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Maldonado-Barrueco A, Utrilla C, Hernández-González A, Perteguer MJ, Díaz-Pollán B, Untoria-Tabares Y, Díaz-Menéndez M, Falces-Romero I, Gutiérrez-Arroyo A, García-Rodríguez J, Montero-Vega D. Intraventricular neurocysticercosis in a migrant from Honduras. J Travel Med 2024; 31:taad090. [PMID: 37406005 DOI: 10.1093/jtm/taad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
We report in Madrid (Spain) a case of intraventricular neurocysticercosis in a migrant from Choluteca (Honduras), which was confirmed by epidemiological, radiological and microbiological criteria.
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Affiliation(s)
| | - Cristina Utrilla
- Radiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Ana Hernández-González
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
| | - María J Perteguer
- Helminth Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | - Beatriz Díaz-Pollán
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Yeray Untoria-Tabares
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Marta Díaz-Menéndez
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
- Imported Pathology and International Health Unit, CSUR for Adult and Pediatric Imported Tropical Pathology, High Level Isolation Unit, Hospital Universitario La Paz, Madrid 28016, Spain
| | - Iker Falces-Romero
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid 28016, Spain
| | | | | | - Dolores Montero-Vega
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid 28016, Spain
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2
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Eggink H, Maas M, van den Brand JM, Dekker J, Franssen F, Hoving EW, Kortbeek LM, Kranendonk ME, Meiners LC, Rittscher AE, Roelfsema J, Schölvinck EH. Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands. Emerg Infect Dis 2024; 30:555-559. [PMID: 38407150 PMCID: PMC10902551 DOI: 10.3201/eid3003.231402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
A neurocysticercosis-like lesion in an 11-year-old boy in the Netherlands was determined to be caused by the zoonotic Taenia martis tapeworm. Subsequent testing revealed that 15% of wild martens tested in that region were infected with T. martis tapeworms with 100% genetic similarity; thus, the infection source was most likely local.
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Affiliation(s)
| | | | - Judith M.A. van den Brand
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Jasja Dekker
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Frits Franssen
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Eelco W. Hoving
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Laetitia M. Kortbeek
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Mariëtte E.G. Kranendonk
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Linda C. Meiners
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Anne E. Rittscher
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Jeroen Roelfsema
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
| | - Elisabeth H. Schölvinck
- University Medical Center Groningen, Groningen, the Netherlands (H. Eggink, L.C. Meiners, E.H. Schölvinck)
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M. Maas, F. Franssen, L.M. Kortbeek, J. Roelfsema)
- Utrecht University, Utrecht, the Netherlands (J.M.A. van den Brand, A.E. Rittscher)
- Jasja Dekker Dierecologie B.V., Arnhem, the Netherlands (J. Dekker)
- Princess Maxima Center, Utrecht (E.W. Hoving, M.E.G. Kranendonk)
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3
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Stelzle D, Makasi CE, Schmidt V, Van Damme I, Trevisan C, Ruether C, Fleury A, Noh J, Handali S, Dorny P, Magnussen P, Zulu G, Mwape KE, Bottieau E, Gabriël S, Ngowi BJ, Winkler AS. Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania: a diagnostic accuracy study. THE LANCET. INFECTIOUS DISEASES 2024; 24:98-106. [PMID: 37660709 DOI: 10.1016/s1473-3099(23)00378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/26/2023] [Accepted: 06/12/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Neurocysticercosis is a common cause of epilepsy in Taenia solium-endemic areas in sub-Saharan Africa but is often undiagnosed because of an absence of affordable diagnostic tools. This study evaluated the diagnostic accuracy of a T solium cysticercosis antibody-detecting lateral-flow point-of-care assay (TS POC test) for the neuroimaging-based diagnosis of neurocysticercosis. METHODS Patients with epileptic seizures or severe progressive headache were recruited consecutively from three hospitals in southern Tanzania. All patients were tested with the TS POC test. All patients positive for cysticercosis on the TS POC test and every tenth patient who was negative for cysticercosis received a brain CT examination and underwent reference testing for T solium cysticercosis (ie, rT24H-EITB, LLGP-EITB, and antigen ELISA). The primary outcome of the study was the sensitivity of the TS POC test for the diagnosis of neurocysticercosis. FINDINGS Of the 601 recruited participants, 102 (17%) tested positive for cysticercosis with the TS POC test. Overall, 48 (62%) of the 77 patients positive for cysticercosis and five (17%) of the 29 patients negative for cysticercosis on the TS POC test had CT-confirmed neurocysticercosis. The TS POC test yielded a sensitivity of 49% (uncertainty interval [UI] 41-58) for neurocysticercosis. Sensitivity was similar to that of the rT24H-EITB (44%, UI 37-51) and the antigen ELISA (50%, 43-56). For the subset of neurocysticercosis cases with at least one active (ie, vesicular) lesion, sensitivity was above 98% for the TS POC test, the rT24H-ETIB, and the antigen ELISA. INTERPRETATION The TS POC test showed promising results for the diagnosis of neurocysticercosis in patients with vesicular lesions, which need to be confirmed in a larger study. This test could be considered to support policies on screening patients with suspected neurocysticercosis in clinical settings, which would allow appropriate referral for neuroimaging and early treatment. FUNDING German Federal Ministry of Education and Research and the European & Developing Countries Clinical Trials Partnership. TRANSLATION For the Swahili translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Dominik Stelzle
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Charles E Makasi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; Kilimanjaro Christian Medical University, College of Tumaini University, Moshi, Tanzania
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Inge Van Damme
- Department of Translational Physiology, Infectiology, and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Chiara Trevisan
- Department of Translational Physiology, Infectiology, and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Charlotte Ruether
- Department of Neuroradiology, RoMed Clinic Rosenheim, Rosenheim, Germany
| | - Agnès Fleury
- Department of Genomic Medicine and Environmental Toxicology, Instituto de Investigaciones Biomédicas - UNAM, Ciudad de México, Mexico; Neurocysticercosis Clinic, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Pascal Magnussen
- Department of Microbiology and Immunology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Translational Physiology, Infectiology, and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Bernard J Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
| | - Andrea S Winkler
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, Munich, Germany; Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
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4
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Toribio L, Guzman C, Noazin S, Zimic-Sheen A, Zimic M, Gonzales I, Saavedra H, Pretell EJ, Bustos JA, Handali S, García HH. Multiantigen print immunoassay (MAPIA) for the diagnosis of neurocysticercosis: a single-center diagnostic optimization and accuracy study in Lima, Peru. J Clin Microbiol 2023; 61:e0076023. [PMID: 37966225 PMCID: PMC10729656 DOI: 10.1128/jcm.00760-23] [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: 06/14/2023] [Accepted: 09/21/2023] [Indexed: 11/16/2023] Open
Abstract
Neurocysticercosis (NCC) is the most common helminthic infection of the human central nervous system. The antibody detection assay of choice is the enzyme-linked immunoelectrotransfer blot assay using lentil-lectin purified parasite antigens (LLGP-EITB, Western blot), an immunoassay with exceptional performance in clinical samples. However, its use is mainly restricted to a few research laboratories because the assay is labor-intensive and requires sophisticated equipment, expertise, and large amounts of parasite material for preparation of reagents. We report a new immunoprint assay (MAPIA) that overcomes most of these barriers. We initially compared the performance of five different antigen combinations in a subset of defined samples in the MAPIA format. After selecting the best-performing assay format (a combination of rGP50 + rT24H + sTs14 antigens), 148 archived serum samples were tested, including 40 from individuals with parenchymal NCC, 40 with subarachnoid NCC, and 68 healthy controls with no evidence of neurologic disease. MAPIA using three antigens (rGP50 + rT24H + sTs14) was highly sensitive and specific for detecting antibodies in NCC. It detected 39 out of 40 (97.5%) parenchymal NCC cases and 40/40 (100%) subarachnoid cases and was negative in 67 out of 68 (98.53%) negative samples. MAPIA using three recombinant and synthetic antigens is a simple and economical tool with a performance equivalent to the LLGP-EITB assay for the detection of specific antibodies to NCC. The MAPIA overcomes existing barriers to adoption of the EITG LLGP and is a candidate for worldwide use.
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Affiliation(s)
- L. Toribio
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C. Guzman
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Noazin
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
| | - A. Zimic-Sheen
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - M. Zimic
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - I. Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - H. Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - E. J. Pretell
- Hospital Nacional Alberto Sabogal Sologuren, ESSALUD, Callao, Peru
| | - J. A. Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Handali
- Parasitic Diseases Branch, Division of Parasitic Diseases & Malaria, Center for Global Health, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - H. H. García
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
| | - on behalf of The Cysticercosis Working Group in Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
- Hospital Nacional Alberto Sabogal Sologuren, ESSALUD, Callao, Peru
- Parasitic Diseases Branch, Division of Parasitic Diseases & Malaria, Center for Global Health, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
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5
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Stelzle D, Schmidt V, Keller L, Ngowi BJ, Matuja W, Escheu G, Hauke P, Richter V, Ovuga E, Pfausler B, Schmutzhard E, Amos A, Harrison W, Kaducu J, Winkler AS. Characteristics of people with epilepsy and Neurocysticercosis in three eastern African countries-A pooled analysis. PLoS Negl Trop Dis 2022; 16:e0010870. [PMID: 36342903 PMCID: PMC9639810 DOI: 10.1371/journal.pntd.0010870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. METHODOLOGY We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sites were in Uganda, Malawi and in Tanzania (Dar es Salaam and Haydom). The study in Uganda and Malawi were community-based, the two studies in Tanzania were hospital-based. The same questionnaire was used for assessment of clinical characteristics of patients with epilepsy. Computed tomography (CT) scans and serological testing were performed in order to diagnose NCC. RESULTS Overall, 1,179 people with epilepsy were included in our analysis. Of those, 941 PWE underwent CT scanning and were pooled for NCC analysis. Seventy patients were diagnosed with NCC, but NCC prevalence differed considerably between sites ranging from 2.0% (95%CI 0.4% to 3.6%) in Dar es Salaam to 17.5% (95%CI 12.4% to 22.6%) in Haydom. NCC prevalence did not show any association with sex but increased with age and was higher in rural than urban settings. In addition, being a farmer, non-Muslim, eating pork and living with pigs close by was associated with a higher NCC prevalence. PWE with NCC experienced their first epileptic seizure around 3 years later in life compared to PWE without NCC and their epileptic seizures seemed to be better controlled (p<0.001). There was no difference between focal onset seizures and focal signs on neurological examination in both groups (p = 0.49 and p = 0.92, respectively). The rT24H-EITB had a sensitivity for the detection of NCC of 70% (95% confidence interval [CI] 51 to 84%), the LLGP of 76% (95%CI 58 to 89%) and the antigen ELISA of 36% (95% CI 20 to 55%). CONCLUSIONS NCC is prevalent among PWE in eastern Africa, although it may not be as common as previously stated. Demographic characteristics of PWE with NCC differed from those without NCC, but semiological characteristics and results on neurological examination did not differ compared to PWE without NCC. Interestingly, seizures seemed to be less frequent in PWE with NCC. Being aware of those differences and similarities may help triaging PWE for neuroimaging in order to establish a diagnosis of NCC.
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Affiliation(s)
- Dominik Stelzle
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Luise Keller
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Bernard J. Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
- University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania
| | - William Matuja
- Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gabrielle Escheu
- Department of Neurology, Kliniken Ostallgaeu-Kaufbeuren, Kaufbeuren, Germany
| | - Peter Hauke
- Department of Neurology, Kliniken Ostallgaeu-Kaufbeuren, Kaufbeuren, Germany
| | - Vivien Richter
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Emilio Ovuga
- Department of Mental Health, Gulu University, Gulu, Uganda
| | - Bettina Pfausler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Erich Schmutzhard
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Action Amos
- National Epilepsy Association Malawi, International Bureau of Epilepsy, Lilongwe, Malawi
| | - Wendy Harrison
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | - Andrea S. Winkler
- Center for Global Health, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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6
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Keller L, Stelzle D, Schmidt V, Carabin H, Reinhold AK, Keller C, Welte TM, Richter V, Amos A, Boeckman L, Harrison W, Winkler AS. Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study. PLoS Negl Trop Dis 2022; 16:e0010675. [PMID: 36108075 PMCID: PMC9477368 DOI: 10.1371/journal.pntd.0010675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the proportion of NCC among people with epilepsy (PWE) in a large cross-sectional study in a rural district of southern Malawi.
Methods
We conducted a community-based door-to-door screening study for epileptic seizures in Balaka, Malawi between October and December 2012. Past epileptic seizures were reported through a 15-item questionnaire answered by at least one person per household generating five major criteria. People who screened positive were further examined by a neurologist to establish diagnosis. Patients diagnosed with epilepsy were examined and offered Taenia solium cyst antigen and antibody serological tests, and a CT scan for the diagnosis of NCC.
Results
In total, screening information on 69,595 individuals was obtained for lifetime occurrence of epileptic seizures. 3,100 (4.5%) participants screened positive, of whom 1,913 (62%) could be followed-up and underwent further assessment. Lifetime prevalence was 3.0% (95% Bayesian credible interval [CI] 2.8 to 3.1%) and 1.2% (95%BCI 0.9 to 1.6%) for epileptic seizures and epilepsy, respectively. NCC prevalence among PWE was estimated to be 4.4% (95%BCI 0.8 to 8.5%). A diagnosis of epilepsy was ultimately reached for 455 participants.
Conclusion
The results of this large community-based study contribute to the evaluation and understanding of the burden of epilepsy in the population and of NCC among PWE in sub-Saharan Africa.
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Affiliation(s)
- Luise Keller
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hélène Carabin
- Département de Pathologie et Microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
- Département de médecine sociale et préventive, École de santé publique de l’université de Montréal, Montréal, Canada
- Centre de Recherche en Santé Publique (CReSP) de l’université de Montréal et du CIUSS du Centre Sud de Montréal, Montréal, Canada
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Université de Montréal, Saint-Hyacinthe, Canada
| | - Ann-Kristin Reinhold
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Anaesthesiology, University Hospital Würzburg, Würzburg, Germany
| | - Claudius Keller
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tamara M. Welte
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Vivien Richter
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Action Amos
- National Epilepsy Association Malawi, International Bureau of Epilepsy, School of Health Social Sciences University of Edinburgh, Edinburgh, United Kingdom
| | - Lindsay Boeckman
- The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Wendy Harrison
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- * E-mail:
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7
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Dixon MA, Winskill P, Harrison WE, Whittaker C, Schmidt V, Flórez Sánchez AC, Cucunuba ZM, Edia-Asuke AU, Walker M, Basáñez MG. Global variation in force-of-infection trends for human T aenia solium taeniasis/cysticercosis. eLife 2022; 11:76988. [PMID: 35984416 PMCID: PMC9391040 DOI: 10.7554/elife.76988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/07/2022] [Indexed: 12/01/2022] Open
Abstract
Infection by Taenia solium poses a major burden across endemic countries. The World Health Organization (WHO) 2021–2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified T. solium control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa, and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab-seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab-seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in T. solium transmission rates indicate the need for setting-specific intervention strategies to achieve the WHO goals.
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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, 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.,SCI Foundation, Edinburgh House, 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
| | | | - Charles Whittaker
- 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, 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
| | - 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
| | | | - Zulma M Cucunuba
- 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, 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
| | | | - Martin Walker
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research (LCNTDR), Royal Veterinary College, Hatfield, United Kingdom
| | - María-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, 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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8
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Diaz MM, Sokhi D, Noh J, Ngugi AK, Minja FJ, Reddi P, Fèvre EM, Meyer ACL. Prevalence of Epilepsy, Human Cysticercosis, and Porcine Cysticercosis in Western Kenya. Am J Trop Med Hyg 2022; 106:1450-1455. [PMID: 38223984 PMCID: PMC9128686 DOI: 10.4269/ajtmh.21-0594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/21/2021] [Indexed: 01/16/2024] Open
Abstract
Cysticercosis is the leading cause of acquired epilepsy worldwide and has been shown to be highly prevalent in pig populations in western Kenya. We conducted a community-based door-to-door survey in a region of western Kenya with a high proportion of pig-keeping households. Persons with epilepsy (PWE) were determined using a screening questionnaire followed by a neurologist evaluation. Cysticercosis serum apDia antigen ELISAs and Western blot for LLGP and rT24h antigen were performed on all PWE and 2% of screen-negative patients. All PWE or people with positive apDia underwent contrast-enhanced brain computed tomography (CT). Of a sample of 810 village residents, 660 (81%) were present in the homestead, of whom 648 (98%) participated. Of these, 17 were confirmed to have lifetime epilepsy, an estimated crude prevalence of 2.6%. No humans with (N = 17) or without (N = 12) epilepsy had serological evidence of cysticercosis infection. Fourteen PWE and one individual with borderline positive apDia antigen ELISA underwent brain CT; none had radiographic findings consistent with neurocysticercosis. Nearly 30% of households kept pigs, with 69% always tethered in both wet and dry seasons. More than 8% (6/72) of pigs had palpable lingual cysts; these pigs all originated from homesteads with latrines, one-third of which were free-ranging at least some of the time. Epilepsy prevalence in our study was greater than the national prevalence, but we found no individuals with epilepsy attributable to cysticercosis. Additional studies are required to identify causes of epilepsy, human and porcine cysticercosis, the role of spatial clustering, and protective factors like host-pathogen immunity.
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Affiliation(s)
- Monica M. Diaz
- Yale University, New Haven, Connecticut
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Dilraj Sokhi
- International Livestock Research Institute, Nairobi, Kenya
| | - John Noh
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Prabhakhar Reddi
- Aga Khan University East Africa, Nairobi, Kenya
- Aga Khan Hospital, Kisumu, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- University of Liverpool, Liverpool, United Kingdom
| | - Ana-Claire L. Meyer
- Yale University, New Haven, Connecticut
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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9
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Rahantamalala A, Rakotoarison RL, Rakotomalala E, Rakotondrazaka M, Kiernan J, Castle PM, Hakami L, Choi K, Rafalimanantsoa AS, Harimanana A, Wright P, Grandjean Lapierre S, Schoenhals M, Small PM, Marcos LA, Vigan-Womas I. Prevalence and factors associated with human Taenia solium taeniosis and cysticercosis in twelve remote villages of Ranomafana rainforest, Madagascar. PLoS Negl Trop Dis 2022; 16:e0010265. [PMID: 35404983 PMCID: PMC9064101 DOI: 10.1371/journal.pntd.0010265] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/03/2022] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Infections with the tapeworm Taenia solium (taeniosis and cysticercosis) are Neglected Tropical Diseases (NTD) highly endemic in Madagascar. These infections are however underdiagnosed, underreported and their burden at the community level remains unknown especially in rural remote settings. This study aims at assessing the prevalence of T. solium infections and associated risk factors in twelve remote villages surrounding Ranomafana National Park (RNP), Ifanadiana District, Madagascar. Methodology A community based cross-sectional survey was conducted in June 2016. Stool and serum samples were collected from participants. Tapeworm carriers were identified by stool examination. Taenia species and T. solium genotypes were characterised by PCR and sequencing of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Detection of specific anti-cysticercal antibodies (IgG) or circulating cysticercal antigens was performed by ELISA or EITB/Western blot assays. Principal findings Of the 459 participants with paired stool and blood samples included ten participants from seven distinct villages harbored Taenia spp. eggs in their stools samples DNA sequencing of the cox1 gene revealed a majority of T. solium Asian genotype (9/10) carriage. The overall seroprevalences of anti-cysticercal IgGs detected by ELISA and EITB were quite similar (27.5% and 29.8% respectively). A prevalence rate of 12.4% of circulating cysticercal antigens was observed reflecting cysticercosis with viable cysts. Open defecation (Odds Ratio, OR = 1.5, 95% CI: 1.0–2.3) and promiscuity with households of more than 4 people (OR = 1.9, 95% CI: 1.1–3.1) seem to be the main risk factors associated with anticysticercal antibodies detection. Being over 15 years of age would be a risk factor associated with an active cysticercosis (OR = 1.6, 95% CI: 1.0–2.7). Females (OR = 0.5, 95% CI: 0.3–0.9) and use of river as house water source (OR = 0.3, 95% CI: 0.1–1.5) were less likely to have cysticercosis with viable cysts. Conclusions/Significance This study indicates a high exposure of the investigated population to T. solium infections with a high prevalence of cysticercosis with viable cysts. These data can be useful to strengthen public health interventions in these remote settings. Taenia solium infections in humans (taeniosis and neurocysticercosis) and in pigs (cysticercosis) are endemic in Madagascar presenting a significant public health burden. Neurocysticercosis with localization of the parasite in the Central Nervous System is the most severe and frequent form of parasitic brain diseases in humans and responsible of thousands of worldwide deaths per year. Madagascar is a T. solium endemic country where poor sanitation, free roaming pigs and outdoor defecation are common, and maintain the parasite transmission cycle. Little information is available regarding taeniosis/cysticercosis epidemiology in Madagascar. We carried out a community-based study to investigate the prevalence of human taeniosis/cysticercosis and associated risk factors in 12 rural remote villages of Ranomafana and Kelilalina townships (Ifanadiana district, Madagascar). Our results reveal that in 7/12 villages investigated, a high number of participants had teaniosis. Moreover, a high number of active cysticercosis cases were detected. Open defecation and promiscuity were seemed to be the main risk factors associated to T. solium infections. The results of this study will be useful to guide interventions in these remote settings surrounding the Ranomafana National Park.
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Affiliation(s)
- Anjanirina Rahantamalala
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
- * E-mail:
| | | | - Emma Rakotomalala
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
| | | | - Jaydon Kiernan
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Paul M. Castle
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Lee Hakami
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Koeun Choi
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | | | - Aina Harimanana
- Institut Pasteur de Madagascar, Epidemiology and Clinical Research Unit, Antananarivo, Madagascar
| | - Patricia Wright
- Centre ValBio, Ranomafana, Ifanadiana, Madagascar
- Department of Anthropology, Stony Brook University, Stony Brook, New York, United States of America
| | - Simon Grandjean Lapierre
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Matthieu Schoenhals
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
| | - Peter M. Small
- Centre ValBio, Ranomafana, Ifanadiana, Madagascar
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Luis A. Marcos
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- Division of Infectious Diseases, Department of Medicine, Department of Microbiology and Molecular Genetics, Stony Brook University, Stony Brook, New York, United States of America
| | - Inès Vigan-Womas
- Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar
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10
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Le TTH, Vu-Thi N, Dang-Xuan S, Nguyen-Viet H, Pham-Duc P, Nguyen-Thanh L, Pham-Thi N, Noh J, Mayer-Scholl A, Baumann M, Meemken D, Unger F. Seroprevalence and Associated Risk Factors of Trichinellosis and T. Solium Cysticercosis in Indigenous Pigs in Hoa Binh Province, Vietnam. Trop Med Infect Dis 2022; 7:tropicalmed7040057. [PMID: 35448832 PMCID: PMC9026120 DOI: 10.3390/tropicalmed7040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022] Open
Abstract
Trichinellosis and cysticercosis remain challenges to human health and animal productivity worldwide, especially in developing countries. While information on the occurrence of both diseases is infrequent, they are endemic in parts of Vietnam and mainly related to indigenous pigs kept by ethnic minorities. This study aimed to determine the seroprevalence and risk factors of both diseases in indigenous pigs and explore the perception and awareness of both human and pig trichinellosis and cysticercosis of pig farmers. A total of 352 pig sera samples from 131 holdings were collected and analyzed using ELISA antibody tests in six communes in the Da Bac districts of Hoa Binh province, Vietnam. A survey was conducted with representatives from these households to understand the knowledge and perspective on food-borne parasitic diseases. Overall, the seroprevalence of trichinellosis and T. solium cysticercosis was 13.6% (95% CI 10.2–17.7) and 1.7% (95% CI 0.6–3.7), respectively. The seroprevalence of trichinellosis was significantly higher in female and older pigs. Risk perception and knowledge of interviewed people on both human and pig trichinellosis and cysticercosis of pig farmers was poor. Risky practices, including free roaming of pigs and eating undercooked or fermented pork, were observed. Educational and awareness campaigns aligned with further research on feasible practice changes are critical to addressing these issues.
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Affiliation(s)
- Trang Thi-Huyen Le
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
| | - Nga Vu-Thi
- National Institute of Veterinary Research, Hanoi 100000, Vietnam; (N.V.-T.); (N.P.-T.)
| | - Sinh Dang-Xuan
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
- Correspondence: ; Tel.: +84-09-6981-3048
| | - Hung Nguyen-Viet
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
| | - Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
| | - Luong Nguyen-Thanh
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi 10000, Vietnam; (P.P.-D.); (L.N.-T.)
| | - Ngoc Pham-Thi
- National Institute of Veterinary Research, Hanoi 100000, Vietnam; (N.V.-T.); (N.P.-T.)
| | - John Noh
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA;
| | - Anne Mayer-Scholl
- Federal Institute for Risk Assessment, National Laboratory for Trichinella, 10589 Berlin, Germany;
| | - Maximilian Baumann
- Working Group Meat Hygiene, Institute of Food Safety and Food Hygiene, Freie Universität Berlin, 14163 Berlin, Germany; (M.B.); (D.M.)
| | - Diana Meemken
- Working Group Meat Hygiene, Institute of Food Safety and Food Hygiene, Freie Universität Berlin, 14163 Berlin, Germany; (M.B.); (D.M.)
| | - Fred Unger
- International Livestock Research Institute, Hanoi 100000, Vietnam; (T.T.-H.L.); (H.N.-V.); (F.U.)
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11
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Jiménez L, Castro-Nolasco NK, Fleury A, Díaz-Camacho SP, Ochoa-Sánchez A, Landa A. Evaluation of recombinant glutathione transferase 26 kDa, thioredoxin-1, and endophilin B1 of Taenia solium in the diagnosis of human neurocysticercosis. Acta Trop 2022; 227:106294. [PMID: 34963579 DOI: 10.1016/j.actatropica.2021.106294] [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: 08/07/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/01/2022]
Abstract
Neurocysticercosis caused by Taenia solium larvae is a neglected disease that persists in several countries, including Mexico, and causes a high disability-adjusted life year burden. Neuroimaging tools such as computed tomography and magnetic resonance imaging are the most efficient for its detection, but low availability and high costs in most endemic regions limit their use. Serological methods such as lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot antibody detection and monoclonal antibody-based enzyme-linked immunosorbent assays for HP10 antigen detection have been useful in supporting the diagnosis of this disease. We evaluated three T. solium recombinant antigens: glutathione transferase of 26 kDa (Ts26GST); thioredoxin-1 (TsTrx-1), and endophilin B1 (TsMEndoB1) by EITB. These are antigenic proteins antigenic, abundant in excretion/secretion products of the parasite, and do not cross-react with homologous host proteins. Ts26GST and TsTrx-1 showed sensitivity of 79 and 88%, specificity of 86 and 97%, PPV of 83 and 97% and NPV of 82 and 91%, respectively, for neurocysticercosis diagnosis. The recombinant antigens allowed the diagnosis of 70% (Ts26GST) and 80% (TsTrx-1) of patients having only one cysticercus. Further studies on specific regions of these proteins could improve T. solium diagnostics.
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12
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Hernández-González A, González-Bertolín B, Urrea L, Fleury A, Ferrer E, Siles-Lucas M, Tamarozzi F, Perteguer MJ. Multiple-bead assay for the differential serodiagnosis of neglected human cestodiases: Neurocysticercosis and cystic echinococcosis. PLoS Negl Trop Dis 2022; 16:e0010109. [PMID: 35030166 PMCID: PMC8759687 DOI: 10.1371/journal.pntd.0010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Neurocysticercosis (NCC), and cystic echinococcosis (CE) are two neglected diseases caused by cestodes, co-endemic in many areas of the world. Imaging studies and serological tests are used in the diagnosis of both parasitic diseases, but cross-reactions may confound the results of the latter. The novel multiplex bead-based assay with recombinant antigens has been reported to increases the diagnostic accuracy of serological techniques. METHODOLOGY We set-up an immunoassay based on the multiplex bead-based platform (MBA), using the rT24H (against Cysticercus cellulosae, causing cysticercosis) and r2B2t (against Echinococcus granulosus sensu lato, causing CE) recombinant antigens, for simultaneous and differential diagnosis of these infections. The antigens were tested on 356 sera from 151 patients with CE, 126 patients with NCC, and 79 individuals negative for both diseases. Specificity was calculated including sera from healthy donors, other neurological diseases and the respective NCC or CE sera counterpart. The diagnostic accuracy of this assay was compared with two commercial ELISA tests, Novalisa and Ridascreen, widely used in the routine diagnosis of cysticercosis and CE, respectively. MAIN FINDINGS For the diagnosis of NCC, sensitivity ranged from 57.94-63.49% for the rT24H-MBA, and 40.48-46.03% for Novalisa ELISA depending on exclusion or inclusion of sera having equivocal results on ELISA from the analysis; specificities ranged from 90.87-91.30% and 70.43-76.96%, respectively. AUC values of the ROC curve were 0.783 (rT24H) and 0.619 (Novalisa) (p-value < 0.001). For the diagnosis of CE, the sensitivity of the r2B2t-MBA ranged from 68.87-69.77% and of Ridascreen ELISA from 50.00-57.62%; specificities from 92.47-92.68% and from 74.15-80.98%, respectively. AUC values were 0.717 and 0.760, respectively. CONCLUSIONS/SIGNIFICANCE Overall, the recombinant antigens tested with the bead-based technology showed better diagnostic accuracy than the commercial assays, particularly for the diagnosis of NCC. The possibility of testing the same serum sample simultaneously for the presence of antibodies against both antigens is an added value particularly in seroprevalence studies for cysticercosis linked to control programs in endemic areas where these two parasites coexist.
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Affiliation(s)
- Ana Hernández-González
- Laboratorio de Helmintos, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Belén González-Bertolín
- Laboratorio de Helmintos, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Urrea
- Laboratorio de Helmintos, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Agnes Fleury
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM); México/Instituto Nacional de Neurología and Neurocirugía, Mexico City, Mexico
| | - Elizabeth Ferrer
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales and Agrobiología de Salamanca, Consejo Superior de Investigaciones Científicas (IRNASA-CSIC), Salamanca, Spain
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Maria J. Perteguer
- Laboratorio de Helmintos, Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
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13
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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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14
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Trevisan C, Damme IV, Ngowi B, Schmidt V, Stelzle D, Møller KS, Kabululu M, Makasi CE, Magnussen P, Bottieau E, Abatih E, Johansen MV, Ngowi H, Ndawi B, Mwape KE, Zulu G, Dorny P, Winkler AS, Gabriël S. Trial Design of a Prospective Multicenter Diagnostic Accuracy Study of a Point-of-Care Test for the Detection of Taenia solium Taeniosis and Neurocysticercosis in Hospital-Based Settings in Tanzania. Diagnostics (Basel) 2021; 11:diagnostics11091528. [PMID: 34573870 PMCID: PMC8470609 DOI: 10.3390/diagnostics11091528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/20/2022] Open
Abstract
Taenia solium diagnosis is challenging as trained personnel, good diagnostic tools, and infrastructure is lacking in resource-poor areas. This paper aims to describe the study trial design adopted to evaluate a newly developed rapid point-of-care test that simultaneously detects taeniosis and neurocysticercosis (TS POC) in three district hospitals in Tanzania. The two-stage design included three types of patients: patients with specific neurological signs and symptoms (group 1); patients with complaints compatible with intestinal worm infections (group 2); patients with other symptom(s) (group 3). For group 1, all patients were tested using the TS POC test (stage 1), after which all positive, and a subset of negative, patients were selected for laboratory reference tests, clinical examination, and a brain computed tomography (CT) scan (stage 2). For groups 2 and 3, a similar design was adopted, but clinical examination and a brain CT scan (stage 2) were only performed in patients who were TS POC test-positive for cysticercosis. Due to the lack of a gold standard, a Bayesian approach was used to determine test accuracy for taeniosis and cysticercosis. For neurocysticercosis, a composite case definition was used as the reference standard. If successful, this study will help the future developments (commercialization and implementation) of the rapid test and improve patient management and disease prevention.
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Affiliation(s)
- Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
- Correspondence: (C.T.); (S.G.)
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Bernard Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre Dar es Salaam, Dar es Salaam 11101, Tanzania; (B.N.); (C.E.M.)
- Department of Public Health, University of Dar es Salaam Tanzania, Dar es Salaam 65015, Tanzania
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, 80809 Munich, Germany
| | - Karen Schou Møller
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg, Denmark;
| | - Mwemezi Kabululu
- Tanzania Livestock Research Institute (TALIRI)-Uyole, Mbeya P.O. Box 6191, Tanzania;
| | - Charles E. Makasi
- National Institute for Medical Research, Muhimbili Medical Research Centre Dar es Salaam, Dar es Salaam 11101, Tanzania; (B.N.); (C.E.M.)
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Emmanuel Abatih
- Department of Applied Mathematics, Computer Sciences and Statistics, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium;
| | | | - Helena Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania;
| | | | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.)
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.)
- Eastern Provincial Health Office, Ministry of Health, Lusaka 30205, Zambia
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
- Correspondence: (C.T.); (S.G.)
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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: 18] [Impact Index Per Article: 6.0] [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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Van Damme I, Trevisan C, Mwape KE, Schmidt V, Magnussen P, Zulu G, Mubanga C, Stelzle D, Bottieau E, Abatih E, Phiri IK, Johansen MV, Chabala C, Winkler AS, Dorny P, Gabriël S. Trial Design for a Diagnostic Accuracy Study of a Point-of-Care Test for the Detection of Taenia solium Taeniosis and (Neuro)Cysticercosis in Community Settings of Highly Endemic, Resource-Poor Areas in Zambia: Challenges and Rationale. Diagnostics (Basel) 2021; 11:diagnostics11071138. [PMID: 34206654 PMCID: PMC8306489 DOI: 10.3390/diagnostics11071138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 11/16/2022] Open
Abstract
Field-applicable, high-quality, and low-cost diagnostic tools are urgently needed for Taenia solium. The aim of this paper is to describe the design, challenges, and rationale for the design of a diagnostic accuracy study in low-resource community settings in Zambia. The trial was designed as a prospective study with a two-stage design to evaluate a new point-of-care test (TS POC) for the detection of taeniosis and (neuro)cysticercosis. Participants within randomly selected households were tested with the TS POC test (index test). Participants who tested TS POC positive for taeniosis and/or cysticercosis and a subset of the negatives were requested to give blood and stool samples for reference testing, and to undergo clinical examination and a cerebral CT scan. The difficulties of conducting a clinical trial in settings with limited research and neuroimaging infrastructure as well as peculiarities specifically related to the disease (low prevalence of taeniosis and the lack of a gold standard) were taken into consideration for the design of this study. The two-stage design increased the efficiency of the study by reducing the number of samples, clinical examinations, and CT scans. Simplified flows and sampling processes were preferred over complex follow-up and randomization systems, aiming to reduce bias and increase the generalizability of the study.
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Affiliation(s)
- Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Correspondence: (I.V.D.); (S.G.)
| | - Chiara Trevisan
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Gideon Zulu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
- Ministry of Health, Lusaka 10101, Zambia
| | - Chishimba Mubanga
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | - Dominik Stelzle
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Emmanuel Abatih
- Department of Applied Mathematics, Computer Sciences and Statistics, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Isaac K. Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (K.E.M.); (G.Z.); (I.K.P.)
| | | | - Chishala Chabala
- Paediatrics and Child Health, Children’s Hospital, University Teaching Hospitals, Lusaka 10101, Zambia;
- Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (V.S.); (D.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (C.T.); (C.M.)
- Correspondence: (I.V.D.); (S.G.)
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17
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Gómez-Morales MÁ, Pezzotti P, Ludovisi A, Boufana B, Dorny P, Kortbeek T, Blocher J, Schmidt V, Amati M, Gabriël S, Pozio E, Winkler AS, Participants TRT. Collaborative Studies for the Detection of Taenia spp. Infections in Humans within CYSTINET, the European Network on Taeniosis/Cysticercosis. Microorganisms 2021; 9:1173. [PMID: 34072437 PMCID: PMC8229687 DOI: 10.3390/microorganisms9061173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022] Open
Abstract
Laboratory tools for diagnosing taeniosis/cysticercosis in non-endemic countries are available; however, there is little data on their performance. To provide information on the sensitivity, specificity, and reproducibility of these tools, inter-laboratory studies were organized within the EU COST-Action CYSTINET (TD1302). Two serological and one coprological Ring Trials (RTs) were organized to test a panel of human-derived sera and stool samples using assays routinely conducted by the participating laboratories to detect Taenia spp. infections. Four Western blots (WBs) and five ELISAs were used by nine laboratories for cysticercosis diagnosis. In the first serological RT, the overall sensitivity was 67.6% (95% CI, 59.1-75.4), whereas specificity was 97% (95% CI, 89.8-99.6). WBs recorded the best accuracy. A second serological RT was organized, to assess the three tests most frequently used during the first RT. Two out of six laboratories performed all the three tests. The overall sensitivity and specificity were 52.8% (95% CI, 42.8-62.7) and 98.1% (95% CI, 93.2-99.7), respectively. Laboratory performance strongly affected test results. Twelve laboratories participated in the coprological RT using conventional microscopy and six laboratories used molecular assays. Traditional diagnosis by microscopy yielded better results than molecular diagnosis. This may have been influenced by the lack of standardization of molecular tests across participating laboratories.
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Affiliation(s)
- María Ángeles Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Alessandra Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Belgees Boufana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
- National Reference Laboratory for Trichinella & Echinococcus National Wildlife Management Centre (NWMC) Animal and Plant Health Agency Sand Hutton, York YO41 1LZ, UK
| | - Pierre Dorny
- Veterinary Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerpen, Belgium;
| | - Titia Kortbeek
- Center IDS, National Institute of Public Health and the Environment, RIVM, 3720 Bilthoven, The Netherlands;
| | - Joachim Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria;
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
| | - Marco Amati
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Edoardo Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Andrea Sylvia Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
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Abstract
Pigs act as the intermediate hosts of the zoonotic tapeworms Taenia solium and Taenia asiatica, as well as of the non-zoonotic Taenia hydatigena. In Vietnam, human taeniasis and cysticercosis have been reported throughout the country; however, data on porcine cysticercosis are scarce. Our study aimed to estimate the prevalence of Taenia spp. in slaughtered pigs in two districts in Phu Tho, a mountainous province in northern Vietnam from where neurocysticercosis patients commonly originate. The carcasses of 399 pigs from 51 small-scale abattoirs were checked for cysticerci, while tongue, liver, masseter muscles, diaphragm and heart were sliced and examined. Retrieved cysticerci underwent polymerase chain reaction-restriction fragment length polymorphism and sequencing for species confirmation. Blood was also collected to detect antibodies by lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot (LLGP-EITB) and recombinant T24H antigen (rT24H)-EITB and circulating antigens by B158/B60 Ag-ELISA. In two pigs, T. asiatica cysticerci were found, confirming the presence of the parasite in pigs in Vietnam at a low prevalence (0.5%; 95% exact confidence interval (CI): 0-1.19%). Cysticerci of T. solium were found in none of the pigs, although one serum sample was positive for antibodies in both LLGP-EITB and rT24H-EITB. Furthermore, a high prevalence of T. hydatigena cysticercosis was observed (18.0%; 95% Wilson score CI: 14.6-22.1%). In more than half of the T. hydatigena-positive pigs, circulating antigens were detected by Ag-ELISA, confirming that this test cannot be used to diagnose T. solium cysticercosis in this region. Finally, Spirometra erinaceieuropaei was found in one pig liver. It is the first record of this zoonotic cestode species in pigs in Vietnam. Overall, the findings confirmed the complex epidemiology of Taenia spp. in pigs in Vietnam.
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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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20
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Schmidt V, O’Hara MC, Ngowi B, Herbinger KH, Noh J, Wilkins PP, Richter V, Kositz C, Matuja W, Winkler AS. Taenia solium cysticercosis and taeniasis in urban settings: Epidemiological evidence from a health-center based study among people with epilepsy in Dar es Salaam, Tanzania. PLoS Negl Trop Dis 2019; 13:e0007751. [PMID: 31809501 PMCID: PMC6897529 DOI: 10.1371/journal.pntd.0007751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/05/2019] [Indexed: 01/11/2023] Open
Abstract
In Africa, urbanization is happening faster than ever before which results in new implications for transmission of infectious diseases. For the zoonotic parasite Taenia solium, a major cause of acquired epilepsy in endemic countries, the prevalence in urban settings is unknown. The present study investigated epidemiological, neurological, and radiological characteristics of T. solium cysticercosis and taeniasis (TSCT) in people with epilepsy (PWE) living in Dar es Salaam, Tanzania, one of the fastest growing cities worldwide. A total of 302 PWE were recruited from six health centers in the Kinondoni district of Dar es Salaam. Serological testing for T. solium cysticercosis-antigen (Ag) and -antibodies (Abs) and for T. solium taeniasis-Abs was performed in all PWE. In addition, clinical and radiological examinations that included cranial computed tomography (CT) were performed. With questionnaires, demographic data from study populations were collected, and factors associated with TSCT were assessed. Follow-up examinations were conducted in PWE with TSCT. T. solium cysticercosis-Ag was detected in three (0.99%; 95% CI: 0–2.11%), -Abs in eight (2.65%; 95% CI: 0.84–4.46%), and taeniasis-Abs in five (1.66%; 95% CI: 0.22–3.09%) of 302 PWE. Six PWE (1.99%; 95% CI: 0.41–3.56%) were diagnosed with neurocysticercosis (NCC). This study demonstrates the presence of TSCT in Dar es Salaam, however, NCC was only associated with a few cases of epilepsy. The small fraction of PWE with cysticercosis- and taeniasis-Abs may suggest that active transmission of T. solium plays only a minor role in Dar es Salaam. A sufficiently powered risk analysis was hampered by the small number of PWE with TSCT; therefore, further studies are required to determine the exact routes of infection and risk behavior of affected individuals. Taenia solium cysticercosis and taeniasis is a zoonotic disease complex which affects thousands of people in sub-Saharan Africa. This parasite has a human-pig life cycle and has been considered a public health problem mainly in rural areas. As African towns and suburbs grow rapidly and disproportionally, adequate infrastructure such as sewage systems and clean water often lack while population density, trade, and travel increase. This may lead to the appearance of parasitic diseases formerly considered `rural´ in urban settings. In this study, we searched for evidence of T. solium infections in the Kinondoni district of Dar es Salaam, Tanzania. We focused on people with epilepsy (PWE) since epilepsy is one of the most common and severe disorders associated with T. solium neurocysticercosis and tested all of them serologically for T. solium cysticercosis and taeniasis. We further investigated neurological and radiological characteristics. Our findings show that in our study area in Dar es Salaam 2.65% of PWE had contracted T. solium infection at some stage. Neurocysticercosis, as confirmed by neuroimaging, was found only in 1.99% of PWE. This, in combination with the relatively small number of PWE detected with taeniasis antibodies (1.66%), points towards the fact that active transmission of T. solium seems to play only a minor role in this urban setting, suggesting that infections may mainly be contracted in rural areas. Further large-scale studies are required to investigate the infection pathways and risk behavior related to T. solium infections within urban areas of sub-Saharan Africa.
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Affiliation(s)
- Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- * E-mail:
| | - Marie-Claire O’Hara
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Neurology, Elbe Klinikum Stade, Stade, Germany
| | - Bernard Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- College of Health and Allied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Karl-Heinz Herbinger
- Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - John Noh
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Patricia Procell Wilkins
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Vivien Richter
- Department of Neurology and Epileptology, Evangelical Hospital Alsterdorf, Hamburg, Germany
| | - Christian Kositz
- Department of Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Schwitzerland
| | - William Matuja
- Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Lee C, Noh J, O’Neal SE, Gonzalez AE, Garcia HH, Handali S. Feasibility of a point-of-care test based on quantum dots with a mobile phone reader for detection of antibody responses. PLoS Negl Trop Dis 2019; 13:e0007746. [PMID: 31589612 PMCID: PMC6797214 DOI: 10.1371/journal.pntd.0007746] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/17/2019] [Accepted: 09/03/2019] [Indexed: 01/14/2023] Open
Abstract
We developed a novel and portable fluorescent sensor that integrates a lateral flow assay with a quantum dot (Qdots) label and a mobile phone reader for detection of specific antibodies in human serum. We evaluated the utility of this assay to test for antibodies to the Taenia solium rT24H antigen. It was a retrospective study by examining 112 positive human sera from patients with neurocysticercosis (NCC) including samples from patients with single viable cyst (n = 18), two or more viable cysts (n = 71), and subarachnoid (racemose) cysts (n = 23). These samples were collected from previous study subjects in Lima, Peru under an approved study protocol in Peru. The sera were made anonymous under a protocol approved by the CDC Institutional Review Board. Definitive diagnosis of the subject was established by computed-tomography and/or magnetic resonance imaging. To test the specificity of the assay, we evaluated a panel of serum samples obtained from patients with other infections (n = 24), and serum samples from persons in the United States and Egypt who had not traveled outside their country, and therefore are presumed negative for cysticercosis (n = 128). The assay specificity in the negative panel was 99% (95–100%) while assay sensitivity was 89% (79–95%) in NCC patients with two or more viable cysts. Our assay has performance characteristics similar to those of traditional platforms for the detection of NCC and shows promise as a mobile phone reader-based point-of-care test for antibody detection. Point-of-care (POC) assays are important tools in control and elimination of parasitic diseases such as lymphatic filariasis, malaria, and leishmaniasis. Most POC assays use immunochromatographic and lateral flow assay principles with gold nanoparticles as a reporter. Assays based on gold nanoparticles usually provide qualitative or semi-quantitative results and have relatively low sensitivity. However, other reporter alternatives are available, including quantum dots (Qdots), up-converting phosphor nanoparticles, and superparamagnetic particles. We developed a Qdots-based test in a lateral flow assay format with a mobile phone reader to detect antibody responses, using neurocysticercosis (NCC) as a disease model, and found that the performance is similar to the traditional platform for detecting antibody responses in subjects with NCC. The incorporation of the mobile phone reader offers the advantage of portability and adaptability for use in areas where laboratories are not immediately accessible. This novel POC assay with mobile phone reader is a feasible option for antibody responses detection.
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Affiliation(s)
- Chan Lee
- Medical College of Georgia, AU/UGA Medical Partnership, Athens, Georgia, United States of America
| | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Seth E. O’Neal
- 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, Salamanca de Monterrico, Lima, Peru
| | - Hector H. Garcia
- Department of Microbiology and Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | | | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
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22
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Neurocysticercosis serodiagnosis: mimotope-based synthetic peptide as potential biomarker. Parasitol Res 2019; 118:1657-1660. [DOI: 10.1007/s00436-019-06288-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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Abstract
Neurocysticercosis is the most common helminth infection of nervous system in humans caused by the encysted larvae of Taenia solium. It is a major cause of epilepsy in tropical areas and the most common cause of focal-onset seizures in North Indian children. Children with neurocysticercosis have pleomorphic manifestations depending on the location, number and viability of the cysts and host response. In endemic areas, neurocysticercosis should be clinically suspected in any child with recent-onset seizures, headache or focal motor deficits where there is no other suggestion of an underlying neurological disorder. Diagnosis of neurocysticercosis is essentially based on neuroimaging; visualization of a scolex is diagnostic. Management includes use of cysticidal drugs usually albendazole, which seems to be effective for lesion resolution and seizure remission, use of steroids and anti-epileptic drugs. Single lesions portend good prognosis with resolution of lesions in >60% of the cases within 6 mo and good seizure control. Prognosis is guarded in cysticercus encephalitis, racemose and extraparenchymal neurocysticercosis.
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Affiliation(s)
- Pratibha Singhi
- Pediatric Neurology and Neurodevelopment Unit, Medanta, The Medicity, Gurgaon, Haryana, India.
| | - Arushi Gahlot Saini
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Ng-Nguyen D, Stevenson MA, Breen K, Phan TV, Nguyen VAT, Vo TV, Traub RJ. The epidemiology of Taenia spp. infection and Taenia solium cysticerci exposure in humans in the Central Highlands of Vietnam. BMC Infect Dis 2018; 18:527. [PMID: 30348095 PMCID: PMC6198533 DOI: 10.1186/s12879-018-3434-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vietnam is endemic for taeniasis and T. solium cysticercosis. Despite this, information on the epidemiological characteristics of the diseases in the Central Highlands of Vietnam are poorly described. The aims of this study were to determine the epidemiological characteristics of taeniasis (Taenia spp.) and T. solium cysticerci exposure in humans in Dak Lak province in the Central Highlands, Vietnam. METHODS This cross-sectional study was carried out in six villages in three districts of Dak Lak. A total of 190 households were visited. From each household, between one and five individuals were asked to donate a single faecal and blood sample and respond to a questionnaire. Serum samples were subjected to lentil lectin purified glycoprotein enzyme-linked immunoelectrotransfer blot assay to detect antibodies against T. solium cysticerci. Multiplex real-time PCR was used to detect Taenia spp. infection in faecal samples. A fixed-effects logistic regression model was developed to identify factors associated with the probability of Taenia spp. infection or T. solium cysticerci exposure risk. The contribution of each of identified factor was quantified using population attributable fractions. RESULTS The prevalence of seroexposure to T. solium in Dak Lak was 5% (95% CI 3% to 8%). Consumption of raw vegetables, sourcing drinking water from lakes, streams or ponds and the practice of outdoor defaecation were identified as primary risk factors for the prevalence of T. solium cysticerci exposure, while consuming undercooked pork and beef, pork tongue and observing Taenia proglottids in stool were associated with Taenia spp. infection. Consumption of raw vegetables attributed to 74% of T. solium cysticerci exposure-positive cases and consumption of undercooked beef attributed to 77% of taeniasis cases in these communities. CONCLUSIONS The prevalence of T. solium seroexposure in Dak Lak is consistent with those reported in other regions of Vietnam. The identified risk factors associated with the prevalence of T. solium seroexposure and taeniasis infection in Dak Lak are modifiable and thus advocate for targeted community intervention programs to mitigating these risks.
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Affiliation(s)
- Dinh Ng-Nguyen
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC, 3052, Australia. .,Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam.
| | - Mark Anthony Stevenson
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Kathleen Breen
- Department of Livestock, Montana Veterinary Diagnostic Lab, Bozeman, MT, USA
| | - Trong Van Phan
- Faculty of Medicine and Pharmacy, Tay Nguyen University, Dak Lak, Vietnam
| | - Van-Anh Thi Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Tinh Van Vo
- Department of Physiology, Pathology and Immunology, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Rebecca Justine Traub
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC, 3052, Australia
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25
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Recent Advances in the Diagnosis of Neurocysticercosis. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2018. [DOI: 10.1007/s40506-018-0173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Ng-Nguyen D, Traub RJ, Nguyen VAT, Breen K, Stevenson MA. Spatial distribution of Taenia solium exposure in humans and pigs in the Central Highlands of Vietnam. PLoS Negl Trop Dis 2018; 12:e0006810. [PMID: 30235251 PMCID: PMC6168177 DOI: 10.1371/journal.pntd.0006810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 10/02/2018] [Accepted: 09/01/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Taenia solium, a pork-borne parasitic zoonosis, is the cause of taeniasis and cysticercosis in humans. In Vietnam, poor sanitation, the practice of outdoor defecation and consumption of raw/undercooked pork have been associated with infection/exposure to T. solium in both humans and pigs. The broad-scale geographic distribution of the prevalence of T. solium varies throughout the country with infection restricted to isolated foci in the north and a more sporadic geographic distribution in the Central Highlands and the south. While cross-sectional studies have allowed the broad-scale geographic distribution of T. solium to be described, details of the geographic distribution of T. solium at finer spatial scales have not been described in detail. This study provides a descriptive spatial analysis of T. solium exposure in humans and pigs and T. solium taeniasis in humans within individual households in village communities of Dak Lak in the Central Highlands of Vietnam. METHODOLOGY/PRINCIPAL FINDINGS We used Ripley's K-function to describe spatial dependence in T. solium exposure positive and negative human and pig households and T. solium taeniasis exposure positive and negative households in villages within the districts of Buon Don, Krong Nang and M'Drak of Dak Lak province in the Central Highlands of Vietnam. The prevalence of exposure to T. solium in pigs in Dak Lak province was 9 (95% CI 5 to 17) cases per 1000 pigs at risk. The prevalence of exposure to the parasite in humans was somewhat higher at 5 (95% CI 3 to 8) cases per 100 individuals at risk. Spatial aggregations of T. solium exposure-positive pig and human households occurred in some, but not all of the villages in the three study districts. Human exposure-positive households were found to be aggregated within a distance of 200 to 300 m in villages in Krong Nang district compared with distances of up to 1500 m for pig exposure-positive households in villages in M'Drak district. Although this study demonstrated the aggregation of households in which either T. solium exposure- or taeniasis-positive individuals were present, we were unable to identify an association between the two due to the very low number of T. solium taeniasis-positive households. CONCLUSIONS Spatial aggregations of T. solium exposure-positive pig and human households occurred in some, but not all of the villages in the three study districts. We were unable to definitively identify reasons for these findings but speculate that they were due to a combination of demographic, anthropological and micro-environmental factors. To more definitively identify characteristics that increase cysticercosis risk we propose that cross-sectional studies similar in design to that described in this paper should be applied in other provinces of Vietnam.
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Affiliation(s)
- Dinh Ng-Nguyen
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Rebecca Justine Traub
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Van-Anh Thi Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Kathleen Breen
- Department of Livestock, Montana Veterinary Diagnostic Lab, Bozeman, Montana, United States of America
| | - Mark Anthony Stevenson
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
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Abstract
Neurocysticercosis accounts for approximately 30% of all epilepsy cases in most developing countries. The immunodiagnosis of cysticercosis is complex and strongly influenced by the course of infection, the disease burden, the cyst location, and the immune response of the host. The main approach to immunodiagnosis should thus be to evaluate whether the serological results are consistent with the diagnosis suggested by imaging. Antibody detection is performed using lentil lectin-purified parasite antigens in an enzyme-linked immunoelectrotransfer blot format, while antigen detection uses a monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Promising new assay configurations have been developed for the detection of both antibody and antigen, including assays based on synthetic or recombinant antigens that may reduce costs and improve assay reproducibility and multiplex bead-based assays that may provide simultaneous quantitative results for several target antigens or antibodies.
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28
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Ng-Nguyen D, Noh J, Breen K, Stevenson MA, Handali S, Traub RJ. The epidemiology of porcine Taenia solium cysticercosis in communities of the Central Highlands in Vietnam. Parasit Vectors 2018; 11:360. [PMID: 29929529 PMCID: PMC6014001 DOI: 10.1186/s13071-018-2945-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Taenia solium cysticercosis, recognized as a neglected tropical disease by the WHO, is distributed mostly in developing countries of Latin America, sub-Saharan Africa and Asia. Pigs and humans act as intermediate hosts, acquiring T. solium cysticerci (larval stage) in their tissue, through the ingestion of T. solium eggs shed in the faeces of humans infected with adult tapeworms. The disease has a negative impact on rural economies due to losses in productivity arising from human disease, pork carcass condemnations and loss of market access. The aim of this study was to estimate the prevalence of T. solium cysticercosis in pigs in Dak Lak Province in the Central Highlands of Vietnam and to identify household level characteristics associated with T. solium porcine cysticercosis. METHODS This was a cross-sectional study of household pigs in three districts of Dak Lak Province. A total of 408 households in six villages in three districts were visited between June and October 2015. A questionnaire was administered to the head of each household, and within each household, serum samples were collected from three pigs. Serum samples were analyzed using the recombinant T24H antigen in enzyme-linked immunoelectrotransfer blot assay and lentil lectin purified glycoprotein in EITB assay. A Bayesian, mixed-effects logistic regression model was developed to identify management factors associated with the probability of a household having at least one cysticercosis-positive pig. RESULTS The prevalence of porcine T. solium cysticercosis in this study was low at 0.94 [95% confidence interval (CI) 0.51-1.68] cases per 100 pigs at risk, in agreement with other studies conducted throughout Vietnam. Scavenging of food and coprophagy were associated with T. solium cysticercosis [odds ratios 1.98 (95% CrI: 0.55-4.74) and 2.57 (95% CrI: 1.22-4.66), respectively]. CONCLUSIONS This study proves that the seroprevalence of porcine cysticercosis in Dak Lak Province was as low as that of other studies conducted throughout Vietnam. Scavenging of food and coprophagy are modifiable factors, providing the opportunity to decrease the prevalence of porcine cysticercosis further in the province.
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Affiliation(s)
- Dinh Ng-Nguyen
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia. .,Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Buon Ma Thuot, Dak Lak, Vietnam.
| | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen Breen
- Department of Livestock, Montana Veterinary Diagnostic Lab, Bozeman, Montana, USA
| | - Mark Anthony Stevenson
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Justine Traub
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia
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Moss DM, Handali S, Chard AN, Trinies V, Bullard S, Wiegand RE, Doumbia S, Freeman MC, Lammie PJ. Detection of Immunoglobulin G Antibodies to Taenia solium Cysticercosis Antigen Glutathione- S-Transferase-rT24H in Malian Children Using Multiplex Bead Assay. Am J Trop Med Hyg 2018; 98:1408-1412. [PMID: 29582729 DOI: 10.4269/ajtmh.17-0310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Blood samples from 805 students attending 42 elementary schools in Mopti, Sikasso, and Koulikoro regions, and Bamako district in Mali participated in a school water, sanitation, and hygiene intervention. Immunoglobulin (Ig) G responses to several antigens/pathogens were assessed by a multiplex bead assay (MBA), and the recombinant Taenia solium T24H antigen was included. Of all students tested, 8.0% were positive to rT24H, but in some schools 25-30%. A cluster of 12 widespread school locations showed not only a relative risk of 3.23 for T. solium exposure and significantly higher IgG responses (P < 0.001) but also significantly lower elevation (P = 0.04) (m, above sea level) compared with schools outside the cluster. All schools at elevations < 425 m showed significantly higher IgG responses (P = 0.017) than schools at elevations ≥ 425 m. The MBA is an excellent serological platform that provides cost-effective opportunities to expand testing in serosurveys.
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Affiliation(s)
- Delynn M Moss
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna N Chard
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Victoria Trinies
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Stevan Bullard
- Division Of Toxicology And Human Health Sciences, Geospatial Research, Analysis And Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan E Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Patrick J Lammie
- Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Dermauw V, Carabin H, Cissé A, Millogo A, Tarnagda Z, Ganaba R, Noh J, Handali S, Breen K, Richter V, Cissé R, Preux PM, Boncoeur-Martel MP, Winkler AS, Van Hul A, Dorny P, Gabriël S. Evaluating the Recombinant T24H Enzyme-Linked Immunoelectrotransfer Blot Assay for the Diagnosis of Neurocysticercosis in a Panel of Samples from a Large Community-Based Randomized Control Trial in 60 Villages in Burkina Faso. Am J Trop Med Hyg 2017; 98:565-569. [PMID: 29280427 DOI: 10.4269/ajtmh.17-0541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Current guidelines for the diagnosis of neurocysticercosis (NCC) recommend the use of the lentil lectin-bound glycoprotein enzyme-linked immunoelectrotransfer blot assay (LLGP-EITB) as the reference standard for serological testing. In response to the drawbacks involved with the use of the LLGP-EITB, a recombinant T24H antigen (rT24H) EITB assay was developed, with promising results. However, the test has yet to be evaluated among individuals from sub-Saharan Africa (SSA). The aim of the present study was to investigate the performance of the rT24H EITB assay for the detection of NCC cases in a panel of serum samples (N = 366, of which 173 patients presented with epileptic seizures and/or severe chronic headaches, and 193 matched manifestation-free participants) collected as part of a large community-based trial in Burkina Faso. A perfect agreement between the rT24H EITB and the native gp24 (and its homodimer, gp42) LLGP-EITB was found (kappa value of 1.0). Furthermore, among patients with the neurological manifestations of interest who underwent a computed tomography scan, the rT24H EITB and native antigen LLGP-EITB had a comparable ability to correctly identify NCC cases with multiple viable (rT24H: sensitivity: 80.0%), single viable (66.7%), and calcified/degenerating cysts only (25.0%), albeit for multiple viable and calcified cysts, the rT24H estimated sensitivity seemed lower, but more uncertain, than previously reported. The rT24H EITB specificity was high (98.2%) and in line with previous studies. This study confirms the value of the recombinant rT24H EITB as an alternative to the native antigen LLGP-EITB for the diagnosis of NCC in a SSA community setting.
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Affiliation(s)
- Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hélène Carabin
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Assana Cissé
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | - Athanase Millogo
- Department of Medicine, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - Zékiba Tarnagda
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - John Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen Breen
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vivian Richter
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Rabiou Cissé
- Department of Radiodiagnosis and Medical Imagery, Yalgado Ouedraogo University Hospital Center, Ouagadougou, Burkina Faso
| | - Pierre-Marie Preux
- Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, INSERM, University of Limoges, CHU Limoges, Limoges, France
| | | | - Andrea Sylvia Winkler
- Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Neurology, Center for Global Health, Technical University Munich, Munich, Germany
| | - Anke Van Hul
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Pierre Dorny
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Garcia HH, Castillo Y, Gonzales I, Bustos JA, Saavedra H, Jacob L, Del Brutto OH, Wilkins PP, Gonzalez AE, Gilman RH. Low sensitivity and frequent cross-reactions in commercially available antibody detection ELISA assays for Taenia solium cysticercosis. Trop Med Int Health 2017; 23:101-105. [PMID: 29160912 DOI: 10.1111/tmi.13010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the diagnostic performance of two commercially available ELISA kits, Novalisa® and Ridascreen® , for the detection of antibodies to Taenia solium, compared to serological diagnosis of neurocysticercosis (NCC) by LLGP-EITB (electro-immunotransfer blot assay using lentil-lectin purified glycoprotein antigens). METHODS Archive serum samples from patients with viable NCC (n = 45) or resolved, calcified NCC (n = 45), as well as sera from patients with other cestode parasites (hymenolepiasis, n = 45 and cystic hydatid disease, n = 45), were evaluated for cysticercosis antibody detection using two ELISA kits, Novalisa® and Ridascreen® . All NCC samples had previously tested positive, and all samples from heterologous infections were negative on LLGP-EITB for cysticercosis. Positive rates were calculated by kit and sample group and compared between the two kits. RESULTS Compared to LLGP-EITB, the sensitivity of both ELISA assays to detect specific antibodies in patients with viable NCC was low (44.4% and 22.2%), and for calcified NCC, it was only 6.7% and 4.5%. Sera from patients with cystic hydatid disease were highly cross-reactive in both ELISA assays (38/45, 84.4%; and 25/45, 55.6%). Sera from patients with hymenolepiasis cross-reacted in five cases in one of the assays (11.1%) and in only one sample with the second assay (2.2%). CONCLUSIONS The performance of Novalisa® and Ridascreen® was poor. Antibody ELISA detection cannot be recommended for the diagnosis of neurocysticercosis.
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Affiliation(s)
- Hector H Garcia
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Yesenia Castillo
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Isidro Gonzales
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Javier A Bustos
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Herbert Saavedra
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Louis Jacob
- Faculty of Medicine, University of Paris, Paris, France
| | - Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
| | | | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Robert H Gilman
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gómez-Morales MA, Gárate T, Blocher J, Devleesschauwer B, Smit GSA, Schmidt V, Perteguer MJ, Ludovisi A, Pozio E, Dorny P, Gabriël S, Winkler AS. Present status of laboratory diagnosis of human taeniosis/cysticercosis in Europe. Eur J Clin Microbiol Infect Dis 2017; 36:2029-2040. [PMID: 28669015 PMCID: PMC5653711 DOI: 10.1007/s10096-017-3029-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/23/2017] [Indexed: 11/08/2022]
Abstract
Human cysticercosis (CC) is a parasitic zoonosis caused by the larval stage (cyst) of the Taenia solium. Cysts can establish in the human central nervous system (neurocysticercosis, NCC) and other organs and tissues; they also develop in pigs, the natural intermediate host. Human taeniosis may be caused by T. solium, Taenia saginata and Taenia asiatica tapeworms; these infections are usually asymptomatic, but show a significant relevance as they perpetuate the parasites’ life cycle, and, in the case of T. solium, they are the origin of (N)CC. In European Union (EU) member states and associated countries, the occurrence of autochthonous T. solium cases is debated, and imported cases have significantly increased lately; the status of T. asiatica has been never reported, whereas T. saginata is prevalent and causes an economic impact due to condemned carcasses. Based on their effects on the EU society, the specific diagnosis of these pathologies is relevant for their prevention and control. The aims of this study were to know the diagnostic tests used in European laboratories for human taeniosis/cysticercosis by means of a questionnaire, to determine potential gaps in their detection, and to obtain preliminary data on the number of diagnosed taeniosis/CC cases.
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Affiliation(s)
- M A Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy.
| | - T Gárate
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain.
| | - J Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - B Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - G S A Smit
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.,Faculty of Veterinary Medicine, Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.,Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - V Schmidt
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - M J Perteguer
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain
| | - A Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - E Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - P Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - S Gabriël
- Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Ghent University, Ghent, Belgium
| | - A S Winkler
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany. .,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway.
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Affiliation(s)
- Jennifer M Boland
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, United States.
| | - Bobbi S Pritt
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
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Hernández-González A, Noh J, Perteguer MJ, Gárate T, Handali S. Comparison of T24H-his, GST-T24H and GST-Ts8B2 recombinant antigens in western blot, ELISA and multiplex bead-based assay for diagnosis of neurocysticercosis. Parasit Vectors 2017; 10:237. [PMID: 28506245 PMCID: PMC5433036 DOI: 10.1186/s13071-017-2160-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/25/2017] [Indexed: 01/16/2023] Open
Abstract
Background Currently, the reference standard assay for the serodiagnosis of neurocysticercosis (NCC) is the lentil lectin-bound glycoproteins/enzyme-linked immunoelectrotransfer blot (LLGP-EITB). The main disadvantage of this technique is the complexity of obtaining and purifying the LLGP extract. This could be solved by replacement with highly specific recombinant antigens from Taenia solium. Based on previous studies, we selected and produced the recombinant Ts8B2 and T24H proteins and applied them to three diagnostic techniques: western blot (WB), enzyme-linked immunosorbent assay (ELISA) and the multiplex bead-based assay (MBA). Methods The Ts8B2 and T24H cDNA sequences were expressed in a prokaryotic system and the corresponding expression products purified; three recombinant proteins were further characterized: T24H-his, GST-T24H and GST-Ts8B2. The proteins on WB, ELISA and MBA were tested against 149 sera from patients with NCC confirmed by brain imaging, 40 sera from patients with other parasitic diseases, and 131 sera from US. individuals without evidence of neurocysticercosis (clinical/serological/brain imaging). The sensitivity and specificity of each antigen by WB were calculated by counting the number of true positive, false positive, true negative and false negative results. Using the receiver operating characteristic (ROC) curves, the cut-off values for the ELISA and MBA were established as well as the sensitivity and specificity of each assay. Results All three antigens showed a high sensitivity on WB in active NCC cases with two or more viable cysts and low sensitivity for cases with single viable cyst or calcified lesions and inactive NCC. WB showed the highest specificity and sensitivity out of the three diagnostic techniques. The recombinant T24H-his was the best diagnostic reagent in WB (100% sensitivity, 99.4% specificity), exhibiting similar results to the LLGP-EITB, against the same panel of NCC sera. The GST-T24H antigen worked better than the others in ELISA and MBA protocols (88.3 and 96.1% sensitivity, respectively and 96.5% specificity). Conclusions The sensitivity and specificity that we obtained were similar to results from a previous study using a similar recombinant antigen (rT24H), suggesting that recombinant antigens may be good alternatives to crude extracts in a variety of diagnostic techniques. Furthermore, these antigens can be applied in the development of point-of-care tests which would be useful in NCC field studies.
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Affiliation(s)
- Ana Hernández-González
- Helminth Unit, Parasitology Department, Centro Nacional de Microbiología, Instituto de Salud Carlos III , Crtra. Majadahonda-Pozuelo, km 2.2, 28220, Majadahonda, 28220, Madrid, Spain.
| | - John Noh
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, 30329, GA, USA
| | - María Jesús Perteguer
- Helminth Unit, Parasitology Department, Centro Nacional de Microbiología, Instituto de Salud Carlos III , Crtra. Majadahonda-Pozuelo, km 2.2, 28220, Majadahonda, 28220, Madrid, Spain
| | - Teresa Gárate
- Helminth Unit, Parasitology Department, Centro Nacional de Microbiología, Instituto de Salud Carlos III , Crtra. Majadahonda-Pozuelo, km 2.2, 28220, Majadahonda, 28220, Madrid, Spain
| | - Sukwan Handali
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, 30329, GA, USA
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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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Association between Taenia solium infection and HIV/AIDS in northern Tanzania: a matched cross sectional-study. Infect Dis Poverty 2016; 5:111. [PMID: 27903304 PMCID: PMC5131417 DOI: 10.1186/s40249-016-0209-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 11/07/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The frequency of Taenia solium, a zoonotic helminth, is increasing in many countries of sub-Saharan Africa, where the prevalence of the human immunodeficiency virus (HIV) is also high. However, little is known about how these two infections interact. The aim of this study was to compare the proportion of HIV positive (+) and negative (-) individuals who are infected with Taenia solium (TSOL) and who present with clinical and neurological manifestations of cysticercosis (CC). METHODS In northern Tanzania, 170 HIV+ individuals and 170 HIV- controls matched for gender, age and village of origin were recruited. HIV staging and serological tests for TSOL antibodies (Ab) and antigen (Ag) were performed. Neurocysticercosis (NCC) was determined by computed tomography (CT) using standard diagnostic criteria. Neurological manifestations were confirmed by a standard neurological examination. In addition, demographic, clinical and neuroimaging data were collected. Further, CD4+ cell counts as well as information on highly active antiretroviral treatment (HAART) were noted. RESULTS No significant differences between HIV+ and HIV- individuals regarding the sero-prevalence of taeniosis-Ab (0.6% vs 1.2%), CC-Ab (2.4% vs 2.4%) and CC-Ag (0.6% vs 0.0%) were detected. A total of six NCC cases (3 HIV+ and 3 HIV-) were detected in the group of matched participants. Two individuals (1 HIV+ and 1 HIV-) presented with headaches as the main symptom for NCC, and four with asymptomatic NCC. Among the HIV+ group, TSOL was not associated with CD4+ cell counts, HAART duration or HIV stage. CONCLUSIONS This study found lower prevalence of taeniosis, CC and NCC than had been reported in the region to date. This low level of infection may have resulted in an inability to find cross-sectional associations between HIV status and TSOL infection or NCC. Larger sample sizes will be required in future studies conducted in that area to conclude if HIV influences the way NCC manifests itself.
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Lightowlers MW, Garcia HH, Gauci CG, Donadeu M, Abela-Ridder B. Monitoring the outcomes of interventions against Taenia solium: options and suggestions. Parasite Immunol 2016; 38:158-69. [PMID: 26538513 PMCID: PMC4819694 DOI: 10.1111/pim.12291] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 10/26/2015] [Indexed: 11/27/2022]
Abstract
There is an increasing interest in reducing the incidence of human neurocysticercosis, caused by infection with the larval stage of Taenia solium. Several intervention trials are currently assessing various options for control of T. solium transmission. A critical aspect of these trials will be the evaluation of whether the interventions have been successful. However, there is no consensus about the most appropriate or valuable methods that should be used. Here, we undertake a critical assessment of the diagnostic tests which are currently available for human T. solium taeniasis and human and porcine cysticercosis, as well as their suitability for evaluation of intervention trial outcomes. Suggestions are made about which of the measures that are available for evaluation of T. solium interventions would be most suitable, and which methodologies are the most appropriate given currently available technologies. Suggestions are also made in relation to the most urgent research needs in order to address deficiencies in current diagnostic methods.
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Affiliation(s)
- M W Lightowlers
- Veterinary Clinical Centre, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic., Australia
| | - H H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.,Department of Microbiology, School of Sciences, Centre for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C G Gauci
- Veterinary Clinical Centre, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic., Australia
| | - M Donadeu
- Veterinary Clinical Centre, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic., Australia
| | - B Abela-Ridder
- Department of Control of Neglected Tropical Diseases, World Health Organization, Genève 27, Switzerland
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Singhi P, Saini AG. Pediatric neurocysticercosis: current challenges and future prospects. Pediatric Health Med Ther 2016; 7:5-16. [PMID: 29388588 PMCID: PMC5683283 DOI: 10.2147/phmt.s79058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Neurocysticercosis (NCC) is an acquired infection of the nervous system caused by encysted larvae of Taenia solium. It is a major cause of epilepsy in the tropics and the commonest cause of focal seizures in North Indian children. T. solium teniasis-cysticercosis is considered a parasitic "Neglected Tropical Diseases" endemic throughout Southeast Asia. NCC in children has pleomorphic manifestations depending on the location, number and viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.
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Affiliation(s)
- Pratibha Singhi
- Department of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Gahlot Saini
- Department of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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