Seroprevalence and risk factors of porcine cysticercosis: A cross-sectional study in Indonesia

Background and Aim:

Cysticercosis is a zoonotic disease with a global concern. Estimation of the prevalence and identification of potential risk factors are necessary for the prevention and control of the disease. This study aimed to estimate the seroprevalence of cysticercosis and the correlation of the increased prevalence with several potential risk factors.

Materials and Methods:

The seroprevalence of cysticercosis was conducted using an enzyme-linked immunosorbent assay (ELISA), developed by the Institute of Tropical Medicine Antwerp, to detect Cysticercus cellulosae. This study used serum samples from 62 pigs taken from two regencies on Timor Island. The data analysis was performed using SPSS software 20.0 (IBM Corp., NY, USA) to evaluate ELISA results and the strength of the relationship between risk factors and the prevalence of disease using the odds ratio (OR).

Results:

Serum samples from 18 out of the 62 pigs were found to be positive; the seroprevalence of cysticercosis was 29%. The results showed that an extensive farming system led to a higher prevalence of cysticercosis compared to an intensive farming system, namely, 10 out of 18 (56.6%), and that the possibility of identifying cysticercosis in pigs in an extensive farming system was 5 times greater than that in pigs in an intensive farming system. In addition, the results showed that nine out of 18 households who did not have toilet facilities were found to be seropositive, indicating a significant relationship between the risk factor of toilet availability with cysticercosis in pigs, with an OR of 4.5. In addition, the results showed that there was no significant relationship between the risk factor of the feed source and the prevalence of cysticercosis in pigs.

Conclusion:

It can be concluded that the seroprevalence of cysticercosis was 29% in domestic pigs of Timor Island. The risk factors of an extensive pig farming system andtoilet availabilityin community houses were significantly related to the possibility of cysticercosis on Timor Island.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in East, Southeast and South Asia

BACKGROUND

Taenia saginata is an important zoonotic parasite, causing taeniosis in humans and cysticercosis in bovines, the latter being a significant concern for the global beef industry. Many countries in East, Southeast and South Asia are experiencing rapid economic growth, and an increasing number of people in these countries are dependent on the livestock industry. Currently, however, an overview of the prevalence of T. saginata in this region is lacking. In this review, we analysed the available literature on T. saginata taeniosis and bovine cysticercosis for East, Southeast and South Asia.

METHODS

A systematic review was conducted, based on both published and grey literature. Articles published between 1990 and 2017 were mined for information on the occurrence, prevalence, and geographical distribution of T. saginata taeniosis and bovine cysticercosis in East, Southeast and South Asia.

RESULTS

The presence of T. saginata was described in 15 of 27 countries of the region, including Afghanistan, Cambodia, China, India, Indonesia, Japan, Lao PDR, Malaysia, Mongolia, Nepal, Pakistan, Philippines, South Korea, Thailand and Vietnam. The only country that reported an absence of T. saginata is Japan, although sporadic reports of imported cases and unconfirmed reports of autochthonous infections were identified. Nationwide surveys of taeniosis with systematic sample collection and high sample numbers were available for Cambodia, China, Lao PDR, and South Korea, although speciation of Taenia was not always performed. Regional prevalence of taeniosis and bovine cysticercosis in endemic regions ranged between 0.02-42.6%, and 0.76-46.7%, respectively. However, data for bovine cysticercosis were only available for five countries (Japan, Lao PDR, Mongolia, Pakistan and Vietnam).

CONCLUSIONS

The data indicate a widespread occurrence of T. saginata throughout East, Southeast and South Asia. Identification of Taenia spp. in human infections was frequently not performed, leading to gaps in knowledge about the distribution of human tapeworm infections, mainly in regions where different human Taenia species co-occur. A high prevalence of T. saginata taeniosis and bovine cysticercosis may reflect insufficiencies in sanitation, limited health education standards, and insufficient food safety measures. Therefore, there is a need to improve local surveillance, notification, and overall control systems.

Current Status of Parasite Infections in Indonesia: A Literature Review

Indonesia and South Korea have become inseparable in various respects since the 2 countries established diplomatic relation in 1973. Indonesia is a tropical region that stretches across the equator, comprised of 5 main islands (Java, Kalimantan, Sumatra, Sulawesi, and Papua) and 4 archipelagoes (Riau, Bangka Belitung, Nusa Tenggara, and Maluku). As most population of Eastern Indonesia (Sulawesi, Papua and Nusa Tenggara & Maluku) live in poor areas, it is expected that there will be many parasites. Nevertheless, little is known about the status of parasites in Indonesia. This study examines the prevalences of malaria and lymphatic filaria, which are prevalent in Indonesia, as well as those of soil-transmitted-helminths (STH). As a result, the Plasmodium falciparum and P. vivax case loads are almost equal. The current prevalence of P. vivax is uniformly low (<5%) in all age groups and annual parasite incidence (API) showed decreasing tendency as 0.84 per 1,000 population in 2016. However, more than 65 million people still live in malaria epidemic regions. Lymphatic filariasis remains an important public health problem and 236 cities were classified as endemic areas in 514 cities/districts in 2017. It is difficult to ascertain the current prevalence rate of STH in Indonesia, although West Sumba and Southwest Sumba in East Nusa Tenggara reported prevalence rate of more than 20%. The study also considers the (sero) prevalences of other parasites identified in Indonesia. This report should be useful not only to parasitologists but also to travelers and people with business in Indonesia.

Towards a cysticercosis-free tropical resort island: A historical overview of taeniasis/cysticercosis in Bali

Taeniasis and cysticercosis are known to be endemic in several Indonesian islands, although relatively little recent epidemiological data are available. As most Indonesian people are Muslims, taeniasis/cysticercosis caused by the pork tapeworm, Taenia solium, has a restricted presence in non-Muslim societies and is endemic only among some Hindu communities on the island of Bali. Bali has long been known to be endemic for taeniasis/cysticercosis; almost a century ago levels of cysticercosis of 20-30% were described in cattle and 2-3% in pigs. Few studies of taeniasis/cysticercosis were undertaken in Bali prior to a series of research programs commenced since the 1990s. Both Taenia saginata and T. solium continue to be endemic in Bali. Molecular studies have revealed that all T. saginata-like tapeworms detected in Bali are T. saginata. No evidence has been found for the presence of Taenia asiatica in Bali. Economic, sanitary and education improvements across much of the island over the past decades have been associated with a decline in the amount of transmission of T. solium such that the parasite now seems to be restricted to the eastern part of the island, a small area on the northeastern slope of Mt. Agung, the highest mountain in Bali. The living environment including sanitation and hygiene condition in this endemic area remains relatively poor especially during the half-year dry season, and pigs continue to roam freely. In this review, historical records and ongoing projects towards elimination of taeniasis/cysticercosis in Bali are reviewed to provide a better understanding of the present situation of taeniasis/cysticercosis in Bali towards a future, cysticercosis-free tropical resort island.

Cysticercosis/taeniasis endemicity in Southeast Asia: Current status and control measures

The parasitic zoonoses cysticercosis/taeniasis is among the 17 major Neglected Tropical Diseases (NTDs) identified by the WHO as a focus for research and control. It is caused by a larval stage (cysticercus) infection of Taenia solium tapeworm in both humans and pigs. Cysticercosis occurs in many resource-poor countries, especially those with warm and mild climates in the regions of Latin America (LA), Asia and Sub-Saharan Africa (SSA). The prevalence of human cysticercosis is marked in those areas where individuals are traditionally keen to consume raw or insufficiently cooked pork and/or where the husbandry of pigs is improper. The worldwide burden of cysticercosis is unclear and notably, large-scale control initiatives are lacking in all regions. This review focuses on the current endemic status of cysticercosis caused by T. solium infection in both humans and pigs living in 13 Southeast Asian countries. We will also emphasize epidemiological data as well as prevention and control of human neurocysticercosis.

The present situation and towards the prevention and control of neurocysticercosis on the tropical island, Bali, Indonesia

Neurocysticercosis (NCC), which is caused by accidental ingestion of eggs of the pork tapeworm, Taenia solium, was common in Bali, Indonesia until the early 1990s. However, improved education on hygiene and sanitation, a move to keeping pigs indoors, and improvement of economic and living conditions have substantially reduced the occurrence of NCC in Bali. Since 2011, T. solium tapeworm carriers (T. solium taeniasis) and heavily infected pigs and dogs have exclusively been detected from villages in mountainous regions of northeastern Bali where NCC and ocular cysticercosis (OCC) cases have also been identified. In response to this continued area of high infection, a one-day workshop was convened to discuss how to prevent and control this potentially lethal zoonotic parasitic infection in Bali. This review presents an overview of the current status of T. solium taeniasis and cysticercosis in Indonesia and proposes a strategy for the prevention and control of this zoonosis in Bali.

Taeniases and cysticercosis in Indonesia: past and present situations

The main aim of this study is to overview the past and present situations of human taeniases and cysticercosis in Indonesia and including future perspectives. Through joint projects from 1996, we have confirmed the occurrence ofTaenia saginata(beef tapeworm) in Bali, ofTaenia solium(pork tapeworm) mainly in Papua and sporadically in Bali, and ofTaenia asiaticain North Sumatra. These taeniases were caused through eating uncooked pork and pig viscera forT. soliumandT. asiatica, respectively, and beef forT. saginata. The distribution of these tapeworms in Indonesia is basically highly restricted by the traditional cultural and religious backgrounds in each island.T. saginatais relatively common in Bali although people consume pork ‘lawar’more than beef ‘lawar’. Taeniases due toT. saginataorT. asiaticaandT. soliumand cysticercosis due toT. soliumhave also been sporadically reported in some other islands. Among these species,T. soliumis exceptional since humans can be infected not only by larval stages (cysticerci) in pork but also by eggs released from human tapeworm carriers. Cysticercosis has been confirmed in Indonesia in humans, pigs and even dogs.

Comparison of the usefulness of hydatid cyst fluid, native antigen B and recombinant antigen B8/1 for serological diagnosis of cystic echinococcosis

For serodiagnosis of cystic echinococcosis (CE), the usefulness of three native antigens, a hydatid cyst fluid (HCF) obtained from infected sheep in China, two types of antigen B prepared from each HCF obtained in Iran and China, and one recombinant antigen B8/1 (RAgB), were evaluated by ELISA using a total of 155 serum samples from Iran, Turkey, China and Japan. Both the Iranian native antigen B and RAgB had high sensitivity, but RAgB showed an excellent specificity in comparison with native antigens because none of the serum samples of healthy people from Iran and Japan became positive with this antigen except one case of taeniasis. The taeniasis case exceptionally showing cross reactivity with all antigens was considered to be co-infected with Echinococcus granulosus and Taenia saginata. The recombinant antigen showing a high diagnostic odds ratio in comparison with other evaluated antigens might be recommended for diagnosis of CE in different CE-endemic areas.

The first workshop towards the control of cestode zoonoses in Asia and Africa

The first workshop towards the control of cestode zoonoses in Asia and Africa was held in Asahikawa Medical University, Japan on 15 and 16 Feb 2011. This meeting was fully supported by the Asian Science and Technology Strategic Cooperation Promotion Programs sponsored by the Special Coordination Funds for Promoting Science and Technology, the Ministry of Education Japan (MEXT) for 3 years from 2010 to Akira Ito. A total of 24 researchers from 9 countries joined together and discussed the present situation and problems towards the control of cestode zoonoses. As the meeting was simultaneously for the establishment of joint international, either bilateral or multilateral collaboration projects, the main purposes were directed to 1) how to detect taeniasis/cysticercosis infected patients, 2) how to differentiate Taenia solium from two other human Taenia species, T. saginata and T. asiatica, 3) how to evaluate T. asiatica based on the evidence of hybrid and hybrid-derived adult tapeworms from Thailand and China, 4) how to evaluate T. solium and T. hyaenae and other Taenia species from the wild animals in Ethiopia, and 5) how to detect echinococcosis patients and 6) how to differentiate Echinococcus species worldwide. Such important topics are summarized in this meeting report.