. [PMID: 26597324 DOI: 10.1016/j.actatropica.2015.10.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/09/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022]
Abstract
This study evaluated the effect of mass drug administration (MDA) with praziquantel administered to school-aged children (SAC) combined with 'track and treat' of taeniosis cases in the general population on the copro-antigen (Ag) prevalence of taeniosis. The study was conducted in 14 villages in Mbozi and Mbeya district, Tanzania. SAC made up 34% of the population and received MDA with praziquantel (40mg/kg) in 2012 (both districts) and in 2013 (Mbozi only). Three cross-sectional population-based surveys were performed in 2012 (R0), 2013 (R1), and 2014 (R2). In each survey approximately 3000 study subjects of all ages were tested for taeniosis using copro-Ag-ELISA. In total 9064 people were tested and copro-Ag-ELISA positive cases were offered treatment 6-8 months after sampling. The copro-Ag prevalence of taeniosis was significantly higher (Χ2-test, p=0.007) in Mbozi (3.0%) at R0 compared to Mbeya (1.5%). Twelve months after MDA in both districts (R1), the copro-Ag prevalence had dropped significantly in both Mbozi (2.0%, p=0.024) and in Mbeya (0.3%, p=0.004), but the significant difference between the districts persisted (Χ2-test, p<0.001). Ten months after the second round of MDA in Mbozi and 22 month after the first MDA (R2), the copro-Ag prevalence had dropped significantly again in Mbozi (0.8%, p<0.001), but had slightly increased in Mbeya (0.5%, p=0.051), with no difference between the two districts (Χ2-test, p=0.51). The taeniosis cases tracked and treated between round R0 and R2 represented 9% of the projected total number of taeniosis cases within the study area, based on the copro-Ag prevalence and village population data. Among SAC in Mbozi, infection significantly decreased at R1 (p=0.004, OR 0.12, CI: 0.02-0.41) and R2 (p=0.001, OR 0.24, CI: 0.09-0.53) when comparing to R0. In Mbeya infection significant decreased at R1 (p=0.013, OR 0.14, CI: 0.02-0.55), but no difference was found for R2 (p=0. 089), when comparing to R0 among SAC. This study showed that school-based MDA with praziquantel in combination with 'track and treat' of taeniosis cases significantly reduced the copro-Ag prevalence of taeniosis, and that annual MDA was significantly better than single MDA. The persistence of taeniosis cases illustrates that a One Health approach must be emphasized for effective control.
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Gabriël S, Dorny P, Mwape KE, Trevisan C, Braae UC, Magnussen P, Thys S, Bulaya C, Phiri IK, Sikasunge CS, Makungu C, Afonso S, Nicolau Q, Johansen MV. Control of Taenia solium taeniasis/cysticercosis: The best way forward for sub-Saharan Africa? Acta Trop 2017; 165:252-260. [PMID: 27140860 DOI: 10.1016/j.actatropica.2016.04.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 04/22/2016] [Accepted: 04/23/2016] [Indexed: 11/15/2022]
Abstract
Taenia solium taeniasis/cysticercosis is a neglected parasitic zoonosis with significant economic and public health impacts. Control measures can be broadly grouped into community health education, improvements in hygiene and sanitary conditions, proper meat handling at household and community level, improved standards of meat inspection, pig management, treatment of individual patients and possibly human populations, and treatment and/or vaccination of porcine populations. This manuscript looks critically into currently existing control options and provides suggestions on which (combination of) tools would be most effective in the control of T. solium taeniasis/cysticercosis in sub-Saharan Africa. Field data and disease transmission simulations suggest that implementation of a single intervention control strategy will not lead to a satisfactory reduction of disease morbidity or transmission. A feasible strategy to combat T. solium taeniasis/cysticercosis would include a combination of approaches focussing on both human (health education and treatment) and animal host (management, treatment and vaccination), which can vary for different communities and different geographical locations. Selection of the specific strategy depends on cost-effectiveness analyses based on solid field data, currently unavailable, though urgently needed; as well as on health priorities and resources of the country. A One Health approach involving medical, veterinary, environmental and social sectors is essential for T. solium to be controlled and eventually eliminated. Finally the success of any intervention is largely dependent on the level of societal and political acceptance, commitment and engagement.
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Affiliation(s)
- S Gabriël
- Institute of Tropical Medicine, Antwerp, Belgium.
| | - P Dorny
- Institute of Tropical Medicine, Antwerp, Belgium; Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K E Mwape
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C Trevisan
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - U C Braae
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - P Magnussen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - S Thys
- Institute of Tropical Medicine, Antwerp, Belgium
| | - C Bulaya
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - I K Phiri
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C S Sikasunge
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C Makungu
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - S Afonso
- Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Q Nicolau
- Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - M V Johansen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Braae UC, Devleesschauwer B, Gabriël S, Dorny P, Speybroeck N, Magnussen P, Torgerson P, Johansen MV. CystiSim - An Agent-Based Model for Taenia solium Transmission and Control. PLoS Negl Trop Dis 2016; 10:e0005184. [PMID: 27984581 PMCID: PMC5161321 DOI: 10.1371/journal.pntd.0005184] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/14/2016] [Indexed: 11/19/2022] Open
Abstract
Taenia solium taeniosis/cysticercosis was declared eradicable by the International Task Force for Disease Eradication in 1993, but remains a neglected zoonosis. To assist in the attempt to regionally eliminate this parasite, we developed cystiSim, an agent-based model for T. solium transmission and control. The model was developed in R and available as an R package (http://cran.r-project.org/package=cystiSim). cystiSim was adapted to an observed setting using field data from Tanzania, but adaptable to other settings if necessary. The model description adheres to the Overview, Design concepts, and Details (ODD) protocol and consists of two entities—pigs and humans. Pigs acquire cysticercosis through the environment or by direct contact with a tapeworm carrier's faeces. Humans acquire taeniosis from slaughtered pigs proportional to their infection intensity. The model allows for evaluation of three interventions measures or combinations hereof: treatment of humans, treatment of pigs, and pig vaccination, and allows for customary coverage and efficacy settings. cystiSim is the first agent-based transmission model for T. solium and suggests that control using a strategy consisting of an intervention only targeting the porcine host is possible, but that coverage and efficacy must be high if elimination is the ultimate goal. Good coverage of the intervention is important, but can be compensated for by including an additional intervention targeting the human host. cystiSim shows that the scenarios combining interventions in both hosts, mass drug administration to humans, and vaccination and treatment of pigs, have a high probability of success if coverage of 75% can be maintained over at least a four year period. In comparison with an existing mathematical model for T. solium transmission, cystiSim also includes parasite maturation, host immunity, and environmental contamination. Adding these biological parameters to the model resulted in new insights in the potential effect of intervention measures. Taenia solium is the leading cause of preventable epilepsy and the highest ranking foodborne parasite in terms of disease burden worldwide. Currently there are no large scale control programmes implemented against T. solium, but efficacious intervention tools are there, making control programmes the next step forward. Because of the zoonotic properties of the parasite, existing in both humans and pigs, a combination of intervention tools is likely to be needed. cystiSim is an agent-based disease model that provides insight into which intervention tools, and the frequency of administration of these tools, are needed to yield an effect on disease prevalence. cystiSim is a valuable tool in designing future control programmes and will assist in the elimination of T. solium as a public health problem.
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Affiliation(s)
- Uffe Christian Braae
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
- * E-mail:
| | - Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Sarah Gabriël
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Pascal Magnussen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
- Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Paul Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Maria Vang Johansen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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Braae UC, Magnussen P, Harrison W, Ndawi B, Lekule F, Johansen MV. Effect of National Schistosomiasis Control Programme on Taenia solium taeniosis and porcine cysticercosis in rural communities of Tanzania. Parasite Epidemiol Control 2016; 1:245-251. [PMID: 27695711 PMCID: PMC5034013 DOI: 10.1016/j.parepi.2016.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/26/2016] [Accepted: 08/26/2016] [Indexed: 12/03/2022] Open
Abstract
Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA) of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. “Track-and-treat” of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤ 15) from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8%) was significantly lower (p = 0.031, OR 0.40, CI: 0.17–0.89), compared to baseline (4.1%). The prevalence of porcine cysticercosis (8%) had also dropped significantly (p = 0.002, OR 0.49, CI: 0.32–0.76) in this district compared to baseline (13%), whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with ‘track-and-treat’ contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on adults in treated areas as well as reducing the prevalence of T. solium in the intermediate pig host population. Elimination of T. solium in this area would require a One Health approach.
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Affiliation(s)
- Uffe Christian Braae
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-1870 Frederiksberg, Denmark
| | - Pascal Magnussen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-1870 Frederiksberg, Denmark; Centre for Medical Parasitology, Faculty of Health of Medical Sciences, University of Copenhagen, DK-1353 Copenhagen, Denmark
| | - Wendy Harrison
- Faculty of Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Benedict Ndawi
- Bora Professional Consultancy Services, Iringa, Tanzania
| | - Faustin Lekule
- Faculty of Agriculture, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Maria Vang Johansen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-1870 Frederiksberg, Denmark
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Garcia HH, Gonzalez AE, Tsang VCW, O'Neal SE, Llanos-Zavalaga F, Gonzalvez G, Romero J, Rodriguez S, Moyano LM, Ayvar V, Diaz A, Hightower A, Craig PS, Lightowlers MW, Gauci CG, Leontsini E, Gilman RH. Elimination of Taenia solium Transmission in Northern Peru. N Engl J Med 2016; 374:2335-44. [PMID: 27305193 PMCID: PMC4962610 DOI: 10.1056/nejmoa1515520] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Taeniasis and cysticercosis are major causes of seizures and epilepsy. Infection by the causative parasite Taenia solium requires transmission between humans and pigs. The disease is considered to be eradicable, but data on attempts at regional elimination are lacking. We conducted a three-phase control program in Tumbes, Peru, to determine whether regional elimination would be feasible. METHODS We systematically tested and compared elimination strategies to show the feasibility of interrupting the transmission of T. solium infection in a region of highly endemic disease in Peru. In phase 1, we assessed the effectiveness and feasibility of six intervention strategies that involved screening of humans and pigs, antiparasitic treatment, prevention education, and pig replacement in 42 villages. In phase 2, we compared mass treatment with mass screening (each either with or without vaccination of pigs) in 17 villages. In phase 3, we implemented the final strategy of mass treatment of humans along with the mass treatment and vaccination of pigs in the entire rural region of Tumbes (107 villages comprising 81,170 people and 55,638 pigs). The effect of the intervention was measured after phases 2 and 3 with the use of detailed necropsy to detect pigs with live, nondegenerated cysts capable of causing new infection. The necropsy sampling was weighted in that we preferentially included more samples from seropositive pigs than from seronegative pigs. RESULTS Only two of the strategies implemented in phase 1 resulted in limited control over the transmission of T. solium infection, which highlighted the need to intensify the subsequent strategies. After the strategies in phase 2 were implemented, no cyst that was capable of further transmission of T. solium infection was found among 658 sampled pigs. One year later, without further intervention, 7 of 310 sampled pigs had live, nondegenerated cysts, but no infected pig was found in 11 of 17 villages, including all the villages in which mass antiparasitic treatment plus vaccination was implemented. After the final strategy was implemented in phase 3, a total of 3 of 342 pigs had live, nondegenerated cysts, but no infected pig was found in 105 of 107 villages. CONCLUSIONS We showed that the transmission of T. solium infection was interrupted on a regional scale in a highly endemic region in Peru. (Funded by the Bill and Melinda Gates Foundation and others.).
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Affiliation(s)
- Hector H Garcia
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Armando E Gonzalez
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Victor C W Tsang
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Seth E O'Neal
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Fernando Llanos-Zavalaga
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Guillermo Gonzalvez
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Jaime Romero
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Silvia Rodriguez
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Luz M Moyano
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Viterbo Ayvar
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Andre Diaz
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Allen Hightower
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Philip S Craig
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Marshall W Lightowlers
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Charles G Gauci
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Elli Leontsini
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
| | - Robert H Gilman
- From the Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia (H.H.G., S.E.O., L.M.M., V.A., A.D.), the Department of Microbiology (H.H.G.) and School of Public Health (F.L.-Z.), Universidad Peruana Cayetano Heredia, Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas (H.H.G., S.R.), Universidad Nacional Mayor de San Marcos, School of Veterinary Medicine (A.E.G.), and Inter-American Institute for Cooperation on Agriculture (J.R.) - all in Lima, Peru; Immunology Branch, Division of Parasitic Diseases and Malaria, National Center for Infectious Diseases (V.C.W.T.), and Data Management Activity, Division of Parasitic Diseases and Malaria, Center for Global Health (A.H.), Centers for Disease Control and Prevention, and Georgia State University (V.C.W.T.) - both in Atlanta; School of Public Health, Oregon Health and Science University and Portland State University, Portland (S.E.O.); Pan American Health Organization, Managua, Nicaragua (G.G.); University of Salford, School of Environment and Life Sciences, Greater Manchester, United Kingdom (P.S.C.); University of Melbourne, Faculty of Veterinary and Agricultural Sciences, Werribee, VIC, Australia (M.W.L., C.G.G.); and the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (E.L., R.H.G.)
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Pray IW, Swanson DJ, Ayvar V, Muro C, Moyano LM, Gonzalez AE, Garcia HH, O’Neal SE. GPS Tracking of Free-Ranging Pigs to Evaluate Ring Strategies for the Control of Cysticercosis/Taeniasis in Peru. PLoS Negl Trop Dis 2016; 10:e0004591. [PMID: 27035825 PMCID: PMC4818035 DOI: 10.1371/journal.pntd.0004591] [Citation(s) in RCA: 16] [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: 10/06/2015] [Accepted: 03/08/2016] [Indexed: 11/18/2022] Open
Abstract
Background Taenia solium, a parasitic cestode that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. T. solium eggs are released into the environment through the stool of humans infected with an adult intestinal tapeworm (a condition called taeniasis), and cause cysticercosis when ingested by pigs or other humans. A control strategy to intervene within high-risk foci in endemic communities has been proposed as an alternative to mass antihelminthic treatment. In this ring strategy, antihelminthic treatment is targeted to humans and pigs residing within a 100 meter radius of a pig heavily-infected with cysticercosis. Our aim was to describe the roaming ranges of pigs in this region, and to evaluate whether the 100 meter radius rings encompass areas where risk factors for T. solium transmission, such as open human defecation and dense pig activity, are concentrated. Methodology/Principal Findings In this study, we used Global Positioning System (GPS) devices to track pig roaming ranges in two rural villages of northern Peru. We selected 41 pigs from two villages to participate in a 48-hour tracking period. Additionally, we surveyed all households to record the locations of open human defecation areas. We found that pigs spent a median of 82.8% (IQR: 73.5, 94.4) of their time roaming within 100 meters of their homes. The size of home ranges varied significantly by pig age, and 93% of the total time spent interacting with open human defecation areas occurred within 100 meters of pig residences. Conclusions/Significance These results indicate that 100 meter radius rings around heavily-infected pigs adequately capture the average pig’s roaming area (i.e., home range) and represent an area where the great majority of exposure to human feces occurs. Taenia solium, commonly known as the pork tapeworm, is a parasite that affects humans and pigs. It has a disproportionate impact on low and middle income countries, and is most common in rural areas where free-ranging domestic pigs are common, and access to sanitation is limited. Pigs acquire cysticercosis, the larval stage of the disease, when they ingest T. solium eggs that have been released into the environment through the feces of an infected human host. In this study, we tracked free-ranging pigs with GPS devices, and found that most pigs remained close to their owners’ homes throughout the tracking period, and that the majority of pigs’ interactions with open human feces occurred near their owners’ homes. These findings suggest that 100 meter radius rings around heavily-infected pigs capture the most likely area of pig infection, and support focused control interventions in areas surrounding heavily-infected pigs.
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Affiliation(s)
- Ian W. Pray
- School of Public Health, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Dallas J. Swanson
- School of Public Health, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Viterbo Ayvar
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
| | - Claudio Muro
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
| | - Luz M. Moyano
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
- Inserm Neuroépidémiologie Tropicale (NET), Institut d'Epidémiologie et de Neurologie Tropicale (IENT), Faculté de Médecine de l'Université de Limoges, Limoges, France
- Office of Training and Research. Regional Hospital II-2, Tumbes, Peru
| | - Armando E. Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H. Garcia
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E. O’Neal
- School of Public Health, Oregon Health and Science University, Portland, Oregon, United States of America
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Tumbes, Peru
- * E-mail:
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Ron-Garrido L, Coral-Almeida M, Gabriël S, Benitez-Ortiz W, Saegerman C, Dorny P, Berkvens D, Abatih EN. Distribution and Potential Indicators of Hospitalized Cases of Neurocysticercosis and Epilepsy in Ecuador from 1996 to 2008. PLoS Negl Trop Dis 2015; 9:e0004236. [PMID: 26580210 PMCID: PMC4651332 DOI: 10.1371/journal.pntd.0004236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/23/2015] [Indexed: 11/29/2022] Open
Abstract
Background Epilepsy is one of the most common signs of Neurocysticercosis (NCC). In this study, spatial and temporal variations in the incidence of hospitalized cases (IHC) of epilepsy and NCC in Ecuadorian municipalities were analyzed. Additionally, potential socio-economic and landscape indicators were evaluated in order to understand in part the macro-epidemiology of the Taenia solium taeniasis/cysticercosis complex. Methodology Data on the number of hospitalized epilepsy and NCC cases by municipality of residence were obtained from morbidity-hospital systems in Ecuador. SatScan software was used to determine whether variations in the IHC of epilepsy and NCC in space and time. In addition, several socio-economic and landscape variables at municipality level were used to study factors intervening in the macro-epidemiology of these diseases. Negative Binomial regression models through stepwise selection and Bayesian Model Averaging (BMA) were used to explain the variations in the IHC of epilepsy and NCC. Principal findings Different clusters were identified through space and time. Traditional endemic zones for NCC and epilepsy, recognized in other studies were confirmed in our study. However, for both disorders more recent clusters were identified. Among municipalities, an increasing tendency for IHC of epilepsy, and a decreasing tendency for the IHC of NCC were observed over time. In contrast, within municipalities a positive linear relationship between both disorders was found. An increase in the implementation of systems for eliminating excrements would help to reduce the IHC of epilepsy by 1.00% (IC95%; 0.2%–1.8%) and by 5.12% (IC95%; 3.63%-6.59%) for the IHC of NCC. The presence of pig production was related to IHC of NCC. Conclusion/Significance Both disorders were related to the lack of an efficient system for eliminating excrements. Given the appearance of recent epilepsy clusters, these locations should be studied in depth to discriminate epilepsies due to NCC from epilepsies due to other causes. Field studies are needed to evaluate the true prevalence of cysticercosis in humans and pigs in different zones of the country in order to better implement and manage prevention and/or control campaigns. T. solium neurocysticercosis is considered the most important parasitic disease of the central nervous system in humans; it is estimated to be responsible for at least one third of acquired epilepsies in developing countries. In Ecuador, the relationship between acquired epilepsy and neurocysticercosis remains unclear due to different factors such as, the lack of specialized health care personnel, appropriate diagnostic techniques and the fact that acquired epilepsy is characteristic of many other infectious and non-infectious diseases in the endemic zones of the country. In this study, spatio-temporal information and potential socio-economic indicators were studied for the number of hospitalized neurocysticercosis and epileptic cases in the country in order to locate and characterize important clusters in space and time. This study identified traditional endemic clusters in the highlands for both conditions as well as new clusters appearing in recent years in other zones not considered endemic. Also the incidence of hospitalized cases of epilepsy and neurocysticercosis were significantly higher in urban zones, probably due to a better access to health facilities. The presence of systems for excrement disposal was significantly associated with a reduction in the incident cases for both epilepsy and neurocysticercosis. More studies are needed to evaluate the true prevalence of neurocysticercosis associated epilepsy in humans and cysticercosis in pigs around the country in order to better implement and manage control campaigns.
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Affiliation(s)
- Lenin Ron-Garrido
- Universidad Central del Ecuador, Centro Internacional de Zoonosis (CIZ), Ciudadela Universitaria, Quito, Ecuador
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Research Unit of Epidemiology and Risk Analysis applied to the Veterinary Sciences (UREAR-ULg), Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Marco Coral-Almeida
- Universidad Central del Ecuador, Centro Internacional de Zoonosis (CIZ), Ciudadela Universitaria, Quito, Ecuador
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Universidad de las Américas, Escuela de Medicina Veterinaria y Zootecnia, Quito Ecuador
- Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
- * E-mail:
| | - Sarah Gabriël
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Washington Benitez-Ortiz
- Universidad Central del Ecuador, Centro Internacional de Zoonosis (CIZ), Ciudadela Universitaria, Quito, Ecuador
| | - Claude Saegerman
- Research Unit of Epidemiology and Risk Analysis applied to the Veterinary Sciences (UREAR-ULg), Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Dirk Berkvens
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Nji Abatih
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Braae UC, Harrison W, Lekule F, Magnussen P, Johansen MV. Feedstuff and poor latrines may put pigs at risk of cysticercosis — A case-control study. Vet Parasitol 2015; 214:187-91. [DOI: 10.1016/j.vetpar.2015.08.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/06/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
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Coral-Almeida M, Gabriël S, Abatih EN, Praet N, Benitez W, Dorny P. Taenia solium Human Cysticercosis: A Systematic Review of Sero-epidemiological Data from Endemic Zones around the World. PLoS Negl Trop Dis 2015; 9:e0003919. [PMID: 26147942 PMCID: PMC4493064 DOI: 10.1371/journal.pntd.0003919] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/17/2015] [Indexed: 11/24/2022] Open
Abstract
Background Taenia solium cysticercosis is a zoonotic neglected disease responsible for severe health disorders such as seizures and death. Understanding the epidemiology of human cysticercosis (HCC) in endemic regions will help to expose critical information about the transmission of the disease, which could be used to design efficient control programs. This review gathered serological data on apparent prevalence of T. solium circulating antigens and/or seroprevalence of T. solium antibodies, apparent prevalence of human taeniasis and risk factors for HCC from endemic communities in order to understand the differences in exposure to the parasite and active infections with T. solium metacestodes in endemic areas around the world. Methods Three databases were used to search sero-epidemiological data from community-based studies conducted between 1989 and 2014 in cysticercosis endemic communities worldwide. The search focused on data obtained from T. solium circulating antigen detection by monoclonal antibody-based sandwich ELISA and/or T. solium antibody seroprevalence determined by Enzyme-linked Immunoelectrotransfer Blot (EITB). A meta-analysis was performed per continent. Principal Findings A total of 39,271 participants from 19 countries, described in 37 articles were studied. The estimates for the prevalence of circulating T. solium antigens for Africa, Latin America and Asia were: 7.30% (95% CI [4.23–12.31]), 4.08% (95% CI [2.77–5.95]) and 3.98% (95% CI [2.81–5.61]), respectively. Seroprevalence estimates of T. solium antibodies were 17.37% (95% CI [3.33–56.20]), 13.03% (95% CI [9.95–16.88]) and 15.68% (95% CI [10.25–23.24]) respectively. Taeniasis reported prevalences ranged from 0 (95% CI [0.00–1.62]) to 17.25% (95% CI [14.55–20.23]). Significance A significant variation in the sero-epidemiological data was observed within each continent, with African countries reporting the highest apparent prevalences of active infections. Intrinsic factors in the human host such as age and immunity were main determinants for the occurrence of infections, while exposure was mostly related to environmental factors which varied from community to community. Human cysticercosis is a neglected zoonotic disease caused by the larval stage of the parasite Taenia solium. This disease is responsible for severe health disorders such as seizures, and in some cases even death. T. solium cysticercosis is endemic in countries in Africa, Latin America and Asia where conditions such as inadequate hygiene, poor sanitary conditions, open defecation, free roaming pigs and poverty permit the transmission of the disease. Diagnostic tools are capable of detecting exposure to eggs and infection levels in a population through antibody and antigen detection, respectively. This review focused on gathering epidemiological data from endemic communities in Africa, Latin America and Asia in order to understand the causes of the observed variations in exposure/infection patterns in endemic regions. Similar antibody seroprevalences were observed worldwide while infection prevalences varied significantly within each region. Intrinsic factors such as age and immunity were determining factors for the occurrence of infections, while exposure was related to environmental factors which varied from region to region. Understanding the epidemiology of cysticercosis in endemic regions will help expose information on the transmission, which could in turn be used to design appropriate control programs.
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Affiliation(s)
- Marco Coral-Almeida
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
- Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
- Universidad Central del Ecuador, Centro Internacional de Zoonosis (CIZ), Ciudadela Universitaria, Quito, Ecuador
- Universidad de las Américas, Escuela de Medicina Veterinaria y Zootecnia, Quito, Ecuador
- * E-mail:
| | - Sarah Gabriël
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Emmanuel Nji Abatih
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Nicolas Praet
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Washington Benitez
- Universidad Central del Ecuador, Centro Internacional de Zoonosis (CIZ), Ciudadela Universitaria, Quito, Ecuador
- Universidad Central del Ecuador, Facultad de Medicina Veterinaria y Zootecnia, Ciudadela Universitaria, Quito, Ecuador
| | - Pierre Dorny
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
- Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
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Ito A, Yanagida T, Nakao M. Recent advances and perspectives in molecular epidemiology of Taenia solium cysticercosis. INFECTION GENETICS AND EVOLUTION 2015; 40:357-367. [PMID: 26112071 DOI: 10.1016/j.meegid.2015.06.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/19/2015] [Accepted: 06/20/2015] [Indexed: 12/17/2022]
Abstract
Cysticercosis caused by accidental ingestion of eggs of Taenia solium is spreading all over the world through globalization and is one of the most neglected, neglected tropical diseases (NTDs) or neglected zoonotic diseases (NZDs). In the present study, the reason why T. solium cysticercosis has been neglected is discussed at first, and followed with an overview on the most recent advances and perspectives in molecular approaches for epidemiology of T. solium taeniasis/cysticercosis, since although taeniasis does not constitute recognized zoonoses, transmission and complete development are dependent on human definitive hosts. Main topics are discussions on (1) the two, Asian and Afro/American, genotypes of T. solium, (2) comparative analysis of mitochondrial (haploid) and nuclear (diploid) genes, and (3) the presence of hybrids of these two genotypes which indicates out-crossing of two genotypes in hermaphrodite tapeworms in Madagascar. Additional topics are on (4) the usefulness of phylogeographic analyses to discuss where the infection was acquired from, and (5) miscellaneous unsolved topics around these genetic diversity of T. solium.
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Affiliation(s)
- Akira Ito
- Department of Parasitology, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.
| | - Tetsuya Yanagida
- Department of Parasitology, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan; Laboratory of Parasitology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan.
| | - Minoru Nakao
- Department of Parasitology, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.
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Wandra T, Swastika K, Dharmawan NS, Purba IE, Sudarmaja IM, Yoshida T, Sako Y, Okamoto M, Eka Diarthini NLP, Sri Laksemi DAA, Yanagida T, Nakao M, Ito A. The present situation and towards the prevention and control of neurocysticercosis on the tropical island, Bali, Indonesia. Parasit Vectors 2015; 8:148. [PMID: 25881045 PMCID: PMC4356148 DOI: 10.1186/s13071-015-0755-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/18/2015] [Indexed: 12/21/2022] Open
Abstract
Neurocysticercosis (NCC), which is caused by accidental ingestion of eggs of the pork tapeworm, Taenia solium, was common in Bali, Indonesia until the early 1990s. However, improved education on hygiene and sanitation, a move to keeping pigs indoors, and improvement of economic and living conditions have substantially reduced the occurrence of NCC in Bali. Since 2011, T. solium tapeworm carriers (T. solium taeniasis) and heavily infected pigs and dogs have exclusively been detected from villages in mountainous regions of northeastern Bali where NCC and ocular cysticercosis (OCC) cases have also been identified. In response to this continued area of high infection, a one-day workshop was convened to discuss how to prevent and control this potentially lethal zoonotic parasitic infection in Bali. This review presents an overview of the current status of T. solium taeniasis and cysticercosis in Indonesia and proposes a strategy for the prevention and control of this zoonosis in Bali.
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Affiliation(s)
- Toni Wandra
- Sari Mutiara Indonesia University, Medan, North Sumatra, Indonesia.
| | - Kadek Swastika
- Department of Parasitology, Faculty of Medicine, University of Udayana, Denpasar, Bali, Indonesia.
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
- Section of Wildlife Diversity, Center for Human Evolution Modeling Research, Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan.
| | - Nyoman S Dharmawan
- Department of Veterinary Parasitology, Faculty of Veterinary Medicine, University of Udayana, Denpasar, Bali, Indonesia.
| | | | - I Made Sudarmaja
- Department of Parasitology, Faculty of Medicine, University of Udayana, Denpasar, Bali, Indonesia.
| | - Takahiko Yoshida
- Department of Health Science, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Yasuhito Sako
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Munehiro Okamoto
- Section of Wildlife Diversity, Center for Human Evolution Modeling Research, Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan.
| | | | | | - Tetsuya Yanagida
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
- Laboratory of Veterinary Parasitology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi, Japan.
| | - Minoru Nakao
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Akira Ito
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
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Mwape KE, Phiri IK, Praet N, Dorny P, Muma JB, Zulu G, Speybroeck N, Gabriël S. Study and ranking of determinants of Taenia solium infections by classification tree models. Am J Trop Med Hyg 2014; 92:56-63. [PMID: 25404073 DOI: 10.4269/ajtmh.13-0593] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Taenia solium taeniasis/cysticercosis is an important public health problem occurring mainly in developing countries. This work aimed to study the determinants of human T. solium infections in the Eastern province of Zambia and rank them in order of importance. A household (HH)-level questionnaire was administered to 680 HHs from 53 villages in two rural districts and the taeniasis and cysticercosis status determined. A classification tree model (CART) was used to define the relative importance and interactions between different predictor variables in their effect on taeniasis and cysticercosis. The Katete study area had a significantly higher taeniasis and cysticercosis prevalence than the Petauke area. The CART analysis for Katete showed that the most important determinant for cysticercosis infections was the number of HH inhabitants (6 to 10) and for taeniasis was the number of HH inhabitants > 6. The most important determinant in Petauke for cysticercosis was the age of head of household > 32 years and for taeniasis it was age < 55 years. The CART analysis showed that the most important determinant for both taeniasis and cysticercosis infections was the number of HH inhabitants (6 to 10) in Katete district and age in Petauke. The results suggest that control measures should target HHs with a high number of inhabitants and older individuals.
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Affiliation(s)
- Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Praet
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Dorny
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - John B Muma
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Niko Speybroeck
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Sarah Gabriël
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Veterinary Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Zambia; Petauke District Hospital, Petauke, Zambia; Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
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Carabin H, Traoré AA. Taenia solium taeniasis and cysticercosis control and elimination through community-based interventions. CURRENT TROPICAL MEDICINE REPORTS 2014; 1:181-193. [PMID: 25544938 DOI: 10.1007/s40475-014-0029-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Taenia solium was declared potentially eradicable by the International Task Force for Disease Eradication in 1992. Yet, very few well-designed community-based randomized controlled trials have been conducted to measure the effectiveness of alternative control strategies. Most strategies have been tested in pre-post intervention designs in very few communities, often without a control group. The only two community-based randomized controlled trials suggest that an educational program alone or a combination of human and porcine mass treatment reduce porcine cysticercosis in the short term. A transmission dynamics model suggests that improved sanitation and pig management are more effective and sustainable than pig vaccination, human or porcine mass treatment. Current evidence does not support the eradication of Taenia solium in the foreseeable future. Investigators should follow international recommendations on the conduct of community-based randomized control trials to provide more valid estimates of the effect and cost-effectiveness of alternative control strategies for cysticercosis.
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Affiliation(s)
- Hélène Carabin
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104
| | - Aminata A Traoré
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104. Tel: 405 271-2229.
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Ring-screening to control endemic transmission of Taenia solium. PLoS Negl Trop Dis 2014; 8:e3125. [PMID: 25210748 PMCID: PMC4161340 DOI: 10.1371/journal.pntd.0003125] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 07/18/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Taenia solium is a major cause of preventable epilepsy in developing nations. Screening and treatment of human intestinal stage infection (taeniasis) within high-risk foci may reduce transmission and prevent epilepsy by limiting human exposure to infective eggs. We piloted a ring-strategy that involves screening and treatment for taeniasis among households located nearby pigs heavily-infected with the larval stage (cysticercosis). These pigs mark areas of increased transmission and can be identified by tongue examination. METHODOLOGY We selected two villages in northern Peru for a controlled prospective interventional cohort pilot study. In the intervention village (1,058 residents) we examined the tongues of all pigs every 4 months for nodules characteristic of cysticercosis. We then screened all residents living within 100-meters of any tongue-positive pig using enzyme-linked immunosorbent assay to detect Taenia antigens in stool. Residents with taeniasis were treated with niclosamide. In both the intervention and control (753 residents) we measured incidence of exposure by sampling the pig population every 4 months for serum antibodies against cysticercosis using enzyme-linked immunoelectrotransfer blot. PRINCIPAL FINDINGS Baseline seroincidence among pigs born during the study was 22.6 cases per 100 pigs per-month (95% confidence interval [CI] 17.0-30.0) in the intervention and 18.1 (95% CI 12.7-25.9) in the control. After one year we observed a 41% reduction in seroincidence in the intervention village compared to baseline (incidence rate ratio 0.59, 95% CI 0.41-0.87) while the seroincidence in the control village remained unchanged. At study end, the prevalence of taeniasis was nearly 4 times lower in the intervention than in the control (prevalence ratio 0.28, 95% CI 0.08-0.91). CONCLUSIONS/SIGNIFICANCE Ring-screening reduced transmission of T. solium in this pilot study and may provide an effective and practical approach for regions where resources are limited. However, this strategy requires validation in larger populations over a greater period of time.
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Abstract
Human cysticercosis, caused by accidental ingestion of eggs of Taenia solium, is one of the most pathogenic helminthiases and is listed among the 17 WHO Neglected Tropical Diseases. Controlling the life-cycle of T. solium between humans and pigs is essential for eradication of cysticercosis. One difficulty for the accurate detection and identification of T. solium species is the possible co-existence of two other human Taenia tapeworms (T. saginata and T. asiatica, which do not cause cysticercosis in humans). Several key issues for taeniasis/cysticercosis (T/C) evidence-based epidemiology and control are reviewed: (1) advances in immunological and molecular tools for screening of human and animals hosts and identification of Taenia species, with a focus on real-time detection of taeniasis carriers and infected animals in field community screenings, and (2) spatial ecological approaches that have been used to detect geospatial patterns of case distributions and to monitor pig activity and behaviour. Most recent eco-epidemiological studies undertaken in Sichuan province, China, are introduced and reviewed.
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Control of Taenia solium taeniasis/cysticercosis: past practices and new possibilities. Parasitology 2013; 140:1566-77. [DOI: 10.1017/s0031182013001005] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYNeurocysticercosis continues to be a major health burden on humans living in many regions of the world, despite the availability of highly effective taeniacides and identification of the cause, Taenia solium, as being potentially eradicable. Several T. solium control trials have been undertaken, generally achieving limited success and none that has been fully documented has achieved what was demonstrated to be a sustainable level of disease control. Pigs act as intermediate hosts for T. solium and two new control tools have become available for application in pigs – single-dose oxfendazole treatment of porcine cysticercosis and the TSOL18 vaccine. Three potential intervention scenarios for pigs are compared for control of cysticercosis, using either oxfendazole or vaccination. A control scenario involving vaccination plus oxfendazole treatment delivered at 4 monthly intervals was predicted to achieve the best outcome, with no pigs slaughtered at 12 months of age having viable T. solium cysticerci. Now that new control tools are available, there are opportunities to concentrate research attention on evaluation of novel control scenarios leading to the implementation of effective and sustainable control programmes and a reduction in the global burden of neurocysticercosis.
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Assana E, Lightowlers MW, Zoli AP, Geerts S. Taenia solium taeniosis/cysticercosis in Africa: Risk factors, epidemiology and prospects for control using vaccination. Vet Parasitol 2013; 195:14-23. [DOI: 10.1016/j.vetpar.2012.12.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 12/04/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022]
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Gilman RH, Gonzalez AE, Llanos-Zavalaga F, Tsang VCW, Garcia HH. Prevention and control of Taenia solium taeniasis/cysticercosis in Peru. Pathog Glob Health 2013; 106:312-8. [PMID: 23265557 DOI: 10.1179/2047773212y.0000000045] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Taenia solium is endemic in most of the world, causing seizures and other neurological symptoms. Transmission is mainly maintained in rural areas by a human to pig cycle. Despite claims on its eradicability, sustainable interruption of transmission has not yet been reported. This manuscript reviews the conceptual basis for control, available diagnostic and control tools, and recent experiences on control in the field performed in Peru along the past decade.
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Affiliation(s)
- Robert H Gilman
- Department of Microbiology, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
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Human neurocysticercosis: immunological features involved in the host's susceptibility to become infected and to develop disease. Microbes Infect 2013; 15:524-30. [PMID: 23542217 DOI: 10.1016/j.micinf.2013.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/13/2013] [Accepted: 03/15/2013] [Indexed: 11/23/2022]
Abstract
Human neurocysticercosis (NC) is a clinically and radiologically heterogeneous disease caused by the establishment of Taenia solium larvae in the central nervous system. Herein, the immunological and endocrinological features involved in resistance to infection and severe forms of the disease are reviewed, and their clinical relevance is discussed.
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Flisser A. State of the art of Taenia solium as compared to Taenia asiatica. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:43-9. [PMID: 23467388 PMCID: PMC3587748 DOI: 10.3347/kjp.2013.51.1.43] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/02/2022]
Abstract
Three species of tapeworms infect humans in their adult stage (Taenia solium, Taenia saginata and Taenia asiatica). The 3 are flat, opaque white or yellowish, and exceptional long segmented parasites, measuring 1 to 12 m in their adult stage. In this review, the development of the knowledge regarding the first species, mainly focused on understanding how the larval stage or cysticercus is transmitted to humans, is described. The second species is a cosmopolitan parasite that only causes taeniosis and not cysticercosis; therefore, it will not be included. Information on the third species, which is presently being produced, since this species was recognized as such only at the end of the 20th century, will be discussed at the end of this review.
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Affiliation(s)
- Ana Flisser
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México 04510 DF, México.
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O'Neal SE, Moyano LM, Ayvar V, Gonzalvez G, Diaz A, Rodriguez S, Wilkins PP, Tsang VCW, Gilman RH, Garcia HH, Gonzalez AE. Geographic correlation between tapeworm carriers and heavily infected cysticercotic pigs. PLoS Negl Trop Dis 2012; 6:e1953. [PMID: 23285305 PMCID: PMC3527375 DOI: 10.1371/journal.pntd.0001953] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 10/26/2012] [Indexed: 11/20/2022] Open
Abstract
Background Neurocysticercosis is a leading cause of preventable epilepsy in the developing world. Sustainable community-based interventions are urgently needed to control transmission of the causative parasite, Taenia solium. We examined the geospatial relationship between live pigs with visible cysticercotic cysts on their tongues and humans with adult intestinal tapeworm infection (taeniasis) in a rural village in northern Peru. The objective was to determine whether tongue-positive pigs could indicate high-risk geographic foci for taeniasis to guide targeted screening efforts. This approach could offer significant benefit compared to mass intervention. Methods We recorded geographic coordinates of all village houses, collected stool samples from all consenting villagers, and collected blood and examined tongues of all village pigs. Stool samples were processed by enzyme-linked immunosorbent assay (ELISA) for presence of Taenia sp. coproantigens indicative of active taeniasis; serum was processed by enzyme-linked immunoelectrotransfer blot for antibodies against T. solium cysticercosis (EITB LLGP) and T. solium taeniasis (EITB rES33). Findings Of 548 pigs, 256 (46.7%) were positive for antibodies against cysticercosis on EITB LLGP. Of 402 fecal samples, 6 (1.5%) were positive for the presence of Taenia sp. coproantigens. The proportion of coproantigen-positive individuals differed significantly between residents living within 100-meters of a tongue-positive pig (4/79, 5.1%) and residents living >100 meters from a tongue-positive pig (2/323, 0.6%) (p = 0.02). The prevalence of taeniasis was >8 times higher among residents living within 100 meters of a tongue-positive pig compared to residents living outside this range (adjusted PR 8.1, 95% CI 1.4–47.0). Conclusions Tongue-positive pigs in endemic communities can indicate geospatial foci in which the risk for taeniasis is increased. Targeted screening or presumptive treatment for taeniasis within these high-risk foci may be an effective and practical control intervention for rural endemic areas. Taenia solium, aka the pork tapeworm, is an important cause of epilepsy in developing nations. People with intestinal tapeworms, a condition known as taeniasis, pass infectious eggs in their feces which contaminate the environment. These eggs can cause serious disease in both humans and pigs if they are ingested. Treating taeniasis is one way to potentially control transmission of the parasite in affected communities. However, this is difficult because people with taeniasis usually have no symptoms and therefore don't know they are infected. As a result, control programs may resort to offering treatment to entire communities in order to reach a few tapeworm carriers. Focusing detection and treatment on high-risk subgroups is another approach which might reduce unnecessary treatments. In this study, we found that people with taeniasis are more likely to be found living nearby pigs with visible signs of infection, specifically tapeworm cysts on their tongues. This suggests that routine tongue examination by pig owners and buyers could identify neighborhoods where detection and treatment of taeniasis may be more efficient.
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Affiliation(s)
- Seth E O'Neal
- Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, Oregon, United States of America.
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Rosales-Mendoza S, Govea-Alonso DO, Monreal-Escalante E, Fragoso G, Sciutto E. Developing plant-based vaccines against neglected tropical diseases: where are we? Vaccine 2012; 31:40-8. [PMID: 23142588 DOI: 10.1016/j.vaccine.2012.10.094] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/09/2012] [Accepted: 10/25/2012] [Indexed: 10/27/2022]
Abstract
Neglected tropical diseases (NTDs) impair the lives of 1 billion people worldwide, and threaten the health of millions more. Although vaccine candidates have been proposed to prevent some NTDs, no vaccine is available at the market yet. Vaccines against NTDs should be low-cost and needle-free to reduce the logistic cost of their administration. Plant-based vaccines meet both requirements: plant systems allow antigen production at low cost, and also yield an optimal delivery vehicle that prevents or delays digestive hydrolysis of vaccine antigens. This review covers recent reports on the development of plant-based vaccines against NTDs. Efforts conducted by a number of research groups to develop vaccines as a mean to fight rabies, cysticercosis, dengue, and helminthiasis are emphasized. Future perspectives are identified, such as the need to develop vaccination models for more than ten pathologies through a plant-based biotechnological approach. Current limitations on the method are also noted, and molecular approaches that might allow us to address such limitations are discussed.
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Affiliation(s)
- Sergio Rosales-Mendoza
- Laboratorio de biofarmacéuticos recombinantes, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, SLP, 78210, Mexico.
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