Why are tapeworm carriers so difficult to find? A methodological proposal for their search and recovery

Neurocysticercosis, caused by the larval stage of Taenia solium, is a life-threatening condition and the most severe form of the disease. Yet, despite being a required link in the parasite life cycle, tapeworm carriers are rarely reported. This study is aimed to find and evaluate T. solium carriers, describing some characteristics of these patients and the treatment. Taeniasis cases were searched for in various Mexican states from 1983 to 2016. Previous informed consent, tapeworm-carrier patients were administered with niclosamide and a saline purge. Parasite specimens were recovered and identified, both morphologically and by PCR. From 117 treated patients, Taenia sp. specimens were obtained from 46 subjects (47.8%). From these, complete parasites were recovered from 42 (90.5%), and only detached proglottids from 4 patients. Cases were more frequent in Morelos, Chiapas, and Guerrero. More than one adult cestode was recovered from 4 patients (9.5%). To improve treatment efficacy and adherence, the drug was administered in late afternoon, resulting a high recovery yield of complete parasites (90.5%). The success rate of deworming campaigns in areas of Mexico and the world that are endemic for Taenia sp. could be improved by administering the treatment at times that do not interfere with the patients' daily activities, and national health authorities could apply this simple strategy to help eradication efforts in endemic areas. The detection of carriers will only be possible through the coordinated efforts of public and private health services, a better education of the general population to improve self-detection, and adequate, personalized diagnostic procedures for suspect cases.

Taenia solium taeniasis/cysticercosis: From parasite biology and immunology to diagnosis and control

Infection with the pork tapeworm (Taenia solium) is responsible for a substantial global burden of disease, not only restricted to its impact on human health, but also resulting in a considerable economic burden to smallholder pig farmers due to pig cysticercosis infection. The life-cycle, parasitology and immunology of T. solium are complex, involving pigs (the intermediate host, harbouring the larval metacestode stage), humans (the definitive host, harbouring the adult tapeworm, in addition to acting as accidental intermediate hosts) and the environment (the source of infection with eggs/proglottids). We review the parasitology, immunology, and epidemiology of the infection associated with each of the T. solium life-cycle stages, including the pre-adult/adult tapeworm responsible for human taeniasis; post-oncosphere and cysticercus associated with porcine and human cysticercosis, and the biological characteristics of eggs in the environment. We discuss the burden associated, in endemic settings, with neurocysticercosis (NCC) in humans, and the broader cross-sectoral economic impact associated both with NCC and porcine cysticercosis, the latter impacting food-value chains. Existing tools for diagnostics and control interventions that target different stages of the T. solium transmission cycle are reviewed and their limitations discussed. Currently, no national T. solium control programmes have been established in endemic areas, with further work required to identify optimal strategies according to epidemiological setting. There is increasing evidence suggesting that cross-sectoral interventions which target the parasite in both the human and pig host provide the most effective approaches for achieving control and ultimately elimination. We discuss future avenues for research on T. solium to support the attainment of the goals proposed in the revised World Health Organisation neglected tropical diseases roadmap for 2021-2030 adopted at the 73rd World Health Assembly in November 2020.

Effect of mice Taenia crassiceps WFU cysticerci infection on the ovarian folliculogenesis, enzyme expression, and serum estradiol

The murine infection with Taenia crassiceps WFU (T. crassiceps WFU) cysticerci has been widely used as an experimental model to better understand human cysticercosis. Several reports have established that the host hormonal environment determines the susceptibility and severity of many parasite infections. Female mice are more susceptible to infection with T. crassiceps cysticerci suggesting that a rich estrogen environment facilitates their reproduction. Ovarian androgens and estrogens are synthesized by key enzymes as P450-aromatase and 17α-hydroxilase/17, 20 lyase (P450_C17). The aim of this study was to determine the effect of chronic intraperitoneal infection of T. crassiceps WFU cysticerci on mice ovarian follicular development, ovulation, the expression of ovarian P450-aromatase and P450_C17, and serum 17β-estradiol, key enzymes of the ovarian steroidogenic pathway. To perform this study ovaries and serum were obtained at two, four and six months from T. crassiceps WFU cysticerci infected mice, and compared to those of healthy animals. The ovaries were fixed and processed for histology or lysed in RIPA buffer for Western blot using specific antibodies for P450_C17 and P450-aromatase. 17β-estradiol serum concentration was measured by ELISA. The results showed that the infection with T. crassiceps WFU cysticerci significantly reduced the number of primordial and primary follicles after two months of infection. Through the course of the study, the corpus luteum number began to decrease, whereas atretic follicles increased. The expression of ovarian P450_C17 and P450-aromatase as well as serum E2 concentration were significantly increased in the infected group compared to control. These findings show that chronic infection with Taenia crassiceps WFU may alter the reproductive functions of the female mice host.