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Background: The lack of cheap, easy-to-use, rapid diagnostic tests has led to the development of several rapid diagnostic tests for taeniosis and cysticercosis, such as the new prototype two-strip, Taenia solium point of care test (TS-POC), developed by the Centers for Disease Control and Prevention (Atlanta, USA) and the Technical University of Munich (Germany). It detects antibodies against taeniosis (TS-POC T) and cysticercosis (TS-POC CC). The objective of this study was to evaluate the performance of the TS POC for taeniosis and cysticercosis diagnosis in a community setting. Methods: A community-based study was conducted in Sinda district, Eastern Province, Zambia. A sample of 1254 randomly-recruited participants was tested with the TS-POC. All TS-POC test-positive, and 20% of test-negative participants were selected for stool and serum sampling. Reference tests included; recombinant rES33 enzyme-linked immune-electro-transfer blot (rES33 EITB), copro polymerase chain reaction (copro-PCR), and copro antigen enzyme-linked immunosorbent assay (Copro-Ag ELISA) for taeniosis, the lentil-lectin glycoprotein EITB (LLGP EITB), recombinant T24H EITB (rT24H EITB), and the serum B60/158 ELISA (Serum-Ag ELISA) for cysticercosis. Performance characteristics were estimated using a Bayesian approach with probabilistic constraints. Results: In total, 1254 participants were tested with 1249 giving a valid TS-POC test. Thirteen, tested positive for taeniosis while 1236 tested negative using the TS-POC T. For cysticercosis, 177 tested positive while 1072 tested negative. Based on 161 participants with complete data, the estimated sensitivity and specificity for the TS-POC T test were 38% (95% CI: 5-93%) and 99% (95% CI: 98-100%), respectively. For cysticercosis, 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. Conclusion: We highlight the challenge of high variability in the number of positive cases detected and discordance of test results among T. solium taeniosis reference tests and recommend multi-testing and further investigation on the test combination that gives the best diagnostic performance during diagnostic evaluation. Diagnostic performance needs to be improved potentially by bench marking antigen concentration in the strip against existing cysticercosis tests such as the LLGP and rT24HEITB. [ABSTRACT FROM AUTHOR]

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. • Taenia solium taeniasis/cysticercosis is the most frequent cause of acquired seizures and epilepsy, accounting for 30% of seizure disorders in wide endemic areas across the world • To diagnose and manage NCC requires to understand its diverse presentations. Neuroimaging and serology should be interpreted in the context of each disease type and stage • Parenchymal cysts establish and later degenerate and disappear or calcify. Extraparenchymal cysts grow and infiltrate neighboring spaces, with mass effects and intracranial hypertension. • NCC diagnosis rests in neuroimaging and serological confirmation. Ideally, both should be made available and their correlations or discrepancies should be carefully interpreted. • Symptomatic management is the first step. Antiparasitic treatment resolves extraparenchymal NCC, avoiding disease progression. Resolution of intraparenchymal cysts results in fewer seizure relapses. [ABSTRACT FROM AUTHOR]