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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

PurposeNeurocysticercosis is common in regions endemic for Taenia solium. Active-stage neurocysticercosis can be treated with antiparasitic medication, but so far no study on efficacy and safety has been conducted in Africa.MethodsWe conducted a prospective cohort study on treatment of neurocysticercosis in Tanzania between August 2018 and January 2022. Patients were initially treated with albendazole (15 mg/kg/d) for 10 days and followed up for 6 months. Additionally in July 2021, all participants who then still had cysts were offered a combination therapy consisting of albendazole (15 mg/kg/d) and praziquantel (50 mg/kg/d). Antiparasitic treatment was accompanied by corticosteroid medication and anti-seizure medication if the patient had experienced epileptic seizures before treatment.ResultsSixty-three patients were recruited for this study, of whom 17 had a complete follow-up after albendazole monotherapy. These patients had a total of 138 cysts at baseline, of which 58 (42%) had disappeared or calcified by the end of follow-up. The median cyst reduction was 40% (interquartile range 11-63%). Frequency of epileptic seizures reduced considerably (p < 0.001). Three patients had all active cysts resolved or calcified and of the remaining 14, eight received the combination therapy which resolved 63 of 66 cysts (95%). Adverse events were infrequent and mild to moderate during both treatment cycles.ConclusionCyst resolution was unsatisfactory with albendazole monotherapy but was very high when it was followed by a combination of albendazole and praziquantel.

Objectives: Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe. Methods: We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000–2019) and extracted demographic, clinical and radiological information on each case, if available. Results: Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases. Conclusions: Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe.Therefore, training and guidance of clinicians is recommended for optimal patient management.

En la presente revisión bibliográfica se analiza un análisis desde un enfoque general sobre la Neurocisticercosis, esta infección ocasionada generalmente por quistes larvales presenta un resultado negativo en la salud humana, su proceso de infección y propagación en el cuerpo humano implica el desarrollo de problemas de salud, provocando generalmente la cisticercosis. Mediante una metodología descriptiva se realiza una recopilación de información actualizada proveniente de revistas indexadas y artículos científicos en la cual se detalla las características de esta infección, proceso infeccioso, causas y efectos en el organismo humano y tratamientos aplicados para mitigar la infección. En conclusión, esta infección requiere de una atención medica inmediata, el diagnóstico de la neurocisticercosis requiere de equipos médicos de alta precisión para determinar el progreso de la infección en el organismo y evitar graves problemas de salud en el ser humano. El determinar los síntomas a tiempo y una revisión médica permite reconocer la presencia de estos parásitos y su pronta intervención para eliminar las larvas mediante cirugía., In this bibliographic review an analysis is analyzed from a general approach on Neurocysticercosis, this infection generally caused by larval cysts presents a negative result on human health, its infection and spread process in the human body implies the development of problems health, generally causing cysticercosis. Using a descriptive methodology, a compilation of updated information is carried out from indexed journals and scientific articles in which the characteristics of this infection, infectious process, causes and effects on the human organism and treatments applied to mitigate the infection are detailed. In conclusion, this infection requires immediate medical attention, the diagnosis of neurocysticercosis requires high precision medical equipment to determine the progress of the infection in the body and avoid serious health problems in humans. Determining the symptoms in time and a medical check-up allows us to recognize the presence of these parasites and prompt intervention to eliminate the larvae through surgery.

Neurocysticercosis is recognized as an important health issue in the Malagasy population. To date, investigations into prevalence of infection with the causative agent, Taenia solium, in the parasite's natural animal intermediate hosts, have relied on serological methods which have been found to be non-specific. We determined the prevalence of porcine cysticercosis among pigs from a contiguous area of the Betafo and Mandoto administrative districts, Vakinankaratra Region, Madagascar. One hundred and four slaughter-weight pigs were examined by detailed necropsy examination including slicing of the heart, tongue, masseter muscles, diaphragm and carcase musculature. Thirty-seven animals (35.6%) were found infected with T. solium, representing one of the highest rates of infection ever reported, worldwide. These findings highlight the importance of T. solium in Madagascar and support the need for increased efforts to prevent the parasite's transmission to reduce its burden on the health of the Malagasy population.

Neurocysticercosis is the disease resulting from the infestation of the larval form of the intestinal helminth Taenia solium (cysticerci) in the central nervous system. It is a disease of universal distribution, endemic in countries where the pig is an important source of food. The clinical symptoms depend on the location, number of parasites and the host's immune response to them. In parenchymal lesions, it usually begins with epileptic seizures and even with focal symptoms due to a mass effect. The inflammation that surrounds them can cause cerebral infarctions by occluding small perforating arteries. Extraparenchymal lesions can cause hydrocephalus, either due to mechanical obstruction of the ventricular system, or due to arachnoiditis when located in the subarachnoid space. A correct diagnosis of Neurocysticercosis must include an adequate interpretation of the clinical and epidemiological background and different neuroimaging and serological techniques. A set of elements has been proposed to refine the diagnosis and combine epidemiological, clinical, imaging and serological information to establish cases with confirmed or probable NCC. To treat Neurocysticercosis there is no single treatment, because it is a disease with multiple presentations and clinics that deserve a specific treatment. Treatment depends on the acuteness and severity of the clinical presentation, host immune response, location and number of lesions, stage of cyst degeneration, and potential future complications. Measures should be included to prevent morbidity and mortality. A descriptive methodology was applied, with a documentary approach, that is, reviewing sources available on the network, with timely and relevant content to respond to what is discussed in this article., La Neurocisticercosis es la enfermedad resultante de la infestación de la forma larvaria del helminto intestinal Taenia solium (los cisticercos) en el sistema nervioso central. Es una enfermedad de distribución universal, endémica en países en los que el cerdo es una fuente importante de alimentación. La sintomatología clínica depende de la localización, número de parásitos y de la respuesta inmune del hospedador ante los mismos, en lesiones parenquimatosas suele iniciar con crisis epilépticas e incluso con síntomas focales debidos a un efecto de masa. La inflamación que los rodea puede ser causa de infartos cerebrales al ocluir pequeñas arterias perforantes. Las lesiones extraparenquimatosas pueden causar hidrocefalia, bien por obstrucción mecánica del sistema ventricular, o bien por aracnoiditis al localizarse en el espacio subaracnoideo. Un diagnóstico correcto de Neurocisticercosis debe abarcar una interpretación adecuada de los antecedentes clínicos y epidemiológicos y diferentes técnicas de neuroimagines y serológicos. Se ha propuesto un conjunto de elementos que permiten afinar el diagnóstico y que combinan información de tipo epidemiológica, clínica, por imágenes y serología para poder establecer casos con NCC confirmada o probable. Para tratar la Neurocisticercosis no existe un tratamiento único, debido a que es una enfermedad con múltiples presentaciones y clínicas que ameritan un tratamiento específico. El tratamiento depende de la agudeza y severidad de la presentación clínica, repuesta inmune del hospedero, localización y número de lesiones, estadio de degeneración del quiste y potenciales complicaciones futuras. Conviene incluir medidas para evitar morbilidad y mortalidad. Se aplicó una metodología descriptiva, con un enfoque documental, es decir, revisar fuentes disponibles en la red, con contenido oportuno y relevante para dar respuesta a lo tratado en el presente artículo.

Parasitic infections of the central nervous system are an important cause of morbidity and mortality in Africa. The neurological, cognitive, and psychiatric sequelae of these infections result from a complex interplay between the parasites and the host inflammatory response. Here we review some of the diseases caused by selected parasitic organisms known to infect the nervous system including Plasmodium falciparum, Toxoplasma gondii, Trypanosoma brucei spp., and Taenia solium species. For each parasite, we describe the geographical distribution, prevalence, life cycle, and typical clinical symptoms of infection and pathogenesis. We pay particular attention to how the parasites infect the brain and the interaction between each organism and the host immune system. We describe how an understanding of these processes may guide optimal diagnostic and therapeutic strategies to treat these disorders. Finally, we highlight current gaps in our understanding of disease pathophysiology and call for increased interrogation of these often-neglected disorders of the nervous system.

Cysticercosis and Trichinella spp. infection are parasitic zoonoses prevalent among pigs in Southeast Asia, where pork is the most important source of meat. In rural Cambodia, many pigs are raised extensively in family backyards, and information regarding the prevalence in rural small-scale pig production is very limited. This study was conducted in four provinces in north-eastern Cambodia to determine the seroprevalence of porcine cysticercosis and Trichinella spp. infection in rural villages, and to identify possible risk factors. Only households with less than 10 pigs above three months old were eligible. In total, 139 households participated, and 242 blood samples were collected. Farmers were interviewed about food and hygiene habits, disease knowledge and practices. The serum samples were analysed by ELISA to determine antigens to Taenia spp. cysticerci or antibodies to Trichinella spp. muscle larvae. Positivity among the pigs was 11.2% (95% CI 7.5-15.8) for Taenia spp. cysts and 2.5% (95% CI 0.9-5.4) for Trichinella spp. Cysticerci were more common in the province Preah Vihear (p < 0.001) than in the other provinces. Risk factors associated with porcine cysticercosis were management systems for the pigs and access to human faeces (p < 0.001). Trichinella spp. infection in pigs was more common in the province Ratanakiri (p = 0.001). The main risk factor associated with Trichinella spp. transmission was feeding pigs with food waste (p = 0.048). More men had heard about cysticercosis than women (p = 0.002), and men also consumed undercooked pork meat to a greater extent (p = 0.004). Although the present study is relatively small, several risk factors could be identified for porcine infection with Taenia spp. and Trichinella spp., which can be used to guide future interventions to improve both porcine and human health in these provinces.

Cysticercosis is one of the main zoonotic parasitic diseases caused by the larval settlement of Taenia solium. This disease develops mainly in pigs that are reared in non-technified farms where the use of technology and the sanitary conditions are poor. It is quite usual to rear pigs this way and, therefore, there is a public health risk. In this sense, the cysticercosis prevalence was determined among pigs in the Tambopata Province, including 98 animals in the evaluation. Approximately 5 ml of blood were taken from the vena cava in more than 6-month-old female pigs that were not pregnant. Next, the plasma was taken in order to be processed under an enzyme-linked inmunoelectrotransfer bloot assay (EITB) or western blot. It was found that 17% of pigs were positive to cysticercosis. Regarding the sex, the seroprevalence was 5.21% ± 0.82% in males and 11.45% ± 1.93% in females. Finally, the seroprevalence was determined at 10.41% ± 1.75% in young animals (6 to 11 months old) and 6.25% ± 1.01% in adult animals (12 months old and above). These results show how important it is to monitor and control the parasitic diseases in production animals as this study confirmed that porcine cysticercosis is a serious problem in public health., Resumen La cisticercosis es una de las principales enfermedades zoonóticas parasitarias que es causada por el establecimiento de la forma larvaria de Taenia solium. Esta enfermedad se desarrolla principalmente en cerdos que son criados en granjas sin tecnificación, donde el uso de la tecnología y las condiciones sanitarias son mínimas. Este tipo de crianza es muy usual, por lo que representa un riesgo de la salud pública. En ese sentido, se determinó la prevalencia de cisticercosis en porcinos de la provincia de Tambopata, donde fue evaluado un total de 98 porcinos. Se tomaron aproximadamente 5 ml de sangre de la vena cava en animales mayores de 6 meses y hembras que no estuviesen preñadas; posteriormente, se obtuvo el plasma para ser procesado mediante la prueba de enzyme-linked inmunoelectrotransfer bloot assay (EITB) o Western Blot. Se determinó que el 17 % de los cerdos evaluados dio positivo para cisticercosis; con respecto al sexo, se obtuvo una seroprevalencia de 5,21 % ± 0,82 % para machos y 11,45 % ± 1,93 % para hembras. Finalmente, se determinó una seroprevalencia de 10,41 % ± 1,75 % para animales jóvenes de 6 a 11 meses y 6,25 % ± 1,01 % para animales adultos de 12 meses a más. Estos resultados reflejan la importancia de la vigilancia y control de las enfermedades parasitarias en los animales de producción ya que pudo corroborarse que la cisticercosis porcina constituye un serio problema de salud pública.

Taenia solium is a zoonotic parasite that causes taeniasis and cysticercosis in humans (as final hosts) and cysticercosis in pigs (as intermediate hosts). The Russian Federation (RF) is traditionally considered as endemic for this zoonosis. However, the epidemiological data on T. solium infection have not been reviewed for the past 20 years, in which time dynamic economical and societal changes have occurred in the RF. The aim of this systematic review was to analyse the status of T. solium infection in RF in the 2000–2019 period. A literature search was conducted, which collected published articles, grey literature and official data on the epidemiology of T. solium taeniasis and cysticercosis in the RF published from 2000. From a total of 2021 articles and 24 official reports originally returned by the search, data were extracted from 12 full text articles and 11 official reports. Taenia solium taeniasis was continuously reported in the RF between 2000 and 2019, with a tenfold decrease in the incidence, from 0.2 per 100,000 population in 2000 to 0.023/100,000 in 2019. Also, the number of administrative units where taeniasis was detected continuously decreased. Cysticercosis in pigs had a declining trend after 2006. In conclusion, although decreasing, T. solium infection is still endemic in several regions and suspected to be endemic in most of the RF.

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.

Taenia solium is endemic in Madagascar and presents a significant burden on the population and the health system. The parasite cycles through humans who host the adult tapeworm, and pigs that host the larval stages. Accidental infection of humans may occur with the larval stages which encyst in the nervous central system causing neurocysticercosis, a major cause of seizure disorders and a public health problem. One of the interventions to facilitate the control of the disease is mass drug administration (MDA) of the human population with taeniacide. Here we describe a pilot project conducted in Antanifotsy district of Madagascar from 2015 to 2017 where three annual rounds of MDA (praziquantel, 10mg/Kg) were undertaken in 52 villages. Changes in the prevalence of taeniasis were assessed before, during and after the treatments. A total of 221,308 treatments were given to all eligible people above 5 years of age representing a 95% coverage of the targeted population. No major adverse effects were notified related to the implementation of the MDA. The prevalence of taeniasis was measured using Kato-Katz and copro-antigen techniques. Analyses undertaken combining the results of the Kato-Katz with copro-antigen, or using the Kato-Katz results alone, showed that there was a significant reduction in taeniasis 4 months after the last MDA, but 12 months later (16 months after the last MDA) the taeniasis prevalence had returned to its original levels. Results of the pilot project emphasize the need of a multi-sectorial One-Health approach for the sustained control of T. solium.

BackgroundNeurocysticercosis (NCC) is the most common parasitic infection of the central nervous system worldwide and is caused by the larval form of the tapeworm Taenia solium. In general, T. solium larval form may be located in the neuraxis, resulting in pathology. Here, we report a rare case of female with a history of adult onset seizures presenting with adult form T. solium in the fourth ventricle, causing hydrocephalus.Case descriptionA 36-year-old female patient with a known history of adult onset seizures presented with a 1-year history of progressively worsening bilateral headaches with vertigo and intermittent nausea. A computerized tomography scan revealed ventriculomegaly and transependymal flow, with an obstruction at the level of the fourth ventricle. Outpatient magnetic resonance imaging demonstrated obstructive hydrocephalus secondary to a lobulated cystic mass within the fourth ventricle, demonstrating a gross appearance consistent with racemose NCC. The patient underwent endoscopic third ventriculostomy, and gross examination of the resected cyst revealed a mature T. solium larvae encased in a cystic membrane. Given that our patient was born and raised in Mexico but had not returned since the age of 8, NCC was an unexpected finding.ConclusionThe present case highlights the importance of maintaining high suspicion for NCC in all patients presenting with seizures or hydrocephalus of unknown cause. Even in patients with a very remote history of residence in an endemic country, NCC can be an overlooked, underlying cause of both chronic neurologic symptoms, as well as acute, life-threatening neurologic emergencies.

The presentation of cysticercosis is very heterogeneous both between and within countries. Several host and parasite factors are involved in this heterogeneity. Differences in the intensity of infection pressure have not been studied thus far. We have compiled data that could demonstrate that differences in infection pressure are involved in the still high prevalence of parenchymal neurocysticercosis and ocular cysticercosis in some countries (which have a stable infection pressure) and in the high proportion of extraparenchymal neurocysticercosis in others (which have had a progressive decrease in infection pressure). Therefore, the distribution of clinicoradiological forms of cysticercosis could be a marker of the intensity of infection pressure and could help to determine in which countries control programs should be a priority.

Background Neurocysticercosis (NCC) is the most common parasitic neurological disease worldwide and a major cause of epilepsy. Spain is the country reporting the highest number of NCC imported cases in Europe. Methodology Retrospective case series of NCC patients registered in the +REDIVI Network from October 1, 2009 to July 2018. A specific questionnaire, including clinical and diagnostic characteristics, was created and sent to the collaborator centers. Results 46 cases were included in the analysis. 55% were male, mean age of 40 years. 95.6% were migrants. The median duration since migration from an endemic area was 10 years. Predominant nationalities were Ecuadorians (50%) and Bolivians (30.4%). Frequent locations were parenchymal (87%), subarachnoid (26.1%) and intraventricular cysts (10.9%). Serological analysis was performed in 91.3%, being 54.8% positive. Most prevalent clinical manifestations were persistent headache (60.9%), epilepsy (43.5%) and visual changes (13%). Patients were mainly treated with albendazole (76.1%), corticosteroids (67.4%), and anticonvulsionants (52.2%). 82.5% had a favorable clinical outcome. Conclusions Most NCC cases were long-standing migrants. Few clinical differences were observed depending on the cysticerci location. The treatment was often not according to current recommendations, and no uniform criteria were followed when it came to the therapeutic regimen. NCC case management in Spain (including clinician awareness and laboratory capacity improvements) needs to be strengthened.

Background: Taenia solium is a zoonotic parasite responsible for neurocysticercosis—a major cause of late-onset acquired epilepsy in humans. Lack of affordable, specific and sensitive diagnostic tools hampers control of the parasite. This study assessed the performance of an antigen detection enzyme-linked immunosorbent assay (Ag-ELISA) in the diagnosis of viable T. solium cysticercosis in naturally infected slaughter-age pigs in an endemic area in Tanzania. Methods: A total of 350 pigs were bled before they were slaughtered and their carcases examined. Serum was analyzed for circulating antigens by using a monoclonal antibody-based B158/B60 Ag-ELISA. Each carcase was examined for the presence of Taenia hydatigena cysticerci and half carcase musculature together with the whole brain, head muscles, tongue, heart and diaphragm were sliced with fine cuts (< 0.5 cm) to reveal and enumerate T. solium cysticerci. Half carcase dissection can detect at least 84% of infected pigs. Prevalence and their 95% confidence intervals (CI) were calculated in Stata 12. Sensitivity, specificity, predictive values and likelihood ratios were determined. Results: Twenty–nine pigs (8.3%, 95% CI: 5.6–11.7%) had viable T. solium cysticerci while 11 pigs had T. hydatigena cysticerci (3.1%, 95% CI: 1.6–5.5%). No co-infection was observed. Sixty-eight pigs (19.4%, 95% CI: 15.4–20%) tested positive on Ag-ELISA; of these, 24 had T. solium cysticerci and 7 had T. hydatigena cysticerci. Sensitivity and specificity were determined to be 82.7% and 86.3%, respectively. Positive and negative predictive values were 35.2% and 98.2%, respectively. Likelihood ratios for positive and negative Ag-ELISA test results were 6.0 and 0.2, respectively. There was a significant positive correlation between the titre of circulating antigens and intensity of T. solium cysticerci (r(348) = 0.63, P < 0.001). Conclusions: The Ag-ELISA test characteristics reported in this study indicate that the test

BACKGROUND: Taenia solium taeniasis/cysticercosis is a disease of substantial economic and public health importance particularly in low-income countries. The disease was reported to be endemic in Mbeya Rural and Mbozi districts, in the southern highlands of Tanzania, the major pig production area in the country. In 2008, using B158/B60 antigen detection enzyme-linked immunosorbent assay (Ag-ELISA), porcine cysticercosis prevalence of up to 32% was reported in the districts. A number of interventions have been implemented in selected villages including an integrated approach consisting of improving pig confinement and selective treatment of pigs with oxfendazole. Mass drug administration with praziquantel targeting schistosomiasis, with an expected effect on T. solium, was also provided to school-age children in the area. This study aimed at providing an update on prevalence and intensities of porcine cysticercosis; and assessing farmers' knowledge, attitudes and practices which could be associated to disease transmission in the area. The study involved a questionnaire survey conducted using face-to-face household interviews with 890 consenting farmers; and carcass dissections performed on 282 pigs randomly selected from the surveyed households. RESULTS: Twenty-six pigs (9.2%) were infected with T. solium; of which two-thirds (65.4%) had light to moderate infection intensities (1-1000 cysticerci), and one-third (34.6%) had heavy intensities (> 1000 cysticerci). Questionnaire results showed that only 5.7% of the respondents perceived T. solium cysticercosis to be an important disease in pigs. About 18.5% of the respondents were aware of T. solium taeniasis, but 32% of them were unaware of how the infection is acquired. Half of the respondents had seen cysticerci in pork, of whom 61% were not aware that consumption of infected pork could cause taeniasis. Latrines were observed to often (90%) lack doors with 45% considered accessible to pigs. CONCLUSIONS: This stu

Objective: Taenia solium taeniosis is a growing health problem in large parts of the world including Sub-Saharan Africa. Humans are infected by eating undercooked pork with T. solium metacestodes, which cause taeniosis. The aim of the present study was to assess the effect of increasing temperatures on T. solium metacestode viability in pork. Methods: Heavily T. solium infected pieces of pork were cooked in a water-bath at five different temperatures (40 °C, 50 °C, 60 °C, 70 °C and 80 °C) for 10–60 min. At each temperature/time point, five 5x5x5 cm pieces of pork fitted with thermometers at the core were placed in the water-bath. Controls were kept at 5 °C throughout exposure. After exposure, approximately 100 intact metacestodes were harvested and after a maximum of 6 h incubation at 37 °C in a culture media consisting of 50% porcine bile and 50% saline, the metacestodes were evaluated for viability. Results: The metacestodes were fully viable after cooking at a core temperature of 40 °C for up to an hour. The metacestodes were non-viable after cooking for >40 min at a core temperature over 50 °C. All metacestodes were dead after cooking for 30 min at a core temperature of 60 °C; at 70 °C, non-viability was found after 20 min and all metacestodes were dead after 10 min cooking at 80 °C. Conclusion: Findings showed that pork pieces cooked at >80 °C for >10 min proved safe for human consumption. This means that dishes consisting of pork pieces in sizes not greater than a 5 cm cube which are immersed in continuously boiling water for at least 10 min would be safe to eat. However, pork deep-fried in oil may entail a risk due to generally shorter cooking time. More research on the cooking practises is needed in order to produce safe guidelines for risk-free pork consumption.

Cysticercosis and trichinellosis are two parasitic zoonoses that are prevalent among pigs in Southeast Asia. The two diseases can cause serious illnesses in humans and human cysticercosis is a leading cause of death from food-borne diseases globally. In Cambodia, the majority of pigs are raised extensively in family backyards in households with between one and four pigs. Pork is the most importance source of meat in this region and is also an important source of income for the farmers. These factors could increase the risk for cysticercosis and trichinellosis in humans in Cambodia, but information regarding the prevalence in rural small-scale pig production is still very limited. This study was conducted in four provinces in north-eastern Cambodia (Kampong Thom, Preah Vihear, Ratanakiri and Stung Treng). The objective was to determine the seroprevalence of porcine cysticercosis and trichinellosis in rural Cambodia, and to identify possible risk factors for both diseases. In total 139 households participated, and 242 blood samples were collected. Only households with less than 10 pigs above three months old were included in the study. For each pig, sex, age and breed were noted. For each household one person was interviewed about food and hygiene habits, management of the pigs, disease knowledge and practice of treatment with antiparasitic medicines. The serum samples were analysed with ELISA for presence of antigens for cysticercosis or antibodies towards trichinellosis. Univariable statistical analyses were used to identify associations between potential risk factors and positivity for cysticercosis and trichinellosis. Positivity among the pigs was 11.2% (95% CI 7.5-15.8) for cysticercosis and 2.5% (95% CI 0.9-5.4) for trichinellosis. Cysticercosis was more common in the province Preah Vihear (p<0.001) than in the other provinces. Management systems for the pigs and access to human faeces were two risk factors significantly associated with porcine cysticercosis (p

Background Porcine cysticercosis has a negative impact on human health and the meat industry, as it makes infected meat unaproprieted for consuption and it is the main etiology of epileptic seizures in developing countries. There are multiple serological assays that use crude antigens with high sensitivity and specificity for the diagnosis of both porcine and human cysticercosis. Nonetheless, antigen preparation is time-consuming, needs a well-equipped laboratory and trained personnel and places those manipulating the meat at great risk for infection. New serodiagnostic approaches to the diagnosis of porcine and human cysticercosis have been directed towards the development of recombinant deoxyribonucleic acid technology for the generation of synthetic proteins that can serve as simplified, low-cost and harmless substitutes for native antigens. The aim of the present study was to further evaluate the recombinant Tsol-p27 protein as a target molecule in immunoassays for the serodiagnosis of porcine cysticercosis. From these data, we hoped to develop recommendations regarding its use in the serodiagnosis of porcine cysticercosis. Results We studied a panel of 83 naturally infected pig sera from Angonia District, Mozambique, an endemic area for porcine and human cysticercosis. These sera were previously tested by antigen enzyme-linked immunosorbent assay (Ag-ELISA) to detect antigens of T. solium. The serum panel was processed by enzyme-linked immunoelectrotransfer blot (EITB) assay against the recombinant Tsol-p27 protein and the Ag-ELISA assay results were used to compare and evaluate the performance of Tsol-p27 for the diagnosis of cysticercosis. Out of 83 sera, 24 (29.0%) were positive for Tsol-p27 and 59 (71%) were negative in the same assay. From the 37 sera that tested positive to Ag-ELISA, 11 (13.3%) were positive to Tsol-p27, while from 46 sera that tested negative to Ag-ELISA, 33 (39.7%) also tested negative to Tsol-p27. The sensitivity and specificity of Tso

Objectives: As is the case for all of Southeast Europe, Serbia is an area traditionally endemic for Taenia saginata and Taenia solium infections. This study was performed to analyse the epidemiological data on taeniosis and cysticercosis in Serbia for the period 1990-2018. Methods: Data on cases of T. saginata and T. solium infection were collected via a systematic search of published articles, the grey literature, and official reports, as well as by performing clinical observational studies of patients treated in the departments for infectious diseases of hospitals and university clinics in Serbia. Results: A total of 212 cases of taeniosis were reported, all between 1997 and 2004 when taeniosis was notifiable (incidence range 0.04-0.9/100 000 population/year). From 1990 to 2018, 170 cases of cysticercosis (all but one of neurocysticercosis), were registered (incidence range 0-0.29/100 000 population/year), with a strong decrease since 2000 and a single case in the last 9 years. The annual number of cases of both taeniosis (Pearson's r = 0.914, p = 0.001) and cysticercosis (Pearson's r = 0.582, p = 0.014) correlated with the consumer price index. Conclusions: In Serbia, T. saginata and T. solium infections are autochthonous but occur only sporadically. However, the potential for re-emergence exists, depending on the socio-economic state of the country.

La cysticercose cérébrale ou neurocysticercose, est une infection du système nerveux central, causée par les larves d’un ver plat : le Taenia solium Elle peut être responsable de nombreux tableaux cliniques différents, rendant parfois le diagnostic compliqué. L’intérêt du cas clinique décrit dans cet article réside dans la rareté du diagnostic, le mode de présentation aspécifique et le fait que le patient n’ait pas voyagé dans une région endémique de cysticercose récemment.

Background Parenchymal neurocysticercosis is a frequent cause of seizures in areas endemic for Taenia solium. At present there is scarce data on the evolution of the levels of circulating metacestodal antigen before, during and after treatment with anthelmintic drugs. Case presentation: A patient with paucisymptomatic neurocysticercosis (NCC) diagnosed by Ag-ELISA, and confirmed by MRI images, was treated with praziquantel, albendazole and dexamethasone. The level of circulating T. solium antigen was determined weekly. Circulating antigen disappeared from his blood within 14 days after the start of the treatment and correlated with the involution of the cysticerci in the brain shown by imaging. Seventeen years later, the patient has not shown any side effect nor symptoms related to the treatment or to NCC. Conclusions: If this encouraging finding is confirmed in a larger series of patients, this technique could be used to determine parasitological cure after treatment and might complement or sometimes replace sequential MRIimaging of the brain.

BACKGROUND: Taenia solium, a zoonotic tapeworm, is responsible for about a third of all preventable epilepsy human cases in endemic regions. In Europe, adequate biosecurity of pig housing and meat inspection practices have decreased the incidence of T. solium taeniosis and cysticercosis. Pigs slaughtered at home may have been raised in suboptimal biosecurity conditions and slaughtered without meat inspection. As a result, consumption of undercooked pork from home slaughtered pigs could pose a risk for exposure to T. solium. The aim of this study was to quantify the risk of human T. solium exposure from meat of home slaughtered pigs, in comparison to controlled slaughtered pigs, in European countries. A quantitative microbial risk assessment model (QMRA) was developed and porcine cysticercosis prevalence data, the percentage of home slaughtered pigs, meat inspection sensitivity, the cyst distribution in pork and pork consumption in five European countries, Bulgaria, Germany, Poland, Romania and Spain, were included as variables in the model. This was combined with literature about cooking habits to estimate the number of infected pork portions eaten per year in a country. RESULTS: The results of the model showed a 13.83 times higher prevalence of contaminated pork portions from home slaughtered pigs than controlled slaughtered pigs. This difference is brought about by the higher prevalence of cysticercosis in pigs that are home raised and slaughtered. Meat inspection did not affect the higher exposure from pork that is home slaughtered. Cooking meat effectively lowered the risk of exposure to T. solium-infected pork. CONCLUSIONS: This QMRA showed that there is still a risk of obtaining an infection with T. solium due to consumption of pork, especially when pigs are reared and slaughtered at home, using data of five European countries that reported porcine cysticercosis cases. We propose systematic reporting of cysticercosis cases in slaughterhouses, and in additio

© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. BACKGROUND: In neurocysticercosis, the larval form of the pork tapeworm Taenia solium appears to evolve through three phases-active, degenerative and sometimes calcification-before disappearance. The antihelmintic drug, albendazole, has been shown to hasten the resolution of active cysts in neurocysticercosis. Little is known about the time cysts take to progress through each phase, with or without treatment. METHODS: We reconfigured brain imaging data from patient level to cyst level for 117 patients in a randomized clinical trial of albendazole in which images were taken at baseline, 1, 6, 12 and 24 mo. Applying a multistate model, we modelled the hazard of a cyst evolving to subsequent cyst phases before the next imaging (vs no change). We examined the impact of albendazole treatment overall and by patient and cyst characteristics on the hazard. RESULTS: Albendazole accelerated the evolution from the active to degenerative phase (HR=2.7, 95% CI 1.3 to 6.5) and from the degenerative phase to disappearance (HR=1.9, 95% CI 1.1 to 3.9). Albendazole's impact was stronger for patients who were male, did not have calcified cysts at baseline and who had multiple cysts in different locations. CONCLUSIONS: This research provides a better understanding of where in the cyst trajectory albendazole has the greatest impact.

Importance:Identifying infectious causes of subacute or chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed. Objective:To present a case series of patients with diagnostically challenging subacute or chronic meningitis using metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) supported by a statistical framework generated from mNGS of control samples from the environment and from patients who were noninfectious. Design, Setting, and Participants:In this case series, mNGS data obtained from the CSF of 94 patients with noninfectious neuroinflammatory disorders and from 24 water and reagent control samples were used to develop and implement a weighted scoring metric based on z scores at the species and genus levels for both nucleotide and protein alignments to prioritize and rank the mNGS results. Total RNA was extracted for mNGS from the CSF of 7 participants with subacute or chronic meningitis who were recruited between September 2013 and March 2017 as part of a multicenter study of mNGS pathogen discovery among patients with suspected neuroinflammatory conditions. The neurologic infections identified by mNGS in these 7 participants represented a diverse array of pathogens. The patients were referred from the University of California, San Francisco Medical Center (n = 2), Zuckerberg San Francisco General Hospital and Trauma Center (n = 2), Cleveland Clinic (n = 1), University of Washington (n = 1), and Kaiser Permanente (n = 1). A weighted z score was used to filter out environmental contaminants and facilitate efficient data triage and analysis. Main Outcomes and Measures:Pathogens identified by mNGS and the ability of a statistical model to prioritize, rank, and simplify mNGS results. Results:The 7 participants ranged in age from 10 to 55 years, and 3 (43%) were female. A parasitic worm (Taenia solium, in 2 participants), a virus (HIV-1), and 4 fungi (Cryptococcus neoformans, Aspergillus oryzae, Histopla

This thesis presents results of parasitological studies conducted in rural areas of western DRC. Findings indicate that single and co-infections with soil-transmitted helminths, schistosomes and taeniasis/cysticercosis are common and are heterogeneously distributed in space and within host populations. Co-endemicity of these helminth infections, similarities in age profiles and existence of shared risk factors between single and co-infections are suggestive of an integrated control approach. However, the use of praziquantel in an area potentially endemic for neurocysticercosis calls for more caution given the risk of severe neurological side effects. This thesis also shows that mixed Schistosoma infections alter the efficacy of single praziquantel treatment on S. haematobium though this short term effect disappears after cumulative treatments. All these findings can be useful to the design of an integrated control programme targeting many helminth infections at once., Cette thèse présente les résultats d'études parasitologiques menées dans les zones rurales de l'ouest de la RDC. Les résultats indiquent que les co-infections aux géohelminthes, schistosomes et le complexe téniase/cysticercose sont courantes et inégalement distribuées dans l'espace et au sein des populations hôtes. La co-endémicité de ces helminthiases, le jeune âge de la téniase et l'existence de facteurs de risque partagés entre les mono-infections et les co-infections suggèrent une approche de contrôle intégré. Cependant, l'utilisation du praziquantel dans une zone potentiellement endémique à la neurocysticercose nécessite plus de prudence compte tenu du risque d'effets secondaires neurologiques sévères. Cette thèse montre également que les infections mixtes à Schistosoma altèrent l'efficacité d’une dose unique de praziquantel sur S. haematobium, bien que cet effet à court terme disparaisse après des traitements cumulatifs. Ces résultats peuvent être utiles à la conception d'un contrôle intégré ciblant de nombreuses infections helminthiques à la fois, (SP - Sciences de la santé publique) -- UCL, 2018

Background: Taenia solium and Taenia saginata are food-borne parasites of global importance. In eastern Europe only fragmented information is available on the epidemiology of these zoonotic parasites in humans and animal populations. In particular for T. solium, on-going transmission is suspected. The aim of this systematic review was to collect the available data and describe the current knowledge on the epidemiology of T. solium and T. saginata in eastern Europe. Methods: Literature published in international databases from 1990 to 2017 was systematically reviewed. Furthermore, local sources and unpublished data from national databases were retrieved from local eastern European experts. The study area included 22 countries. Results: Researchers from 18 out of the 22 countries provided data from local and unpublished sources, while no contacts could be established with researchers from Belarus, Kosovo, Malta and Ukraine. Taeniosis and human cysticercosis cases were reported in 14 and 15 out of the 22 countries, respectively. Estonia, the Former Yugoslav Republic of Macedonia, Lithuania, Moldova, Poland, Romania, Serbia, and Slovakia reported cases of porcine cysticercosis. Croatia, Czech Republic, Estonia, Former Yugoslav Republic of Macedonia, Moldova, Poland, Romania, Serbia, Slovakia, and Ukraine reported bovine cysticercosis. Conclusions: There is indication that taeniosis and cysticercosis are present across eastern Europe but information on the occurrence of T. solium and T. saginata across the region remains incomplete. Available data are scarce and species identification is in most cases absent. Given the public health impact of T. solium and the potential economic and trade implications due to T. saginata, notification of taeniosis and human cysticercosis should be implemented and surveillance and notification systems in animals should be improved.

BACKGROUND: Taenia solium and Taenia saginata are food-borne parasites of global importance. In eastern Europe only fragmented information is available on the epidemiology of these zoonotic parasites in humans and animal populations. In particular for T. solium, on-going transmission is suspected. The aim of this systematic review was to collect the available data and describe the current knowledge on the epidemiology of T. solium and T. saginata in eastern Europe.METHODS: Literature published in international databases from 1990 to 2017 was systematically reviewed. Furthermore, local sources and unpublished data from national databases were retrieved from local eastern European experts. The study area included 22 countries.RESULTS: Researchers from 18 out of the 22 countries provided data from local and unpublished sources, while no contacts could be established with researchers from Belarus, Kosovo, Malta and Ukraine. Taeniosis and human cysticercosis cases were reported in 14 and 15 out of the 22 countries, respectively. Estonia, the Former Yugoslav Republic of Macedonia, Lithuania, Moldova, Poland, Romania, Serbia, and Slovakia reported cases of porcine cysticercosis. Croatia, Czech Republic, Estonia, Former Yugoslav Republic of Macedonia, Moldova, Poland, Romania, Serbia, Slovakia, and Ukraine reported bovine cysticercosis.CONCLUSIONS: There is indication that taeniosis and cysticercosis are present across eastern Europe but information on the occurrence of T. solium and T. saginata across the region remains incomplete. Available data are scarce and species identification is in most cases absent. Given the public health impact of T. solium and the potential economic and trade implications due to T. saginata, notification of taeniosis and human cysticercosis should be implemented and surveillance and notification systems in animals should be improved.

Background Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type. Methods In this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n= 88) or placebo (n= 90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up. Results Treatment with albendazole was associated with a reduction in the …

Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-inf

BACKGROUND: Taenia solium is a neglected zoonotic parasite. The performances of existing tools for the diagnosis of porcine cysticercosis need further assessment, and their shortcomings call for alternatives. The objective of this study was to evaluate the performance of tongue palpation and circulating antigen detection for the detection of porcine cysticercosis in naturally infected pigs of slaughter age compared to full carcass dissections (considered the gold standard). Additionally, alternative postmortem dissection procedures were investigated. A total of 68 rural pigs of slaughter age randomly selected in the Eastern Province of Zambia were dissected. Dissections were conducted on full carcasses (or half carcass in case cysticerci were already detected in the first half), including all the organs. Total cysticercus counts, location and stages were recorded and collected cysticerci were identified morphologically and molecularly. All sera were analysed with the B158/B60 antigen detecting ELISA (Ag-ELISA). RESULTS: Key findings were the high occurrence of T. solium infected pigs (56%) and the presence of T. solium cysticerci in the livers of 26% of infected animals. More than half of the infected carcasses contained viable cysticerci. Seven carcasses had T. hydatigena cysticerci (10%), out of which five carcasses were co-infected with T. hydatigena and T. solium; two carcasses (3%) had only T. hydatigena cysticerci. Compared to full carcass dissection, the specificity of the Ag-ELISA to detect infected carcasses was estimated at 67%, the sensitivity at 68%, increasing to 90% and 100% for the detection of carcasses with one or more viable cysticerci, and more than 10 viable cysts, respectively. Tongue palpation only detected 10% of the cases, half carcass dissection 84%. Selective dissection of the diaphragm, tongue and heart or masseters can be considered, with an estimated sensitivity of 71%, increasing to 86% in carcasses with more than 10 cysticerci. CONCLUS

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.

This paper reports the case of a 57-year-old female patient from the San Martín de Porres district in Lima, who attended the emergency room at Hospital II Lima Norte-Callao Luis Negreiros Vega of EsSalud due to a tumor in her right thigh. The patient complained of thigh pain on palpation and when she started walking.Studies were carried out and the tumor was surgically removed. The macroscopic analysis found a piece of tissue of 5x4x11cm, lozenge of the skin of 4x1.5cm, and an irregular surface composed of adipose tissue. Upon sectioning, 0.8cm of the skin showed a yellowish brown nodular formation of 1.5x1.8cm, with a cystic formation of 0.6cm, well delimited by fibrous tissue. In addition, three other cystic formations were found, with 0.3 to 0.8cm of diameter.The histological diagnosis found cystic formations in the subcutaneous cellular tissue of fibrous walls, covered by macrophages in the inner part and foreign body epithelioid cells, which is compatible with subcutaneous cysticercosis., Se presenta el caso de una paciente de 57 años de edad, natural del distrito de San Martín de Porres en Lima, quien acude a emergencias en el Hospital II Lima Norte-Callao Luis Negreiros Vega de EsSalud por presentar una tumoración en el muslo derecho. La paciente refiere dolor al palpar el muslo y al ponerse en marcha, por lo que se realizan estudios y se procede a la exéresis quirúrgica de dicha tumoración. El análisis macroscópico indicó fragmento de tejido de 5x4x11cm con losange de piel de 4x1.5cm y superficie irregular compuesta de tejido adiposo; al corte a 0.8cm de la piel presenta formación nodular de color pardo amarillento de 1.5x1.8cm con formación quística de 0.6cm, bien delimitada por el tejido fibroso. Además, presenta otras tres formaciones quísticas de 0.3 a 0.8cm de diámetro. De igual forma, el diagnóstico histológico señaló formaciones quísticas en tejido celular subcutáneo de paredes fibrosas recubiertas en su parte interna por macrófagos y células epitelioides a cuerpo extraño, compatible con cisticercosis subcutánea.

Introduction: Swine cysticercosis caused by the larval stage of Taenia solium, causes serious economic losses for their holders and a risk to public health in Colombia and the world, especially in Asia, Africa and other Latin American countries. This parasitic disease is spread easily in areas with hygienic sanitary, environmental and socio economic precarious.Objective: determine the seroprevalence of cysticercosis swine using the essay Enzyme Immunoassay (ELISA) and the detection of taeniasis human by test coproparasitologic in people brooders of pigs in the area urban.Materials and methods: Took blood sample to swine 102 puncture the pinna and they impregnated filter paper disks to detect Flisser antibodies using the ELISA technique with 53kDa antigenic fraction. To them holders of pigs and others participating conformed by a group of 159 people, is les requested a shows of Lee that was preserved in reagent of Mertiolate iodine formalin to the 5% (MIF). Is preserved to 4 ° C, for its processing is employed the technical of concentration of formol-eter, the diagnosis is made by observation microscopic with objective of 40 X.Results: Of the 102 pigs, the 17% (17 / 102) presented antibodies Flisser. With respect to the variable socio-demographic of the study is observed greater association with sources of water, patient’s teniasicos, conditions environmental, type of power. The general prevalence of intestinal parasitism in the breeders was 43.3% and 11.1% (3/159) found eggs of Taenia spp., identified the sources of water and holding of pigs as variables statistically significant (p≤0. 005) with the presence of intestinal parasitism in the community., Introdução: Cisticercose porcina causada pelo estágio larval de Taenia solium, provoca sérias perdas econômicas para os seus titulares e um risco para a saúde pública na Colômbia e no mundo, especialmente na Ásia, África e outros países da América Latina. Esta doença parasitária é disseminada facilmente em áreas com higiene higiênica, ambiental e socioeconômica precária. Objetivo: Determinar a soroprevalência de cisticercose porco utilizando o ensaio imunoenzimático (ELISA) e a detecção de taeníase humana por teste coproparasitológico em pessoas criadas por porcos na área urbana.Materiais e métodos: Tomou amostras de sangue para suínos 102 perfurando o pinna e impregnaram discos de papel de filtro para detectar anticorpos Flisser usando a técnica ELISA com fração antigênica de 53kDa. A eles, titulares de porcos e outros participantes, conformados por um grupo de 159 pessoas, solicita-se um show de Lee que foi preservado em reagente de Mertiolate iodine formalin a 5% (MIF). É preservada a 4 ° C, para o processamento é empregada a técnica de concentração de formol eter, o diagnóstico é feito por observação microscópica com objetivo de 40 X. Resultados: Dos 102 porcos, 17% (17/102) apresentaram anticorpos Flisser. Com relação à variável sociodemográfica do estudo, observa-se maior associação com fontes de água, teniasicos do paciente, condições ambientais, tipo de poder. A prevalência geral de parasitismo intestinal nos criadores foi de 43,3% e 11,1% (3/159) encontraram ovos de Taenia spp., Identificaram as fontes de água e a retenção de porcos como variáveis estatisticamente significativas (p≤0. 005) com a presença De parasitismo intestinal na comunidade.Conclusões: O estudo revelou um valor significativo de seroprevalência de cisticercose porcina na área avaliada, causando um grave problema de saúde pública na comunidade coyaimuna. Introdução: Cisticercose porcina causada pelo estágio larval de Taenia solium, provoca sérias perdas econômicas para os seus titulares e, Introducción: La cisticercosis porcina causada por la etapa larval de Taenia solium, ocasiona graves pérdidas económicas para sus tenedores y un riesgo para la salud pública en Colombia y en el mundo especialmente en Asia, África y otros países de Latino América. Esta parasitosis se propaga con facilidad en zonas con condiciones higiénicas sanitarias, ambientales y socio económicas precarias. Objetivo: Determinar la seroprevalencia de cisticercosis porcina empleando el ensayo inmunoenzimático (ELISA) y la detección de teniasis humana por examen coproparasitológico en personas criadoras de cerdos en el área urbana.Materiales y Métodos: Se tomó muestra de sangre a 102 porcinos por punción en el pabellón auricular y se impregnaron en discos de papel de filtro para detectar anticuerpos anticisticerco empleando la técnica de ELISA con la fracción antigénica de 53kDa. A los tenedores de porcinos y demás participantes conformado por un grupo de 159 personas, se les solicitó una muestra de heces, que fue conservada en reactivo de Mertiolate Yodo Formol al 5%(MIF). Se preservó a 4°C, para su procesamiento se empleó la técnica de concentración de formol-éter, el diagnóstico se realizó por observación microscópica con objetivo de 40X.Resultados: De los 102 porcinos, el 17% (17/102) presentaron anticuerpos anticisticerco. Con respecto a las variables sociodemográficas del estudio se observó mayor asociación con fuentes de agua, pacientes teniásicos, condiciones ambientales, tipo de alimentación. La prevalencia general de parasitismo intestinal en los criadores fue de 43.3%, y en el 11.1% (3/159) se hallaron huevos de Taenia spp, Se identificó a las fuentes de agua y la tenencia de porcinos como variable estadísticamente significativa (p≤0,005) con la presencia de parasitismo intestinal en la comunidad.Conclusión: El estudio reveló un valor significativo de seroprevalencia de cisticercosis porcina en el área evaluada, ocasionando un serio problema de salud pública en la comunida

According to the World Health Organization (WHO), neglected tropical diseases (NTDs) affect almost 1,000,000,000 people in 149 countries (http://www.who.int/neglected_diseases/diseases/en/). Most are small family farmers living in the least-developed countries where health systems are often inadequate, and climate conditions are favourable to infectious and parasitic diseases. These diseases hinder socioeconomic development, maintain poverty, and impede the achievement of UN sustainable development goals (SDGs) [1]. Economic analyses have shown that their control, elimination, or eradication would lead to net economic benefits [2]. Rapid progress can be achieved when organised health systems, whether public, private, or mixed, are in place to provide diagnostic methods and facilities, treatments, and vaccines. Of the 18 diseases on WHO's list of NTDs, only 5 are zoonoses: Taenia solium cysticercosis, echinococcosis, leishmaniasis, rabies, and human African trypanosomiasis (HAT). Some authors consider this list incomplete and believe that at least 3 other major zoonoses—anthrax, bovine tuberculosis, and brucellosis—should be included [3]. Moreover, while some public–private partnerships—e.g., the Global Alliance for Livestock Veterinary Medicines, GALVmed (https://www.galvmed.org/)—now target major livestock diseases impacting smallholders by connecting academia, public research institutes, and the pharmaceutical sector, no strictly animal disease (i.e., nonzoonotic) has been labelled “neglected”. Nevertheless, animal diseases directly impact people's livelihoods. Furthermore, due to the multiple functions fulfilled by livestock in rural societies—as sources of food, income, and social status—animal diseases ultimately also impact human health.

Background: Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. Methods: We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. Results: Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata, although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002-7.82%. Conclusions: Detection and reporting of taeniosis in western Europe should be improved. The existence

Introduction: Cysticercosis is caused by Taenia solium cysticerci, which are located mainly in the central nervous system causing neurocysticercosis. In Venezuela, few epidemiological studies on this disease have been conducted.Objective: To determine the seroprevalence and risk factors for cysticercosis in two rural communities in Anzoátegui state.Material and methods: We conducted a survey to collect data on possible risk factors and signs and symptoms of the disease, and we took 182 samples in two communities, Boquerón and Punto Lindo. Detection of IgG antibodies against T. solium cysticerci was performed by ELISA.Results: Seroprevalence in Boquerón was 3.3%; due to the low number of seropositives the statistical analysis was not possible. However, the three seropositive persons had knowledge of the disease, and a history of consumption of undercooked pork meat, and presence of headache. In Punto Lindo, seroprevalence was 28.9%. There were no significant differences by sex or age; however, we found more seropositives among individuals younger than 20 years. With regard to risk factors and signs and symptoms, significant associations were found with consumption of undercooked pork (OR=18; 95% CI: 5.78 to 55.9), headaches (OR=3.6; 95% CI: 1.15 to 11.4), seizures (OR=18.9; 95% CI: 2.15 to 166.5) and visual problems (OR=5.7; 95% CI: 2.13 to 15.34).Conclusions: The results showed low transmission of cysticercosis in Boquerón, and high in Punto Lindo, where the high prevalence in children suggests recent transmission., Introducción. La cisticercosis es causada por las larvas de Taenia solium, las cuales se localizan principalmente en el sistema nervioso central y causan neurocisticercosis. En Venezuela se han hecho pocos estudios epidemiológicos de esta enfermedad.Objetivo. Determinar la seroprevalencia y los factores de riesgo de la cisticercosis en dos comunidades rurales del estado Anzoátegui, Venezuela.Materiales y métodos. Se hizo una encuesta para recolectar datos sobre los posibles factores de riesgo y los signos y síntomas de la enfermedad, y se tomaron 182 muestras de los habitantes de las comunidades de Boquerón y Punto Lindo. Se determinaron los anticuerpos IgG contra cisticercos de T. solium mediante ensayo inmunoenzimático (ELISA).Resultados. En Boquerón, se presentó una seroprevalencia de 3,3 %; debido al bajo número de muestras positivas no se pudo hacer el análisis estadístico. Sin embargo, las tres personas positivas tenían conocimiento de la enfermedad, antecedentes de tenencia de cerdos no confinados, consumo de carne de cerdo semicruda y cefalea frecuente. En Punto Lindo, la seroprevalencia fue de 28,9 %. No hubo diferencias estadísticamente significativas en cuanto al sexo y la edad, sin embargo, se encontró mayor frecuencia en menores de 20 años. Con respecto a los factores de riesgo y los signos y síntomas, se encontró asociación significativa con el consumo de carne de cerdo semicruda (odds ratio, OR=18; IC95% 5,78-55,9), cefalea frecuente (OR=3,6; IC95% 1,15-11,4), convulsiones (OR=18,9; IC95% 2,15-166,5) y problemas de visión (OR=5,7; IC95% 2,13-15,34).Conclusión. Los resultados demostraron que había poca transmisión de cisticercosis en Boquerón, pero mucha en Punto Lindo, sobre todo en niños, lo cual sugeriría que se trata de transmisión reciente.

Neurocysticercosis is the most common parasitic infection in the central nervous system. This disease is presented when a person ingests Taenia solium eggs excreted in feces from another individual infected with taeniasis. In 50% of the cases, neurocysticercosis takes place in the brain parenchyma, and its appearance is less frequent in the posterior fossa and the spinal cord.The case of a patient with an atypical location of the parasite at the medulla oblongata, between parenchymal and spinal areas, is presented. The initial symptoms were common but its subsequent manifestations were similar to those of Bruns syndrome. Furthermore, the epidemiological profile of neurocysticercosis in Colombia, its control measures and prevention strategies were reviewed in this study., La neurocisticercosis es la infección parasitaria más frecuente en el sistema nervioso central; esta enfermedad se desarrolla cuando los huevos de Taenia solium excretados en heces de un individuo con teniasis son ingeridos por otra persona. La presentación de la neurocisticercosis tiene lugar en el parénquima cerebral en 50% de los casos, mientras que en la fosa posterior y en la médula espinal es menos frecuente.Se presenta el caso de un paciente que tuvo una ubicación exótica del parásito a nivel del bulbo raquídeo concomitando con la forma parenquimatosa y medular; las manifestaciones clínicas iniciales fueron las comunes, pero sus síntomas posteriores se caracterizaron por el síndrome de Bruns. Además, durante la investigación se revisó el perfil epidemiológico de la neurocisticercosis en Colombia y las medidas de control y de prevención.

Introducción: El complejo teniosis/cisticercosis es un problema de salud pública a nivel mundial. En Colombia estudios epidemiológicos evidencian la presencia de ésta parasitosis en humanos ocasionando Neurocisticercosis (NCC).Objetivo: Determinar la sintomatología asociada a Neurocisticercosis en personas del área urbana y periurbana del municipio de Coyaima del departamento del Tolima y posibles variables asociadas.Materiales y Métodos: Se realizó un estudio descriptivo de corte transversal en los habitantes del área urbana y periurbana del municipio de Coyaima en el departamento del Tolima, a quienes se les socializó un consentimiento informado. A las 159 personas que aceptaron participar voluntariamente, se les diligenció una encuesta epidemiológica estructurada, toma de 5ml de sangre periférica y simultáneamente por punción digital sangre colectada en círculos de papel filtro de 4mm diámetro; de igual manera se solicitó una muestra coprológica que se fijó con reactivo de MIF al 5% y se procesó con la técnica de concentración de formol-éter y finalmente almacenadas a 4°C. Para la evaluación serológica, se empleó la técnica de ELISA bajo los siguientes parámetros: antígeno, fracción de 53kDa del metacéstodo de Taenia solium.; en concentración de 0,4µg/ml, dilución de suero y sangre total tomada con papel de filtro1/1, suero total 1/100 y conjugado 1/2500. El análisis estadístico incluyo tablas de contingencia de 2x2, cálculo de frecuencias y ji cuadrado.Resultados: De los 159 participante, el 17% (27/159) fueron diagnosticados seropositivos y de estos, el 67%(18/27) presentó alguna sintomatología de posible asociación con NCC. Los síntomas de mayor frecuencia en la población estudiada fueron: cefalea, 19,5%; disminución de capacidad visual, 5,7%; crisis convulsiva de aparición tardía, 4,4%; accidentes cerebrovasculares y alteración de conciencia 1,3% y 0,6%; respectivamente. Se confirmaron cuatro personas con NCC, del grupo de seropositiv

Introduction: Neurocysticercosis (NCC) is the most common infection of the central nervous system caused by larvae of taenia solium. This disease is endemic in developing countries, showing the hig­hest incidence in schoolchildren and adolescent patients of the pediatric population. It shows clinical diversity and pathological findings, generally presenting intraparenchymal forms associated with seizures or extraparenchymal forms related to intracranial hypertension. Clinical and epidemio­logical suspicion of the disease obliges studies of computed tomography and magnetic resonance imaging, besides the specific serological studies. Case presentation: A clinical case of a preschool girl with neurocysticercosis was registered at the Hospital Infantil Napoleon Franco Pareja (HINFP) in Cartagena de Indias, Colombia, characterized by a clinical picture which debuts with tonic seizures in extremities, so that a study of ct was requested, that showed encephalitis images compatible with brain cysticercosis. Hospitalization was decided, starting with cesticide, anticonvulsant, and anti-inflammatory management. Conclusion: The imaging findings and clinical course of neu­rocysticercosis in childhood are associated with the disease stage and the host immune response., Introdução: A neurocisticercose (ncc) é a infeção parasitária mais comum do sistema nervoso central causada pela larva da Taenia solium. Esta patologia é endémica nos países em vias de desenvolvimento apresentando sua maior incidência em pacientes escolares e adolescentes da população pediátrica. Apresenta uma diversidade clínica e achados patológicos em geral, se apre­senta com formas intraparenquimatosas associadas com convulsões ou formas extra-parenqui­matosas associadas com hipertensão endocraniana. A suspeita clínica e epidemiológica da doença obriga a solicitar estudos de tomografia axial computorizada (tac) e/ou ressonância magnética além dos estudos serológicos específicos. Apresentação do caso: descreve-se um caso clínico de uma menina pré-escolar com Neurocisticercose sucedido no Hospital Infantil Napoleón Franco Pareja (hinfp-Cartagena de Indias-Colombia), o qual se caracteriza por apresentar um quadro clínico que debuta com crises tónicas em extremidades, pelo que solicita-se estudo de tac cerebral, que mostra imagens de encefalite compatível com cistercose cerebral, decide-se hospitalizar se iniciando manejo cesticida, anticonvulsivante, e anti-inflamatório. Conclusão: os achados ima­genológicos e a evolução clínica da neurocisticercose na infância estão associados ao estádio da doença e a resposta imunológica do hóspede., Introducción: La neurocisticercosis (ncc) es la infección parasitaria más común del sistema ner­vioso central causada por la larva de la Taenia solium. Esta patología es endémica en los países en vías de desarrollo y presenta su mayor incidencia en pacientes escolares y adolescentes de la población pediátrica. Muestra una diversidad clínica y hallazgos patológicos, en general, se presenta con formas intraparenquimatosas asociadas con convulsiones o formas extraparenqui­matosas relacionadas con hipertensión endocraneana. La sospecha clínica y epidemiológica de la enfermedad obliga a solicitar estudios de tomografía axial computarizada (tac) y/o resonancia magnética, además de los estudios serológicos específicos. Presentación de caso: se describe un caso clínico de una niña preescolar con neurocisticercosis sucedido en el Hospital Infantil Napo­león Franco Pareja (hinfp) en Cartagena de Indias, Colombia, el cual se caracteriza por presentar un cuadro clínico que debuta con crisis tónicas en extremidades, por lo que se solicita estudio de tac cerebral, que muestra imágenes de encefalitis compatible con cistercosis cerebral, se decide hospitalizar iniciándose manejo cesticida, anticonvulsivante y antiinflamatorio. Conclusión: Los hallazgos imagenológicos y la evolución clínica de la neurocisticercosis en la infancia están aso­ciados con el estadio de la enfermedad y la respuesta inmunológica del huésped.

Background and Objectives: Cysticercosis is a common tropical disease. Human cysticercosis is caused by the dissemination of the embryo of Taenia solium in the intestine via the hepatoportal system to the tissues and organs of the body. The organs most commonly affected are the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver, and occasionally the heart, thyroid, and pancreas. Fine needle aspiration cytology (FNAC) plays an important role in prompt recognition of this disease. Aims: To study the role of FNAC in the diagnosis of cysticercosis. Methods: Fifteen patients with subcutaneous and intramuscular nodules, who were clinically diagnosed as lipoma, neurofibroma, lymphadenitis, cold abscess, epidermal inclusion cyst, sebaceous cyst, fibroadenoma and cysticercosis were included in the present study. Results: In 4 (26.6%) cases, a definitive diagnosis of cysticercosis was obtained in the form of fragments of parasite bladder wall and, biopsy confirmed the diagnosis. In the rest 11 (73.3%) cases, larval fragments could not be identified on the aspirates and the diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings. Follow-up biopsy confirmed the diagnosis of cysticercosis. Conclusions: Cysticercosis is continuing to be a major health problem in developing countries. Fine needle aspiration cytology (FNAC) is cost effective and simple procedure. The cytological diagnosis is quite straightforward in cases where the actual parasite structure is identified in the smears. However, in other cases, presence of eosinophils, histiocytes, a typical granular dirty background are the features which should always alert the pathologist to this possibility.

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.

Two fraternal twin sisters developed cysticercosis localizing to the right lateral orbit over the same period after a presumed common-source exposure in China. This case demonstrates that cysticercosis can be related to travel. Similar temporal and spatial occurrences of these infections suggest a genetic tropism of the infecting organism in these twins.

Taenia solium taeniasis/cysticercosis is an important public health problem occurring mainly in developing countries. This work aimed to study the determinants of human T. solium infections in the Eastern province of Zambia and rank them in order of importance. A household (HH)-level questionnaire was administered to 680 HHs from 53 villages in two rural districts and the taeniasis and cysticercosis status determined. A classification tree model (CART) was used to define the relative importance and interactions between different predictor variables in their effect on taeniasis and cysticercosis. The Katete study area had a significantly higher taeniasis and cysticercosis prevalence than the Petauke area. The CART analysis for Katete showed that the most important determinant for cysticercosis infections was the number of HH inhabitants (6 to 10) and for taeniasis was the number of HH inhabitants > 6. The most important determinant in Petauke for cysticercosis was the age of head of household > 32 years and for taeniasis it was age < 55 years. The CART analysis showed that the most important determinant for both taeniasis and cysticercosis infections was the number of HH inhabitants (6 to 10) in Katete district and age in Petauke. The results suggest that control measures should target HHs with a high number of inhabitants and older individuals.

The pork tapeworm, Taenia solium, causes an important economic and health burden, mainly in rural or marginalized communities of sub-Saharan Africa, Asia, and Latin-America. Although improved pig rearing conditions seem to have eliminated the parasite in most Western European countries, little is known about the true endemicity status of T. solium throughout Europe. Three recent reviews indicate that autochthonous human T. solium taeniasis/cysticercosis may be possible in Europe, but that current peer-reviewed literature is biased towards Western Europe. Officially reported data on porcine cysticercosis are highly insufficient. Favourable conditions for local T. solium transmission still exist in eastern parts of Europe, although the ongoing integration of the European Union is speeding up modernisation and intensification of the pig sector. Further evidence is urgently needed to fill the gaps on the European T. solium endemicity map. We urge to make human cysticercosis notifiable and to improve the reporting of porcine cysticercosis.