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Bobes RJ, Estrada K, Rios-Valencia DG, Calderón-Gallegos A, de la Torre P, Carrero JC, Sanchez-Flores A, Laclette JP. The Genomes of Two Strains of Taenia crassiceps the Animal Model for the Study of Human Cysticercosis. Front Cell Infect Microbiol 2022; 12:876839. [PMID: 35619649 PMCID: PMC9128525 DOI: 10.3389/fcimb.2022.876839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/12/2022] [Indexed: 12/13/2022] Open
Abstract
Human cysticercosis by Taenia solium is the major cause of neurological illness in countries of Africa, Southeast Asia, and the Americas. Publication of four cestode genomes (T. solium, Echinococcus multilocularis, E. granulosus and Hymenolepis microstoma) in the last decade, marked the advent of novel approaches on the study of the host-parasite molecular crosstalk for cestode parasites of importance for human and animal health. Taenia crassiceps is another cestode parasite, closely related to T. solium, which has been used in numerous studies as an animal model for human cysticercosis. Therefore, characterization of the T. crassiceps genome will also contribute to the understanding of the human infection. Here, we report the genome of T. crassiceps WFU strain, reconstructed to a noncontiguous finished resolution and performed a genomic and differential expression comparison analysis against ORF strain. Both strain genomes were sequenced using Oxford Nanopore (MinION) and Illumina technologies, achieving high quality assemblies of about 107 Mb for both strains. Dotplot comparison between WFU and ORF demonstrated that both genomes were extremely similar. Additionally, karyotyping results for both strains failed to demonstrate a difference in chromosome composition. Therefore, our results strongly support the concept that the absence of scolex in the ORF strain of T. crassiceps was not the result of a chromosomal loss as proposed elsewhere. Instead, it appears to be the result of subtle and extensive differences in the regulation of gene expression. Analysis of variants between the two strains identified 2,487 sites with changes distributed in 31 of 65 scaffolds. The differential expression analysis revealed that genes related to development and morphogenesis in the ORF strain might be involved in the lack of scolex formation.
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Affiliation(s)
- Raúl J. Bobes
- Biomedical Research Institute, Universidad Nacional Autónoma de México, CDMX, Mexico
| | - Karel Estrada
- Biotechnology Institute, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | | | | | - Patricia de la Torre
- Biomedical Research Institute, Universidad Nacional Autónoma de México, CDMX, Mexico
| | - Julio C. Carrero
- Biomedical Research Institute, Universidad Nacional Autónoma de México, CDMX, Mexico
| | - Alejandro Sanchez-Flores
- Biotechnology Institute, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
- *Correspondence: Juan P. Laclette, ; Alejandro Sanchez-Flores,
| | - Juan P. Laclette
- Biomedical Research Institute, Universidad Nacional Autónoma de México, CDMX, Mexico
- *Correspondence: Juan P. Laclette, ; Alejandro Sanchez-Flores,
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Abstract
PURPOSE Toxocariasis is a helminthozoonosis caused by the infection of a human host by the larva of Toxocara spp., predominately involving Toxocara canis and Toxocara cati, which are common nematodes in dogs and cats, respectively. Human transmission occurs through contact with animals or by consumption of food contaminated with parasite's eggs. The purpose of this article is to review the current knowledge regarding human neurotoxocariasis. METHODS We conducted a systematic review of the existing literature concerning toxocariasis of the nervous system. RESULTS Clinical spectrum of human toxocariasis varies widely from a subclinical course to significant organ morbidity. Clinical course depends on parasitic load, the migration route of the larvae and host response. Human neurotoxocariasis is a relatively rare entity yet associated with severe sequelae. Manifestations include meningitis (usually eosinophilic), encephalitis, myelitis, cerebellar vasculitis, space-occupying lesion, behavioral abnormalities, and optic neuritis. Even though valid diagnostic criteria are lacking, neurotoxocariasis should be suspected in patients with neurologic symptoms and cerebrospinal fluid (CSF) pleocytosis with eosinophilia, positive serology for anti-Toxocara antibodies, in serum and/or CSF, sterile CSF and clinical improvement after antihelminthic treatment. Neurotoxocariasis is treated by benzimidazole components, most frequently albendazole, corticosteroids, or diethylcarbamazine. CONCLUSION Parasite larvae migrate through tissues and are able to reach the nervous system causing neurotoxocariasis. Its clinical spectrum varies and includes myelitis, meningoencephalitis, brain abscess, and vasculitis. Neurotoxocariasis should always be suspected in patients with neurologic symptoms accompanied by eosinophilia in blood and/or CSF. Early diagnosis and treatment could prevent long-term neurologic impairment.
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Development of multi-epitope driven subunit vaccine against Fasciola gigantica using immunoinformatics approach. Int J Biol Macromol 2019; 138:224-233. [DOI: 10.1016/j.ijbiomac.2019.07.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/13/2022]
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Hill CE, Lin CC, Burke JF, Kerber KA, Skolarus LE, Esper GJ, Magliocco B, Callaghan BC. Claims data analyses unable to properly characterize the value of neurologists in epilepsy care. Neurology 2019; 92:e973-e987. [PMID: 30674587 DOI: 10.1212/wnl.0000000000007004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/25/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To determine the association of a neurologist visit with health care use and cost outcomes for patients with incident epilepsy. METHODS Using health care claims data for individuals insured by United Healthcare from 2001 to 2016, we identified patients with incident epilepsy. The population was defined by an epilepsy/convulsion diagnosis code (ICD codes 345.xx/780.3x, G40.xx/R56.xx), an antiepileptic prescription filled within the succeeding 2 years, and neither criterion met in the 2 preceding years. Cases were defined as patients who had a neurologist encounter for epilepsy within 1 year after an incident diagnosis; a control cohort was constructed with propensity score matching. Primary outcomes were emergency room (ER) visits and hospitalizations for epilepsy. Secondary outcomes included measures of cost (epilepsy related, not epilepsy related, and antiepileptic drugs) and care escalation (including EEG evaluation and epilepsy surgery). RESULTS After participant identification and propensity score matching, there were 3,400 cases and 3,400 controls. Epilepsy-related ER visits were more likely for cases than controls (year 1: 5.9% vs 2.3%, p < 0.001), as were hospitalizations (year 1: 2.1% vs 0.7%, p < 0.001). Total medical costs for epilepsy care, nonepilepsy care, and antiepileptic drugs were greater for cases (p ≤ 0.001). EEG evaluation and epilepsy surgery occurred more commonly for cases (p ≤ 0.001). CONCLUSIONS Patients with epilepsy who visited a neurologist had greater subsequent health care use, medical costs, and care escalation than controls. This comparison using administrative claims is plausibly confounded by case disease severity, as suggested by higher nonepilepsy care costs. Linking patient-centered outcomes to claims data may provide the clinical resolution to assess care value within a heterogeneous population.
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Affiliation(s)
- Chloe E Hill
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN.
| | - Chun Chieh Lin
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - James F Burke
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - Kevin A Kerber
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - Lesli E Skolarus
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - Gregory J Esper
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - Brandon Magliocco
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
| | - Brian C Callaghan
- From the Health Services Research Program (C.E.H., C.C.L., J.F.B., K.A.K., L.E.S., B.C.C.), Department of Neurology, University of Michigan, Ann Arbor; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and American Academy of Neurology (B.M.), Minneapolis, MN
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Bartolini L, Majidi S, Koubeissi MZ. Uncertainties from a worldwide survey on antiepileptic drug withdrawal after seizure remission. Neurol Clin Pract 2018; 8:108-115. [PMID: 29708173 DOI: 10.1212/cpj.0000000000000441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/05/2017] [Indexed: 11/15/2022]
Abstract
Background We sought to determine differences in practice for discontinuation of antiepileptic drugs (AEDs) after seizure remission and stimulate the planning and conduction of withdrawal trials. Methods We utilized a worldwide electronic survey that included questions about AED discontinuation for 3 paradigmatic cases in remission: (1) focal epilepsy of unknown etiology, (2) temporal lobe epilepsy after surgery, and (3) juvenile myoclonic epilepsy. We analyzed 466 complete questionnaires from 53 countries, including the United States. Statistical analysis included χ2 and multivariate logistic regression. Results Case 1: responders in practice for <10 years were less likely to taper AEDs: odds ratio (OR) (95% confidence interval [CI]) 0.52 (0.32-0.85), p = 0.02. The likelihood of stopping AEDs was higher among doctors treating children: OR (95% CI): 11.41 (2.51-40.13), p = 0.002. Doctors treating children were also more likely to stop after 2 years or less of remission: OR (95% CI): 6.91 (2.62-19.31), p = 0.002, and the same was observed for US physicians: OR (95% CI): 1.61 (1.01-2.57), p = 0.0049. Case 2: responders treating children were more likely to taper after 1 year or less of postoperative remission, with the goal of discontinuing all medications: OR (95% CI): 1.91 (1.09-3.12), p = 0.015, and so were US-based responders: OR (95% CI): 1.73 (1.21-2.41), p = 0.003. Case 3: epileptologists were less likely to withdraw the medication: OR (95% CI): 0.56 (0.39-0.82), p = 0.003, and so were those in practice for 10 or more years: OR (95% CI): 0.54 (0.31-0.95), p = 0.025. Conclusions We observed several differences in practice for AED withdrawal after seizure remission that highlight global uncertainty. Trials of AED discontinuation are needed to provide evidence-based guidance.
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Affiliation(s)
- Luca Bartolini
- Clinical Epilepsy Section (LB) and Stroke Diagnostics and Therapeutics Section (SM), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; and Department of Neurology (SM, MZK), George Washington University Hospital, Washington, DC
| | - Shahram Majidi
- Clinical Epilepsy Section (LB) and Stroke Diagnostics and Therapeutics Section (SM), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; and Department of Neurology (SM, MZK), George Washington University Hospital, Washington, DC
| | - Mohamad Z Koubeissi
- Clinical Epilepsy Section (LB) and Stroke Diagnostics and Therapeutics Section (SM), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; and Department of Neurology (SM, MZK), George Washington University Hospital, Washington, DC
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Verastegui MR, Mejia A, Clark T, Gavidia CM, Mamani J, Ccopa F, Angulo N, Chile N, Carmen R, Medina R, García HH, Rodriguez S, Ortega Y, Gilman RH. Novel rat model for neurocysticercosis using Taenia solium. THE AMERICAN JOURNAL OF PATHOLOGY 2016. [PMID: 26216286 DOI: 10.1016/j.ajpath.2015.04.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Neurocysticercosis is caused by Taenia solium infecting the central nervous system and is the leading cause of acquired epilepsy and convulsive conditions worldwide. Research into the pathophysiology of the disease and appropriate treatment is hindered by lack of cost-effective and physiologically similar animal models. We generated a novel rat neurocysticercosis model using intracranial infection with activated T. solium oncospheres. Holtzman rats were infected in two separate groups: the first group was inoculated extraparenchymally and the second intraparenchymally, with different doses of activated oncospheres. The groups were evaluated at three different ages. Histologic examination of the tissue surrounding T. solium cysticerci was performed. Results indicate that generally infected rats developed cysticerci in the brain tissue after 4 months, and the cysticerci were observed in the parenchymal, ventricle, or submeningeal brain tissue. The route of infection did not have a statistically significant effect on the proportion of rats that developed cysticerci, and there was no dependence on infection dose. However, rat age was crucial to the success of the infection. Epilepsy was observed in 9% of rats with neurocysticercosis. In histologic examination, a layer of collagen tissue, inflammatory infiltrate cells, perivascular infiltrate, angiogenesis, spongy change, and mass effect were observed in the tissue surrounding the cysts. This study presents a suitable animal model for the study of human neurocysticercosis.
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Affiliation(s)
- Manuela R Verastegui
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Alan Mejia
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Taryn Clark
- Cysticercosis Working Group in Peru, Lima, Peru; Weill Cornell Medical College, New York, New York
| | - Cesar M Gavidia
- Cysticercosis Working Group in Peru, Lima, Peru; Public Health Section, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Javier Mamani
- Cysticercosis Working Group in Peru, Lima, Peru; Faculty of Veterinary Medicine and Animal Husbandry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Fredy Ccopa
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Noelia Angulo
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nancy Chile
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rogger Carmen
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Roxana Medina
- Cysticercosis Working Group in Peru, Lima, Peru; Department of Biology Science, Universidad Nacional del Altiplano, Puno, Peru
| | - Hector H García
- Cysticercosis Working Group in Peru, Lima, Peru; Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru
| | - Silvia Rodriguez
- Cysticercosis Working Group in Peru, Lima, Peru; Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru
| | - Ynes Ortega
- Cysticercosis Working Group in Peru, Lima, Peru; Department of Food Science & Technology, The University of Georgia, Athens, Georgia
| | - Robert H Gilman
- Cysticercosis Working Group in Peru, Lima, Peru; Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland; Asociación Benéfica PRISMA, San Miguel, Lima, Peru
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Abstract
Toxocara canis and T. cati are highly prevalent nematode infections of the intestines of dogs and cats. In paratenic hosts, larvae do not mature in the intestine but instead migrate through the somatic tissues and organs of the body. The presence of these migrating larvae can contribute to pathology. Toxocara larvae can invade the brains of humans, and while case descriptions of cerebral toxocariasis are historically rare, improved diagnosis and greater awareness have contributed to increased detection. Despite this, cerebral or neurological toxocariasis (NT) remains a poorly understood phenomenon. Furthermore, our understanding of cognitive deficits due to toxocariasis in human populations remains particularly deficient. Recent data describe an enhanced expression of biomarkers associated with brain injury, such as GFAP, AβPP, transforming growth factor β1 (TGF-β1), NF-L, S100B, tTG, and p-tau, in mice receiving even low doses of Toxocara ova. Finally, this review outlines a hypothesis to explore the relationship between the presence of T. canis larvae in the brain and the progression of Alzheimer's disease (AD) due to enhanced AD-associated neurodegenerative biomarker expression.
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Kumar N, Garg RK, Malhotra HS, Gupta RK, Verma R, Sharma PK. Natural course of typical and atypical parenchymal solitary cysticercus granuloma of the brain: a 3-year prospective clinico-radiological study. Neuroradiol J 2015; 29:19-29. [PMID: 26659345 DOI: 10.1177/1971400915620437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the role of advanced magnetic resonance (MR) sequences (fast imaging employing steady-state acquisition (FIESTA), T2 star-weighted angiography (SWAN) and spoiled gradient recalled echo (SPGR)) in patients with single small enhancing computed tomography lesions and scolex demonstration in typical and atypical parenchymal neurocysticercosis. METHODS In this study, 59 patients of new-onset seizures with single small enhancing computed tomography lesions of the brain were included. Along with routine MR sequences, advanced MR sequences, like SWAN, FIESTA, and pre and post-contrast SPGR, were performed. Follow-up MR studies focussing on the morphology of the lesions and demonstration of scolex were performed 6 monthly for 3 years. RESULTS The majority of patients (62.7%) were men with partial seizure as the most common manifestation. On SPGR, contrast lesions were identified as either 'typical' (42, 71.2%) or 'atypical' (17, 28.8%). In the typical lesion group, SWAN and FIESTA sequences detected scolex in 30 (71.4%) and 32 (76.2%), respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 35 (83.3%) patients compared to 19 (45.2%) by routine sequences (P < 0.001). In the atypical lesion group, SWAN and FIESTA sequences detected scolex in 15 (88.2%) and 16 (94.1%) patients, respectively. The combination of SPGR-contrast, FIESTA and SWAN sequences detected scolex in 16 (94.1%) patients compared to 10 (58.8%) by routine sequences (P < 0.001). Follow-up showed greater resolution with lesser calcification in the typical group compared to the atypical group. CONCLUSION This study provides an insight into the natural course of typical and atypical solitary cysticercus granuloma lesions, and the utility of SPGR-contrast, FIESTA and SWAN MR sequences in scolex demonstration and identification of atypical lesions.
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Affiliation(s)
- Neeraj Kumar
- Department of Neurology, King George Medical University, India
| | | | | | - Rakesh Kumar Gupta
- MR Section, Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India
| | - Rajesh Verma
- Department of Neurology, King George Medical University, India
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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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Kamuyu G, Bottomley C, Mageto J, Lowe B, Wilkins PP, Noh JC, Nutman TB, Ngugi AK, Odhiambo R, Wagner RG, Kakooza-Mwesige A, Owusu-Agyei S, Ae-Ngibise K, Masanja H, Osier FHA, Odermatt P, Newton CR. Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa. PLoS Negl Trop Dis 2014; 8:e2908. [PMID: 24875312 PMCID: PMC4038481 DOI: 10.1371/journal.pntd.0002908] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 04/16/2014] [Indexed: 11/21/2022] Open
Abstract
Background Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa. Methods and Findings A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52–2.58, p<0.001), Toxocara canis (OR = 1.52; 95%CI: 1.23–1.87, p<0.001), Toxoplasma gondii (OR = 1.28; 95%CI: 1.04–1.56, p = 0.018) and higher antibody levels (top tertile) to Toxocara canis (OR = 1.70; 95%CI: 1.30–2.24, p<0.001) were associated with an increased prevalence of ACE. Exposure to multiple infections was common (73.8% of cases and 65.5% of controls had been exposed to two or more infections), and for T. gondii and O. volvulus co-infection, their combined effect on the prevalence of ACE, as determined by the relative excess risk due to interaction (RERI), was more than additive (T. gondii and O. volvulus, RERI = 1.19). The prevalence of T. solium antibodies was low (2.8% of cases and 2.2% of controls) and was not associated with ACE in the study areas. Conclusion This study investigates how the degree of exposure to parasites and multiple parasitic infections are associated with ACE and may explain conflicting results obtained when only seropositivity is considered. The findings from this study should be further validated. The prevalence of epilepsy is greater in developing countries compared to developed countries, and parasitic infestations are thought to contribute to this increased burden. We conducted a case-control study across five sites in sub-Saharan Africa to investigate the relationship between epilepsy and exposure to parasitic infections, and the association between epilepsy and multiple co-incidental infections. Exposure to Onchocerca volvulus, Toxocara canis and Toxoplasma gondii as well as high antibody levels (top tertile) to Toxocara canis was positively associated with the prevalence of active convulsive epilepsy (ACE). Multiple co-incidental parasitic infections were common, and the combined effect of T. gondii and O. volvulus co-infection on ACE was greater than the sum of the individual effects. The contribution of each of these parasitic infections on the burden of epilepsy in sub-Saharan Africa should be explored.
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Affiliation(s)
- Gathoni Kamuyu
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- * E-mail:
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - James Mageto
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Egerton University, Nakuru, Kenya
| | - Brett Lowe
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Patricia P. Wilkins
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - John C. Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases. National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Anthony K. Ngugi
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Research Support Unit, Faculty of Health Sciences, Aga Khan University (East Africa), Nairobi, Kenya
| | - Rachael Odhiambo
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Epidemiology and Public Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Angelina Kakooza-Mwesige
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | | | - Faith H. A. Osier
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Unversity of Basel, Basel, Switzerland
| | - Charles R. Newton
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Neurosciences Unit, UCL Institute of Child Health, London, United Kingdom
- Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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11
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Nitiéma P, Carabin H, Hounton S, Praet N, Cowan LD, Ganaba R, Kompaoré C, Tarnagda Z, Dorny P, Millogo A, ÉFÉCAB. Prevalence case-control study of epilepsy in three Burkina Faso villages. Acta Neurol Scand 2012; 126:270-8. [PMID: 22289127 DOI: 10.1111/j.1600-0404.2011.01639.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate the association between the prevalence of epilepsy and potential risk factors in three Burkina Faso villages. METHODS Three villages were selected based on local reports of high numbers of epilepsy cases and pig-rearing practices. One person aged 7 or older was selected at random from all households of selected concessions for epilepsy screening and blood sampling. Epilepsy was confirmed by a physician using the ILAE definition. The cross-sectional associations between epilepsy and selected factors and seroresponse to the antigens of Taenia solium were estimated using a Bayesian hierarchical logistic regression. Prevalence odds ratios (POR) and their 95% Bayesian Credible Intervals (95% BCI) were estimated. RESULTS Of 888 individuals interviewed, 39 of 70 screened positive were confirmed to have epilepsy for a lifetime prevalence of 4.5% (95% CI: 3.3; 6.0). The prevalence of epilepsy was associated with a positive reaction to cysticercosis Ag-ELISA serology (POR = 3.1, 95% BCI = 1.0; 8.3), past pork consumption (POR = 9.7, 95% BCI = 2.5; 37.9), and being salaried or a trader compared to a farmer or housewife (POR = 2.9, 95% BCI = 1.2; 6.4). DISCUSSION Several factors were associated with prevalent epilepsy, with Ag-ELISA suggesting the presence of neurocysticercosis. The association between epilepsy and some occupations may reflect differences in local attitudes toward epilepsy and should be further explored.
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Affiliation(s)
- P. Nitiéma
- Department of Biostatistics and Epidemiology; University of Oklahoma Health Sciences Center; Oklahoma City; OK; USA
| | - H. Carabin
- Department of Biostatistics and Epidemiology; University of Oklahoma Health Sciences Center; Oklahoma City; OK; USA
| | - S. Hounton
- Sexual and Reproductive Health Branch Technical Division; UNFPA; New York; NY; USA
| | - N. Praet
- Department of Animal Health, Institute of Tropical Medicine; Nationalestraat; 155, B-2000 Antwerp, Belgium
| | - L. D. Cowan
- Department of Biostatistics and Epidemiology; University of Oklahoma Health Sciences Center; Oklahoma City; OK; USA
| | - R. Ganaba
- Agence de Formation, de Recherche et d' Expertise en Santé pour l'Afrique (AFRICSanté); Bobo Dioulasso; Burkina Faso
| | | | - Z. Tarnagda
- Institut de Recherche en Sciences de la Santé; Bobo-Dioulasso; Burkina Faso
| | - P. Dorny
- Department of Animal Health, Institute of Tropical Medicine; Nationalestraat; 155, B-2000 Antwerp, Belgium
| | - A. Millogo
- Department of Internal Medecine; Centre Hospitalier Universitaire Sourou Sanou de Bobo-Dioulasso; Burkina Faso
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12
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Parasitic infections and myositis. Parasitol Res 2011; 110:1-18. [PMID: 21881948 DOI: 10.1007/s00436-011-2609-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/04/2011] [Indexed: 12/20/2022]
Abstract
Infectious myositis may be caused by a wide variety of bacterial, fungal, viral, and parasitic agents. Parasitic myositis is most commonly a result of trichinosis, cystericercosis, or toxoplasmosis, but other parasites may be involved. A parasitic cause of myositis is suggested by history of residence or travel to endemic area and presence of eosinophilia. The diagnosis of parasitic myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by parasitologic, serologic, and molecular methods, together with histopathologic examination of tissue biopsies. Therapy is based on the clinical presentation and the underlying pathogen. Drug resistance should be put into consideration in different geographic areas, and it can be avoided through the proper use of anti-parasitic drugs.
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13
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Nkouawa A, Sako Y, Itoh S, Kouojip-Mabou A, Nganou CN, Saijo Y, Knapp J, Yamasaki H, Nakao M, Nakaya K, Moyou-Somo R, Ito A. Serological studies of neurologic helminthic infections in rural areas of southwest cameroon: toxocariasis, cysticercosis and paragonimiasis. PLoS Negl Trop Dis 2010; 4:e732. [PMID: 20625553 PMCID: PMC2897840 DOI: 10.1371/journal.pntd.0000732] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 05/12/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Both epilepsy and paragonimiasis had been known to be endemic in Southwest Cameroon. A total of 188 people (168 and 20 with and without symptoms confirmed by clinicians, respectively, 84.6% under 20 years old) were selected on a voluntary basis. Among 14 people (8.3%) with history of epilepsy, only one suffered from paragonimiasis. Therefore, we challenged to check antibody responses to highly specific diagnostic recombinant antigens for two other helminthic diseases, cysticercosis and toxocariasis, expected to be involved in neurological diseases. Soil-transmitted helminthic infections were also examined. METHODOLOGY/PRINCIPAL FINDINGS Fecal samples were collected exclusively from the 168 people. Eggs of Ascaris lumbricoides, Trichuris trichiura and hookworms were found from 56 (33.3%), 72 (42.8%), and 19 (11.3%) persons, respectively. Serology revealed that 61 (36.3%), 25 (14.9%) and 2 (1.2%) of 168 persons showed specific antibody responses to toxocariasis, paragonimiasis and cysticercosis, respectively. By contrast, 20 people without any symptoms as well as additional 20 people from Japan showed no antibody responses. Among the 14 persons with epilepsy, 5 persons were seropositive to the antigen specific to Toxocara, and one of them was simultaneously positive to the antigens of Paragonimus. The fact that 2 children with no history of epilepsy were serologically confirmed to have cysticercosis strongly suggests that serological survey for cysticercosis in children is expected to be useful for early detection of asymptomatic cysticercosis in endemic areas. CONCLUSIONS/SIGNIFICANCE Among persons surveyed, toxocariasis was more common than paragonimiasis, but cysticercosis was very rare. However, the fact that 2 children were serologically confirmed to have cysticercosis was very important, since it strongly suggests that serology for cysticercosis is useful and feasible for detection of asymptomatic cysticercotic children in endemic areas for the early treatment.
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Affiliation(s)
- Agathe Nkouawa
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
- Medical Research Center, Institute of Medical Research and Medicinal Plants Studies (IMPM), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Yasuhito Sako
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | - Sonoyo Itoh
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | | | - Christ Nadège Nganou
- Department of Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon
| | - Yasuaki Saijo
- Division of Community Medicine and Epidemiology, Department of Health Science, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | - Jenny Knapp
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | - Hiroshi Yamasaki
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Minoru Nakao
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | - Kazuhiro Nakaya
- Animal Laboratory for Medical Research, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
| | - Roger Moyou-Somo
- Medical Research Center, Institute of Medical Research and Medicinal Plants Studies (IMPM), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
- Department of Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon
| | - Akira Ito
- Department of Parasitology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan
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14
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Abstract
Both helminthiases and epilepsy occur globally, and are particularly prevalent in developing regions of the world. Studies have suggested an association between epilepsy and helminth infection, but a causal relationship is not established in many helminths, except perhaps with neurocysticercosis. We review the available literature on the global burden of helminths, and the epidemiological evidence linking helminths to epilepsy. We discuss possible routes that helminths affect the central nervous system (CNS) of humans and the immunological response to helminth infection in the CNS, looking at possible mechanisms of epileptogenesis. Finally, we discuss the current gaps in knowledge about the interaction between helminths and epilepsy.
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Affiliation(s)
- R G Wagner
- MRC/Wits Rural Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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15
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Singh G, Prabhakar S. The effects of antimicrobial and antiepileptic treatment on the outcome of epilepsy associated with central nervous system (CNS) infections. Epilepsia 2008; 49 Suppl 6:42-6. [DOI: 10.1111/j.1528-1167.2008.01755.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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