Search

Taenia solium is a parasite and is endemic in the developing countries due to various unhygienic faecal practices. The disseminated form is commoner with the brain being the most common site of affliction. This report is of a young female patient with complaints of an insidious and progressive swelling of the right forearm. Clinicoradiological features were suggestive of an isolated myocysticercosis which was symptomatic with restricted pronation and supination. The symptoms persisted post a course of Albendazole, and the cyst had to be excised as it was impinging on the median and radial nerves. The patient has been asymptomatic after a 3-month post-operative period with no signs or imaging evidence of residual disease. The presence of isolated intramuscular cysticercosis is an extremely rare and a high index of suspicion is needed for early diagnosis. Although medical management is extremely effective, surgical excision may be required in certain cases. [ABSTRACT FROM AUTHOR]

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. 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. 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. The TS POC test showed promising results for the diagnosis of neurocysticercosis in patients with vesicular lesions, which need to be confirmed in a larger study. This test could be considered to support policies on screening patients with suspected neurocysticercosis in clinical settings, which would allow appropriate referral for neuroimaging and early treatment. German Federal Ministry of Education and Research and the European & Developing Countries Clinical Trials Partnership. For the Swahili translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

• This mapping study used spatial statistics and a systematic literature review. • The spatiotemporal variation in Taenia solium risk and prevalence is evident in Uganda. • The high prevalence and risk areas show the need for urgent focal T. solium control. • A mapping protocol is presented to support country planning for T. solium control. The lack of subnational mapping of the zoonotic cestode Taenia solium in endemic countries presents a major challenge to achieving intensified T. solium control milestones, as outlined in the "World Health Organization neglected tropical disease roadmap by 2030". We conducted a mapping study in Uganda, considered to be endemic, to identify subnational high-risk areas. T. solium prevalence data, adjusted for diagnostic sensitivity and specificity in a Bayesian framework, were identified through a systematic review. Spatial autocorrelation and interpolation techniques were used to transform demographic and health survey cluster-level sanitation and poverty indicators, overlaid onto a pig density map for Uganda into modelled porcine cysticercosis (PCC) risk maps. A total of 16 articles (n = 11 PCC and n = 5 human cysticercosis (HCC) and/or human taeniasis) were included in the final analysis. The observed HCC prevalence ranged from 0.01% to 6.0% (confidence interval range: 0.004-11.4%), whereas the adjusted PCC ranged from 0.3 to 93.9% (uncertainty interval range: 0-99.8%). There was substantial variation in the modelled PCC risk factors and prevalence across Uganda and over time. The high PCC prevalence and moderate HCC exposure estimates indicate the need for urgent implementation of T. solium control efforts in Uganda. [ABSTRACT FROM AUTHOR]

Taenia asiatica , utilizing pigs as an intermediate host, degenerates and/or calcifies within a few months after infection in pigs, whereas Taenia solium , also using pigs as an intermediate host, can develop into a mature metacestode within a couple of months and can survive for prolong periods in pigs. This raises the question of whether pigs are suitable intermediate hosts for T. asiatica. The host-parasite relationships between T. asiatica and pig strains, such as infection rates and development of metacestodes, have been reported in previous studies: however, little is known about the pathological changes that occur in T. asiatica metacestodes in pigs. Therefore, in the present study, the pathological changes in T. asiatica within 30 days of infection were observed using CLAWN miniature pigs as model animals. Metacestodes were observed on the diaphragmatic surface and throughout the parenchyma of the pig liver 9 days after infection; however, these metacestodes were surrounded by eosinophilic abscesses, and some had already begun to degenerate. By day 20 and 30 post-infection, metacestodes were surrounded by eosinophilic abscesses and had completely degenerated without forming a scolex. These results indicate that although T. asiatica infected miniature pigs, the metacestodes degenerated owing to strong immune responses from the pigs. Therefore, the CLAWN miniature pig are not a suitable intermediate host for T. asiatica. The possible reasons why T. asiatica metacestodes were degenerated and the potential roles of pigs in transmitting the parasite to humans in T. asiatica -endemic regions are discussed in this study. Additionally, data debating whether pigs are suitable intermediate hosts for T. asiatica are provided. [Display omitted] • Pathological changes of Taenia asiatica were examined using CLAWN miniature pigs. • T. asiatica metacestodes were degenerated by the pig's immune responses. • CLAWN miniature pig was not a suitable intermediate host for T. asiatica. • Whether pigs are suitable intermediate hosts is still debatable. [ABSTRACT FROM AUTHOR]

• rrnS PCR sensitivity was similar to previously published qPCRs. • rrnS PCR sensitivity was statistically superior to McMaster2 and Malachite methods. • cox1 PCR did not perform acceptably during prelimary validation. • rrnS PCR and sequencing of microscopy positive samples is a feasible workflow. The diagnostic challenges associated with T. solium continue to hamper control efforts of the world's most significant foodborne parasite and leading cause of epilepsy in low and middle-income countries. This study aimed to validate two conventional PCRs for taeniasis and estimate the diagnostic performance of microscopic and molecular tools. Formalin and ethanol-fixed samples were tested by formalin-ethyl acetate concentration technique (FECT), Malachite smear, McMaster2 method, rrnS PCR and cox1 PCR. Initial validation of PCR methods was completed on 45 microscopy positive individuals. After validation, the performance of microscopic methods and the rrnS were estimated using samples from 1,156 individuals in Laos. Bayesian latent class models (BLCMs) and a composite reference standard were used to estimate diagnostic sensitivity and specificity. On preliminary validation, the rrnS was able to detect 27/45 (60.00 %) infections whereas the cox1 detected 21/45 (46.67 %). As a result, the cox1 was excluded from further performance analysis. Microscopy methods and the rrnS were highly specific with estimates above 99.02 % regardless of analytical method. The rrnS was the most sensitive test by informed BCLM (91.45 %, CrI: 73.41–99.52 %) followed by the FECT (71.20 %, CrI: 50.53–85.48 %), McMaster2 (51.31 %, CrI: 32.00–71.29 %) and Malachite smear (32.23 %, CrI: 15.40–54.47 %). The inability to validate the cox1 PCR suggests that it may not be suitable in its current form for routine characterisation of Taenia spp.. The rrnS presents a suitable alternative, however, it requires its products to be sequenced. Given the low prevalence of taeniasis in most populations, microscopy screening followed by rrnS PCR and sequencing confirmation should be a feasible approach that may be integrated with existing soil-transmitted helminth surveys that often use FECT for microscopic diagnosis. [ABSTRACT FROM AUTHOR]

Meatborne parasites pose significant public health concerns and lead to substantial economic losses. Decisions regarding the introduction of risk-based control strategies to manage these parasites depend on the availability of robust and comparable economic data. To understand the current economic evidence available on meatborne parasite control, a scoping study was conducted to provide recommendations on optimal investment. This study is a part of the COST Action CA18105 (Risk-based Meat Inspection and Integrated Meat Safety Assurance [RIBMINS]), which supports the development and implementation of risk-based meat inspection programs across the EU and partner countries. This study synthesized available evidence published between January 1, 1980, and April 1, 2022, on interventions for controlling four meatborne parasites (Taenia saginata , Taenia solium, T. gondii, and Trichinella spiralis) where economic analyses had been conducted in COST Action CA18105-affiliated countries. We considered interventions conducted at any node within meat value chains, including those undertaken by health systems targeting consumers. Twelve relevant articles related to eleven distinct studies were identified. The outcomes of economic analyses were recorded, and a critical appraisal of these studies was carried out. The economic data identified have been summarized narratively, and this scoping review has revealed a scarcity of economic data on which to base decisions regarding meatborne parasite control and a lack of standardization in the approaches used for economic analysis. We recommend consensus building among researchers working in the food safety assurance space to standardize the methods and reporting of economic analysis of interventions, similar to efforts that have been made in the health economics space. [ABSTRACT FROM AUTHOR]

Neurocysticercosis (NCC) is an unusual cause of seizures in high income settings. It typically presents as an afebrile seizure in a previously well child and can occur years after migration or travel. Children diagnosed with neurocysticercosis from 01 July 2005 to 30 June 2020 were identified from the electronic medical records of a tertiary children's hospital in Australia. Additionally, a 10-year compilation of case reports of paediatric NCC in high income settings was performed by medline search (publication years 2011–2021). Diagnosis and treatment of neurocysticercosis were reviewed with reference to diagnostic criteria of Del Brutto et al., and the 2017 Infectious Diseases Society of America treatment guidelines. Over a fifteen-year period, eight children were diagnosed with NCC at our hospital in Sydney, Australia. Seizures and history of travel to or migration from South Asia were the two most frequently occurring findings. Children diagnosed after 2016 all received antiparasitic therapy. Outcomes were generally favorable, though long-term epilepsy resulted in some cases. Compiled case reports from high income settings revealed migration and travel exposures commensurate with local demographic patterns, and treatment approaches conforming with 2017 Infectious Diseases Society of America guidelines. Clinicians should be aware of NCC as a differential diagnosis in children from endemic areas presenting with unprovoked seizures as misdiagnosis can occur. Expert review of neuroimaging facilitates diagnosis and can avert unnecessary neurosurgery. In Australia, India was a key exposure country for NCC, reflecting its endemic burden of disease and local travel and migration patterns. • Neurocysticercosis (NCC) is infrequent in high income countries. • NCC should be considered as a differential diagnosis in children with first-episode seizure who have migrated or travelled from endemic areas. • Epidemiological risk factors for NCC in non-endemic, high income settings reflect local migration and travel patterns from endemic countries. • In Australia, having lived in or travelled to India is a key risk factor for NCC. [ABSTRACT FROM AUTHOR]

La neurocysticercose, résultat de l'enkystement des larves de Taenia solium (ver du porc) dans le système nerveux central, est une cause majeure de troubles neuropsychiatriques dans les pays en développement. Parfois appelée « la grande imitatrice », son diagnostic est ardu du fait de la diversité de ses symptômes et des faibles performances diagnostiques des examens biologiques. En raison de la mobilité croissante de la population mondiale, les maladies parasitaires sont un problème émergent dans les pays industrialisés et leur prise en charge peut mettre en déroute les médecins des zones non endémiques, peu familiers avec ce type de tableaux. 'Le psychiatre est souvent en première ligne face à ces pathologies qui peuvent se présenter uniquement sous la forme des troubles psychiatriques (état dépressif, troubles psychotiques...). Nous décrivons, ici, le cas d'un jeune adulte malgache, sans antécédent, qui a présenté un épisode d'amnésie et de déambulation durant trois jours. La présentation clinique a fait initialement évoquer une dissociation péritraumatique. Ce cas illustre la difficulté diagnostique de la neurocysticercose, qui n'a pu être évoquée qu'après une relecture attentive des examens complémentaires. De surcroît, le tableau d'obnubilation, présenté par ce patient, interroge sur la physiopathologie sous-jacente. Une plus grande connaissance de la neurocysticercose est primordiale afin d'éviter l'errance diagnostique et un retard de prise en charge pouvant mettre en jeu le pronostic vital. Taenia solium (pork tapeworm) infection is a well-known intestinal infection following ingestion of raw or undercooked meat from cystercotic pigs. But humans can also act as intermediate hosts when they ingest Taenia solium eggs present in contaminated food or water, conducing to cysticercosis. Neurocysticercosis is due to an encystment into the human brain system of Taenia solium larvae. This is a major cause of neuropsychiatric disorders in developing countries where people live in close proximity to livestock. Thirty-three percent of seizures in endemic countries are related to neurocysticercosis. Nevertheless, the World Health Organisation (WHO) classified neurocysticercosis as a zoonosis with an underestimated impact. This parasite mainly spreads in central and South America, sub-Saharan Africa and India. Only imported cases have been described in Europe, of which seventeen percent were found in France, making it one of the most affected countries in the continent. This can be explained by its vast Malagasy community: in Madagascar, the seroprevalence of cysticercosis is high, close to twenty percent. The diagnosis can be very complicated because of the wide array of symptoms (mobility, cognitive, or mental impairments, epilepsy...); neurocysticercosis is also called "the Great Imitator". This complexity is reinforced furthermore by the poor efficiency of paraclinical exams. The main paraclinic exam is the brain imaging (CT-scan or MRI) showing non-specific calcified lesions of cysts. Electroencephalogram (EEG), lumbar puncture, biology, serology and the fundus of the eye are helpful but not flawless for the diagnosis. For example, the increase of eosinophilia is not found in the chronic form of the disease. As a result of the increasing mobility of people all around the world, parasitic diseases are an emergent problem in our region. Doctors in these non-endemic zones can be challenged by these unfamiliar illnesses. Psychiatrists are often on the front line facing these pathologies that can manifest themselves entirely through psychiatric disorders such as depression, psychotic disorders, etc. The main treatment of neurocysticercosis is albendazole and symptomatic treatment when the parasite reaches calcification. Below, we present the case of a 30-year-old Madagascan, without medical history, who displayed retrograde amnesia after being found wandering in the streets of Paris, claiming he was robbed. A peri traumatic dissociation was initially evoked. But the association of a clouding of consciousness (as presented in this case) with the retrograde amnesia is uncommon for a peritraumatic dissociation. This case clearly shows the difficulty of diagnosing neurocysticercosis. Only after carefully re-reading the CT-scan and relating it to the patient's origin, the disease was finally suggested. Del Brutto criterions are helpful to make the diagnosis of neurocysticercosis. In this case, the patient had one major, one minor and one epidemiological criterion making the diagnosis likely. One month later, the patient made a spontaneous full recovery. This case highlights the complexity of diagnosing neurocysticercosis. Indeed, in non-endemic zones, the symptoms of our patient could be explained by many other diagnostics: partial onset seizures, strokes, cranial trauma, drugs or alcohol abuse, hypoglycemia, other infections with brain calcifications, peritraumatic dissociation, etc. Retrospective or prospective studies could be helpful to improve its screening, diagnosis, and treatment. On the other hand, to improve our knowledge of-, and database for this disease, it could be suitable to class it as a notifiable disease. [ABSTRACT FROM AUTHOR]

[Display omitted] • Racemose neurocysticercosis is the most severe and difficult to treat form of extra-parenchymal neurocysticercosis. • The bladder wall of the racemose cyst has an active MAPK signalling pathway compared with the vesicular cyst. • Metformin reduces the proliferation of the bladder wall targeting proliferative cells of the parasite in vitro and in vivo. • Use of metformin for the treatment of racemose NCC represents an attractive alternative that requires further evaluation. Racemose neurocysticercosis is an aggressive infection caused by the aberrant expansion of the cyst form of Taenia solium within the subarachnoid spaces of the human brain and spinal cord, resulting in the displacement of the surrounding host tissue and chronic inflammation. We previously demonstrated that the continued growth of the racemose bladder wall is associated with the presence of mitotically active cells but the nature and control of these proliferative cells are not well understood. Here, we demonstrated by immunofluorescence that the racemose cyst has an active mitogen-activated protein kinases (MAPK) signalling pathway that is inhibited after treatment with metformin, which reduces racemose cell proliferation in vitro, and reduces parasite growth in the murine model of Taenia crassiceps cysticercosis. Our findings indicate the importance of insulin receptor-mediated activation of the MAPK signalling pathway in the proliferation and growth of the bladder wall of the racemose cyst and its susceptibility to metformin action. The antiproliferative action of metformin may provide a new therapeutic approach against racemose neurocysticercosis. [ABSTRACT FROM AUTHOR]

Cysticercosis is caused by Taenia solium, a cestode or tapeworm that preferentially affects the subcutaneous tissue, brain, muscle, and the eye. It is traditionally a disease of low socioeconomic regions, but large-scale population migration has made it a matter of global concern. Its ocular invasion is a potentially blinding disease. In the last two decades, there has been considerable discussion of cysticercosis; however, most comes from a limited number of case observations. Thus, to overcome this limitation, we summarize and analyze twenty years of medical literature (from 2000 to 2020) on cysticercosis in ophthalmology. [ABSTRACT FROM AUTHOR]

[Display omitted] • Major advances over the past 50 years relating to taeniid cestode infections are discussed. • New drugs have made major impacts on treatment, especially of echinococcosis. • Imaging, especially ultrasound, has revolutionized diagnosis and treatment. • Effective recombinant vaccines are licensed and in practical use. • Echinococcosis transmission control, or elimination, has been achieved in some areas. In the past 50 years, enormous progress has been made in the diagnosis, treatment and control of taeniid cestode infections/diseases and in the scientific understanding thereof. Most interest in this group of parasites stems from the serious diseases that they cause in humans. It is through this lens that we summarize here the most important breakthroughs that have made a difference to the treatment of human diseases caused by these parasites, reduction in transmission of the taeniid species associated with human disease, or understanding of the parasites' biology likely to impact diagnosis or treatment in the foreseeable future. Key topics discussed are the introduction of anti-cestode drugs, including benzimidazoles and praziquantel, and the development of new imaging modalities that have transformed the diagnosis and post-treatment monitoring of human echinococcoses and neurocysticercosis. The availability of new anti-cestode drugs for use in dogs and a detailed understanding of the transmission dynamics of Echinococcus granulosus sensu lato have underpinned successful programs that have eliminated cystic echinococcosis in some areas of the world and greatly reduced the incidence of infection in others. Despite these successes, cystic and alveolar echinococcosis and neurocysticercosis continue to be prevalent in many parts of the world, requiring new or renewed efforts to prevent the associated taeniid infections. Major advances made in the development of practical vaccines against E. granulosus and Taenia solium will hopefully assist in this endeavour, as might the understanding of the parasites' biology that have come from an elucidation of the nuclear genomes of each of the most important taeniid species causing human diseases. [ABSTRACT FROM AUTHOR]

Neurocysticercosis is the leading cause for acquired epilepsy worldwide, and it is caused by the larval stage of the parasite Taenia solium. Several proteins of this stage have been characterized and studied to understand the parasite-host interaction, however, the proteins from the early cysticercus stages (the postoncospheral form) have not yet been characterized. The study of the postoncospheral form proteins is important to understand the host-parasite relationship in the early stages of infection. The aim of this work was to identify postoncospheral form antigenic proteins using sera from neurocysticercosis patients. T. solium activated oncospheres were cultured in HCT-8 cells to obtain the postoncospheral form. Soluble total and excretory/secretory proteins were obtained from the postoncospheral form and were incubated with both pool sera and individual serum of neurocysticercosis positive human patients. Immunoblotting showed target antigenic proteins with apparent molecular weights of 23 kDa and 46–48 kDa. The 46–48 kDa antigen bands present in soluble total and excretory/secretory postoncospheral form proteins were analyzed by LC-MS/MS; proteins identified were: nuclear elongation factor 1 alpha, enolase, unnamed protein product/antigen diagnostic GP50, calcium binding protein calreticulin precursor and annexin. The postoncospheral form expresses proteins related to interaction with the host, some of these proteins are predicted to be exosomal proteins. In conclusion, postoncospheral proteins are consistent targets of the humoral immune response in human and may serve as targets for diagnosis and vaccines. • Neurocysticercosis patients develop antibodies against Taenia solium postoncospheral proteins. • Major proteins detected by these antibodies are: nuclear elongation factor 1 alpha, enolase, antigen GP50, calreticulin precursor and annexin. • The annexin is a newly identified postoncospheral form protein, not previously reported in T. solium. [ABSTRACT FROM AUTHOR]

[Display omitted] • Intra-peritoneal Taenia crassiceps cysticercosis in mice induces a parasite-specific antibody response in the serum. • Taenia crassiceps larvae contain and release host immunoglobulins and cytokines over time. • Significantly increased levels of IgG were found in the hippocampi of T. crassiceps -infected mice. • Blood brain barrier permeability to Evans Blue dye was affected in T. crassiceps- infected mice. • No alterations to TNF-α, Il-1β, or IL-6 could be demonstrated in response to T. crassiceps infection. Human cysticercosis is a disease caused by larvae of the cestode Taenia solium. It is an important common cause of adult-onset seizures world-wide where it exacts a debilitating toll on the health and well-being of affected communities. It is commonly assumed that the major symptoms associated with cysticercosis are a result of the direct presence of larvae in the brain. As a result, the possible effects of peripherally located larvae on the central nervous system are not well understood. To address this question, we utilised the Taenia crassiceps intra-peritoneal murine model of cysticercosis, where larvae are restricted to the peritoneal cavity. In this model, previous research has observed behavioural changes in rodents but not the development of seizures. Here we used ELISAs, immunoblotting and the Evans Blue test for blood–brain barrier permeability to explore the central effects of peripheral infection of mice with T. crassiceps. We identified high levels of parasite-targeting immunoglobulins in the sera of T. crassiceps -infected mice. We show that the T. crassciceps larvae themselves also contain and release host immunoglobulins over time. Additionally, we describe, for the first known time, significantly increased levels of IgG within the hippocampi of infected mice, which are accompanied by changes in blood–brain barrier permeability. However, these T. crassiceps -induced changes were not accompanied by alterations to the levels of proinflammatory, pro-seizure cytokines in the hippocampus. These findings contribute to the understanding of systemic and neuroimmune responses in the T. crassiceps model of cysticercosis, with implications for the pathogenesis of human cysticercosis. [ABSTRACT FROM AUTHOR]

The endangered Bengal tiger (Panthera tigris tigris) is a keystone species playing an essential role in ecology as well as in the social and spiritual lives of the Himalayan people. The latest estimate of the Bengal tiger population in Bhutan accounts for 103 individuals. Infectious organisms, including zoonotic parasites causing high burden in human health, have received little attention as a cause of mortality in tigers. Taeniosis/cysticercosis, caused by the cestode Taenia solium , is considered one of the major neglected tropical diseases in Southeast Asia. We present here a case of neurocysticercosis in a Bengal tiger showing advanced neurological disease outside Thimphu, the capital city of Bhutan. After palliative care, the animal died, and necropsy revealed multiple small cysts in the brain. Here we show the presence of two genetic variants of T. solium in the parasite material collected based on PCR and sequencing of the complete cox1 and cytB genes. The sequences form a discrete branch within the Asia plus Madagascar cluster of the parasite. On other hand, tests for feline morbillivirus, feline calicivirus, canine distemper virus, Nipah, rabies, Japanese encephalitis, feline leukaemia and feline immunodeficiency virus were negative. In contrast, PCR for feline herpesvirus was positive and a latex agglutination test revealed an elevated antibody titer against Toxoplasma gondii (titer 1:256). The molecular examination of taeniid eggs isolated from the tiger faeces produced sequences for which the highest homology in GenBank is between 92% and 94% with T. regis and T. hydatigena. This fatal case of T. solium neurocysticercosis, a disease previously unrecorded in tigers or other non-domestic felids, demonstrates an anthropogenically driven transmission of a deadly pathogen which could become a serious threat to the tiger population. [Display omitted] • This is the first report of a fatal infection with Taenia solium in a Bengal tiger. • There is a need for research into infectious disease threats to tigers in Bhutan. • The importance of a 'One Health' approach is demonstrated and recommended. • Non-domestic felids. [ABSTRACT FROM AUTHOR]

Neurocysticercosis (NCC) is the commonest parasitic infection of the central nervous system. There is significant difference in incidence of NCC depending on geographic location, and incidence as high as 4% is reported in the endemic areas. It results from human affliction by the larval stage of Taenia solium. Spinal NCC is quite rare as compared with cranial NCC and accounts for 1.5%–3% of all cases. Both spine and cranium can be rarely involved in NCC, and cranial involvement usually precedes the spinal involvement. We report a case of a 51-year-old woman who had spinal involvement first in the form of spinal intradural extramedullary disease and then developed cranial involvement more than 1 year later. She developed spinal arachnoiditis. She developed communicating hydrocephalous requiring ventriculoperitoneal shunt. Later she developed isolated fourth ventricle and required excision of the fourth ventricular NCC. The unique aspects of our patient were a very aggressive course and involvement of cranium after spinal involvement. We describe her clinical course over 3 years and the management done. NCC can sometimes follow a very aggressive course and can involve both cranial and spinal compartments. Management of such patients is not standardized given the rarity of such cases. [ABSTRACT FROM AUTHOR]

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. Clear epidemiological data are lacking regarding the evolution of cysticercosis incidence and prevalence in different endemic countries. Therefore, it is difficult to compare these parameters across countries. Clinicoradiological presentation of neurocysticercosis (NCC) is heterogeneous in the same country and also between countries. The delay between infection and presentation of symptoms is variable and depends, among other things, on the locations of the parasites. We believe that the differences in the proportion of the different forms of cysticercosis between countries is linked, at least in part, to the differences in infection pressure in these countries. This paper allows for a better understanding of the infection dynamic and could contribute to the establishment of NCC control programs tailored to each country. [ABSTRACT FROM AUTHOR]

• EITB is the only serological tool acceptable for Neurocysticercosis diagnosis. • Commercially available ELISA is unsuitable for NCC diagnosis in endemic regions. • Detection of any band of <50 kDa was not associated with NCC in rural populations. • 15 kDa band had significant association with NCC in both study groups. • 17 kDa and 35 kDa bands were linked to degenerating cyst and multiple cysticerci. Neurocysticercosis (NCC) is infection by cestode Taenia solium/ pork tapeworm. Sero-diagnosis of NCC is still a challenge. Radiological imaging (CT/MRI) are cost intensive, requires technical expertise and resource intensive. Hence, its availability is restricted in endemic zone. Existing Enzyme electro immune transfer blot (EITB) antigens are difficult to make and is not standardized for endemic population. Therefore, there is a definite need for easy and reliable EITB tool. T. solium metacestode were harvested from naturally infected swine post slaughter. The cyst fluid/vesicular fluid was aspirated and processed with ultracentrifugation and immune blot was performed with this antigen. A total of 406 cases [rural 256 (NCC 78, seizures other than NCC 108 and healthy controls 70); urban 150 (NCC 41, seizures other than NCC 59 and healthy controls 50)] were enrolled. Positive EITB (detection of band <50 kDa) was significantly associated with NCC patients of urban population only (p < 0.001) but not in rural populations (p = 0.292). However, identification of 15 kDa band had significant association with NCC both in urban and rural populations with overall sensitivity of 91.5% and specificity of 91.6%. Presence of 35 kDa band was associated with multiple NCC (p < 0.001). The study shows that 15 kDa reactive band on EITB is highly sensitive and specific for diagnosis of NCC in endemic population. Presence of 35 kDa band on EITB was associated with infection by multiple cysticerci. The observations demand purification of cyst fluid antigens to develop simple and easy to execute test in field studies. [ABSTRACT FROM AUTHOR]

Neurocysticercosis, the infection of the CNS with larval cysts of Taenia solium, is a leading cause of seizures in low-income countries. The clinical presentation of neurocysticercosis is variable and depends on the number, size, and location of cysticerci, and on the immune response of the host. In most patients, the affected site is the brain parenchyma, where cysts can precipitate seizures. Neurocysticercosis has seldom been described in pregnant women. In this Grand Round, we report two cases of pregnant women who immigrated to Italy from Bolivia and Ecuador, and who developed seizures in the early post-partum period, due to calcified parenchymal neurocysticercosis lesions. We discuss the complex interactions between neurocysticercosis and the immune system in pregnancy and the post-partum period. Building on this scenario, we propose practices for the management of neurocysticercosis in pregnancy and the post-partum period, highlighting important gaps in the literature that should be addressed. [ABSTRACT FROM AUTHOR]

Changes in the incidence of porcine cysticercosis is used commonly in the assessment of efforts to control the transmission of Taenia solium , the cause of human neurocysticercosis. Although cysticerci may occasionally occur in tissues other than the striated muscles, particularly the brain, infection in pigs can be diagnosed reliably by assessment of muscle tissue alone. [ABSTRACT FROM AUTHOR]

Taenia solium is a widespread zoonotic tapeworm that predominantly affects regions of Latin America, South and South-East Asia, and Sub-Saharan Africa. Neurocysticercosis (NCC), the presence of T. solium cysts in the brain is associated with diverse clinical manifestations, such as epilepsy, seizures, and neurological deficits. It is a significant cause of preventable epilepsy globally, accounting for approximately 30% of cases in endemic regions. The diagnosis of neurocysticercosis relies on neuroimaging techniques, but these resources are often limited in low-income countries, resulting in an underestimation of the disease burden. The present study enrolled 141 patients who were clinically suspected and radiologically confirmed for NCC at the Neurology OPD of PGIMER, Chandigarh. Additionally, 98 control subjects attending the PGIMER OPD for investigation were also included. Plasma and urine samples were collected from all participants for further analysis. Cell-free DNA extraction was performed using specific kits, and the quality of the extracted DNA was assessed. The RT-LAMP assay targeted the cox1 gene. Real-time RT-LAMP results were evaluated using a fluorescence graph obtained with the Genei III fluorimeter. Among a group of patients diagnosed with NCC, the gene was identified in 74.4% of plasma samples and 67.3% of urine samples. In comparison, the T. solium cox1 gene was found in 6.1% of control subjects in plasma and urine samples using the LAMP assay. In conclusion, the study emphasises the need for improved diagnostic methods for NCC and presents promising alternatives, such as RT-LAMP and urine-based cell-free DNA analysis. These approaches offer advantages in terms of cost-effectiveness, simplicity, and diagnostic accuracy. • Real-time LAMP, targeting infection-induced cell-free DNA in plasma and urine samples. • RT-LAMP assay examines the presence of the cox1 gene from Taenia solium. • Six sets of primers, including loop primers, were employed to enhance efficiency. • LAMP assay demonstrated a sensitivity of 74.4% for plasma and 67.3% for urine samples. • LAMP assay exhibited a specificity of 93.8% for both plasma and urine samples. [ABSTRACT FROM AUTHOR]

Neurocysticercosis is a condition characterized by the presence of Taenia solium (larval stage: Cysticercus cellulosae) in the brain and is classified as a tropical disease. Although it was previously uncommon in Europe, the number of cases has been increasing over the past decade. In this report, we present a case of a patient who was admitted with symptoms of raised intracranial pressure and biventricular hydrocephalus, without evidence of infection. Imaging studies revealed the presence of an atypical colloid cyst, which was subsequently removed using a neurosurgical endoscopic approach. Anatomopathologic analysis confirmed the presence of a C. cellulosae larva. It is crucial not to overlook or misdiagnose isolated intraventricular neurocysticercosis because it can lead to complications such as delayed diagnosis and dissemination of the cyst. [ABSTRACT FROM AUTHOR]

Calreticulin is a chaperone and master regulator of intracellular calcium homeostasis. Several additional functions have been discovered. Human and parasite calreticulin have been shown to suppress mammary tumor growth in vivo. Here, we explored the capacity of recombinant Taenia solium calreticulin (rTsCRT) to modulate cancer cell growth in vtro. We used different concentrations of rTsCRT to treat cancer cell lines and analyzed viability and colony formation capacity. We also tested the combination of the IC 20 or IC 50 doses of rTsCRT and of the chemotherapeutic drug 5-fluorouracil on MCF7 and SKOV3 cell lines. As a control, the non-tumorigenic cell line MCF10-A was employed. The effect of the drug combinations was also assessed in cancer stem-like cells. Additionally, scavenger receptor ligands were employed to identify the role of this receptor in the rTsCRT anti-tumoral effect. rTsCRT has a dose-dependent in vitro anti-tumoral effect, being SKOV3 the most sensitive cell line followed by MCF7. When rTsCRT/5-fluorouracil were used, MCF7 and SKOV3 showed a 60% reduction in cell viability; colony formation capacity was also diminished. Treatment of cancer stem-like cells from MCF7 showed a higher reduction in cell viability, while those from SKOV3 were more sensitive to colony disaggregation. Finally, pharmacological inhibition of the scavenger receptor, abrogated the reduction in viability induced by rTsCRT in both the parental and stem-like cells. Our data suggest that rTsCRT alone or in combination with 5-fluorouracil inhibits the growth of breast and ovarian cancer cell lines through its interaction with scavenger receptors. [ABSTRACT FROM AUTHOR]

Neurocysticercosis, caused by the larval form of the tapeworm Taenia solium , is the most common parasitic disease affecting the human central nervous system. The incidence of spinal neurocysticercosis in endemic regions ranges from 0.25% to 5.85%. Surgery is preferred when medical treatment fails to achieve control of the symptoms or when multiple cysts are present. We describe the use of spinal flexible endoscopy for patients with spinal neurocysticercosis who failed to achieve control with standard treatment. Three patients with limb weakness and pain underwent a midline interspinous approach at the L5-S1 level to access the lumbar cistern. The flexible endoscope was introduced, the subarachnoid space was inspected, and the cysticerci were extracted. In 1 patient with cervical subarachnoid blockage, a 3-cm suboccipital craniotomy and removal of the posterior arch of C1 were performed to place a subarachnoid-to-subarachnoid catheter going from the craniocervical junction to the thoracic region. Removal of the cysticerci was possible in all cases. No complications related to the surgery were observed. All patients received medical treatment for 2–3 months, and all symptoms were solved. Flexible spinal endoscopy is a feasible and valuable tool in patients with spinal neurocysticercosis that do not respond adequately to standard treatment. It helps restore cerebrospinal fluid dynamics and can be used to place shunt catheters under guided vision. Longer endoscopes are needed to explore the entire spinal subarachnoid space with a single approach, and more research in this area is needed. [ABSTRACT FROM AUTHOR]

• Serbia is traditionally endemic for both Taenia saginata and Taenia solium infection. • Between 1990 and 2018, the infection was continuously present through sporadic cases. • The annual number of cases was positively correlated with the consumer price index. • There is the potential for re-emergence in the case of socio-economic decline. 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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

The cystiSim model was used to compare strategies for the control of Taenia solium. A three-monthly intervention in pigs for 3 years was substantially more effective than biannual treatment for taeniasis in the human population for 5 years. The intervention period could be shortened further by combining pig and human interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium , Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for major interventions for control, elimination and eradication. This systematic review highlights the progress towards development of rapid tests for the diagnosis of FNZH since 2010 when they were listed as neglected tropical diseases. Methodology A systematic search was conducted in three databases, World of Science, Embase and PubMed using the same search phrase. The search produced 480 hits. Three studies from back referencing were included. Only 22 of these met the inclusion criteria. Data was extracted from these and presented qualitatively. Results Twenty-five rapid diagnostic tests were found to have been developed since 2010, eight for diagnosis of T. solium infections, eight for echinococcosis and nine for FBT infections. The rapid tests for diagnosing T. solium infections included six antibody detecting and two antigen detecting tests. They constitute a combination among them, with some tests providing qualitative, others quantitative results. Similarly, seven out of the eight rapid tests developed for Echinococcus infections were antibody detecting tests save for one loop mediated isothermal amplification test. All of them were qualitative tests. For FBT infections, nine rapid tests were described; two antibody and one nucleic acid detecting test for diagnosis of Fascioliasis; three nucleic acid detecting tests for Opisthorchiasis; one antibody detecting test for Paragonimiasis; and for Clonorchiasis, one antibody and one nucleic acid detecting test. The FBT infection rapid tests were all qualitative in nature. Most of these tests have not undergone field evaluation in endemic areas where they will be used most. Conclusion This review describes the development and evaluation of rapid diagnostic tests, while highlighting the need for in depth validations of the tools to determine how well they can perform in endemic areas. [ABSTRACT FROM AUTHOR]

Abstract Background Taenia solium is a zoonotic tapeworm widely distributed across sub-Saharan Africa. Specific health education is regarded as a central element in controlling T. solium. In 2014, an electronic health education tool called 'The Vicious Worm', which was concerned with prevention of T. solium was introduced to health and agricultural professionals in Mbeya, Tanzania, an endemic setting. Introduction to ´The Vicious Worm' of 1.5 hours significantly improved the participants' knowledge. This study revisited the same study subjects one year later to assess persistence of knowledge regarding T. solium taeniosis/cysticercosis and to assess if the health education had changed work practices for the participants and the public. Methods The study was conducted in Tanzania between June and August 2015, with a fixed population of health and agricultural professionals recruited from a previous study testing 'The Vicious Worm'. The study used a test, a questionnaire survey, as well as semi-structured group and individual interviews. Results The 79 study subjects, all health or agricultural professionals, had within one year relocated from Mbeya to 16 of 21 administrative regions of Tanzania. Sixty-four agreed to participate in the test and 48 to an interview. The test showed significant improvement in knowledge regarding T. solium taeniosis/cysticercosis, compared with the baseline knowledge level of the participants. Interview data found that the participants had used 'The Vicious Worm' as an educational tool and applied the knowledge from the program to implement new practices consisting of by-laws and practical workshops on building latrines, pig pens and hand washing stations in their communities. Conclusion Introduction to 'The Vicious Worm' led to changed practices and persistence in knowledge regarding T. solium. Incorporating health education as a specific health intervention tool should be encouraged and implemented at national or programmatic level. [ABSTRACT FROM AUTHOR]

Highlights • Identifying a novel cathepsin L-like cysteine protease (TsolCL) from Taenia solium. • Cloning and expression of an active TsolCL in baculovirus-insect cell system. • Hydrolyzing Z-Phe-Arg-AMC substrate and bovine serum with the recombinant TsolCL. • Detecting antibodies from pigs with cysticercosis, using recombinant TsolCL. Abstract Porcine cysticercosis is an endemic parasitic disease caused by infection with Taenia solium that is found predominantly in developing countries. In order to aid in the development of simple diagnostic approaches, identification and characterization of potential new antigens for immunodiagnostic purposes is desired. The cysteine protease family has previously been found to have important immunodiagnostic properties. These proteases are expressed as zymogens which contain a signal peptide, pro-peptide, and an active domain. Subsequent catalytic cleavage of the pro-peptide converts these zymogens into enzymes. With the use of bioinformatic tools we identified an active domain of a novel cathepsin L-like cysteine protease (TsolCL) in the T. solium genome. The TsolCL gene includes 705 nucleotides (nt) within a single intron and a 633 nt exonic sequence encoding an active protein of 211 amino acids. Sequence alignment and phylogenetic analysis suggest that the TsolCL gene is closely related to genes found in Echinoccocus granulosus and E. multiloculars. In addition, TsolCL was found to have a 61.9%–99.0% similarity to other cathepsin L proteins found in other helminths and mammals. We cloned, expressed, purified, and characterized the recombinant active TsolCL (27 kDa) using the baculovirus-insect cell expression system. TsolCL showed cysteine protease enzymatic activity with the capacity to hydrolyze the Z-Phe-Arg-AMC substrate as well as bovine serum albumin. However, TsolCL was not able to hydrolyze human immunoglobulin. In addition, TsolCL has cathepsin L conserved amino acid residues in the catalytic site (Gln8, Cys14, His159, Asn179 and Trp181) and the motif GCNGG. Using ELISA, TsolCL was able to distinguish circulating IgG antibodies between healthy animals and naturally infected pigs with cysticercosis, showing a moderate sensitivity of 83.33% (40/48; 95% CI: [69.8%–92.5 %]), and a specificity of 83.78% (31/37; 95% CI: [67.9%–93.8%]). In conclusion, a novel cathepsin L-like cysteine protease from a T. solium metacestode was expressed successfully in Baculovirus system and was evaluated as a candidate antigen to diagnose porcine cysticercosis using the ELISA immunoassay. [ABSTRACT FROM AUTHOR]

Highlights • Neurocysticercosis is an important cause of epilepsy in sub-Saharan Africa. • Epilepsy represents its main manifestation but headache, neuropsychiatric disorders are also possible. • CT scan is the principal neuroimaging available in this setting. • The poor level of sanitation and low economic status contribute to high prevalence of neurocystiercosis. • Commitment of both human and animal stakeholders is one of the conditions to break the Taenia solium lifecycle. Abstract Neurocysticercosis is a public health problem and the leading cause of epilepsy in developing countries especially in sub-Saharan Africa (SSA). In this paper, the authors review the epidemiology of cysticercosis and neurocysticercosis, as well as the non-specific clinical manifestations which render clinical diagnosis challenging especially in the sub-Saharan African context. Special attention is given to the association of epilepsy and neurocysticercosis, the former being the most common symptom of the later, and the role of the later in epileptogenesis is discussed. The state of the art guidelines regarding diagnostic tests and treatment options are discussed and proposals for prevention are made, given the specific socio-culturaland economic context of the endemic countries, mostly in SSA. [ABSTRACT FROM AUTHOR]

Abstract 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. [ABSTRACT FROM AUTHOR]

Highlights • Poverty, ignorance, pig production practises and poor sanitation are risks factors for Taenia solium cysticercosis in most of West Africa. • Cultural beliefs and stigmatization of epilepsy coupled with lack of modern diagnostics facilities and good quality drugs constraint effective control of neuro-cysticercosis in humans. • Although vaccines are available for the control of porcine cysticercosis, lack of fund preclude its use by most pig farmers. • In-depth studies are needed to fully elucidate the epidemiology of the disease in West Africa. Abstract Human and porcine cysticercosis is endemic in West Africa, where epilepsy is relatively common, but rarely reported due to fear of stigmatization. Neurocysticercosis, caused by Taenia solium , tends to affect the poor in developing countries and control is hampered by inadequate infrastructure and financial resources coupled with lack of adequate information about its significance and distribution. The risk factors for human cysticercosis are closely associated with the characteristics of smallholder or backyard pig farming systems prevalent in this region. Poverty, ignorance and lack of political will militate against successful eradication, while tools for effective diagnosis, prevention and treatment, including vaccines for pigs, are not yet available in many countries. Cysticercosis was targeted for control by The World Health Organization global plan for 2008–2015; however, measures for control are yet to be undertaken in a coordinated manner in West Africa. Diagnostic tools, including neuroimaging facilities, should be strategically situated and made accessible to rural populations in West Africa. Community education in combination with a multipronged approach consisting of vaccination of pigs using TSOL18 vaccine and treatment with oxfendazole along with mass chemotherapy of humans with praziquantel could eliminate taeniasis and should be considered. In-depth and extensive epidemiological studies are required in West Africa in order to fully elucidate the prevalence of T. solium and to support more coordinated and effective control of human and porcine cysticercosis. [ABSTRACT FROM AUTHOR]

Objective Discordances between imaging findings of parenchymal neurocysticercosis and seizure expression have been reported, and as such the possibility that neurocysticercosis and seizures may frequently coexist by chance has been raised. In this study, we evaluate the topographic relationship between seizure foci based on semiology and electroencephalography with the location of parenchymal neurocysticercotic lesions. Methods Seizure information, neuroimaging (computed tomography and magnetic resonance imaging [MRI]) and electroencephalographic data from three randomized clinical trials of individuals with parenchymal neurocysticercosis and focal seizures were analyzed. Blinded epileptologists defined a potential seizure onset zone and a symptomatogenic zone for each individual based on semiology. The topographic relationship between semiology, either lesion location or areas of perilesional edema on baseline MRI, and electroencephalographic abnormalities were assessed. Results Fifty-eight patients with one or two parenchymal neurocysticercotic lesions were included in this study. From them, 50 patients (86%; 95% CI, 75%–93%) showed a clinical-topography relationship with the potential seizure onset zone, and 44 (76%) also with the symptomatogenic zone. From the eight patients with no topographic relationship, five had focal seizures 30 days before or after the baseline MRI and showed perilesional edema. All of these five patients showed a clinical-topography relationship between such seizures and an area of perilesional edema, making a total of 55 patients (95%; 95% CI, 85%–99%) with clinical-topography relationship when perilesional edema is considered. Most patients with focal epileptiform discharges (7/8, 88%) had a topographic association between electroencephalographic focality, the potential seizure onset zone and a cysticercotic lesion. Conclusion Seizure semiology and focal epileptiform discharges are topographically related to neurocysticercotic lesions in most patients. These data strongly support seizure origin in the cortex surrounding these lesions. [ABSTRACT FROM AUTHOR]

The larval stage of Taenia solium (cysticerci) is the causal agent of human and swine cysticercosis. When ingested by the host, T. solium eggs are activated and hatch in the intestine, releasing oncospheres that migrate to various tissues and evolve into cysticerci. Plasminogen (Plg) receptor proteins have been reported to play a role in migration processes for several pathogens. This work is aimed to identify Plg-binding proteins in T. solium cysticerci and determine whether T. solium recombinant enolase (rTsEnoA) is capable of specifically binding and activating human Plg. To identify Plg-binding proteins, a 2D-SDS-PAGE ligand blotting was performed, and recognized spots were identified by MS/MS. Seven proteins from T. solium cysticerci were found capable of binding Plg: fascicilin-1, fasciclin-2, enolase, MAPK, annexin, actin, and cytosolic malate dehydrogenase. To determine whether rTsEnoA binds human Plg, a ligand blotting was performed and the results were confirmed by ELISA both in the presence and absence of εACA, a competitive Plg inhibitor. Finally, rTsEnoA-bound Plg was activated to plasmin in the presence of tPA. To better understand the evolution of enolase isoforms in T. solium , a phylogenetic inference analysis including 75 enolase amino acid sequences was conducted. The origin of flatworm enolase isoforms, except for Eno4, is independent of their vertebrate counterparts. Therefore, herein we propose to designate tapeworm protein isoforms as A, B, C, and 4. In conclusion, recombinant enolase showed a strong plasminogen binding and activating activity in vitro . T. solium enolase could play a role in parasite invasion along with other plasminogen-binding proteins. [ABSTRACT FROM AUTHOR]

Enolase (EC 4.2.1.11) acts as a multifunctional enzyme in many organisms, being involved in metabolism, transcription regulation and pathogenesis. In the current study, the recombinant α-enolase from Taenia solium (His-Tseno) was prepared and antiserum against His-Tseno was generated in rabbits. Consequently, we analyzed the enzymatic characteristics, plasminogen binding activity, tissue localization and expression patterns of Tseno. The study demonstrated that the enzymatic activity of His-Tseno was enhanced at pH around 7.0–7.5 and affected by addition of metal ions. Kinetic measurements using 2-phospho- d -glycerate (2-PGA) substrates gave a specific activity of 60.72 ± 0.84 U/mg and 1.1 mM of Km 2-PGA value. Plasminogen binding assay showed that His-Tseno could bind to human plasminogen and generate plasmin activated by a tissue-type plasminogen activator (t-PA). In addition, the lysine analogue 6-aminocaproic acid (ε-ACA) could inhibit the binding of plasminogen to His-Tseno. Quantitative real-time PCR confirmed that Tseno was expressed 2.38 folds higher in the adult worms (p < 0.05) than in the cysticerci. Further, an immunolocalization assay indicated that native Tseno was mainly distributed in the tegument and eggs of gravid proglottis from adult T. solium . In conclusion, Tseno executes the innate glycolytic function to supply energy for the growth, egg production, and even invasion of T. solium . [ABSTRACT FROM AUTHOR]

Cysticercosis is a zoonotic disease caused by the larval form of Taenia solium. Its occurrence as a breast lump is rarely observed and therefore presents significant diagnostic challenges, especially in non-endemic regions. A 25-year-old female patient presented with a lump in her left breast. The lesion was initially non-diagnostic on ultrasound and fine needle aspiration cytology. Excision biopsy of the cystic lesion was done, and histopathological examination confirmed it to be cysticercosis. Post surgery patient was given Albendazole, and she was asymptomatic during the 3 month follow up. This case highlights the disease's ability to present in atypical forms, such as a breast lump, and the importance of considering cysticercosis in differential diagnosis, especially in endemic regions. Ultrasonography remains the preferred initial diagnostic modality, and the role of FNAC and histopathology is crucial for confirmation. The case also emphasizes the need for heightened clinical suspicion, even when traditional risk factors like pork consumption are absent. This case emphasizes the importance of considering cysticercosis as a differential diagnosis for breast lumps, even with atypical presentation or in a non-endemic region. It highlights the need for greater awareness of this disease, stringent public health measures, and improved personal hygiene to combat its spread. • The report outlines a rare case of breast cysticercosis in a young female, initially mistaken for a benign lesion. • The patient contracted cysticercosis despite history of eating disease vectors, underscoring the importance of hygiene. • Cysticercosis should be considered as clinical differential diagnoses for all cystic breast lesions. [ABSTRACT FROM AUTHOR]

• Median cost per NCC case was 18.1% of average wage for a Liangshan prefecture resident in 2021. • Total estimated cost for patients (n = 68) was US$220,007.02. • Direct costs contributed 64.9% (US$142,785.25) of total cost. • Median cost per NCC case was US$2017.82. Neurocysticercosis (NCC) is a potentially life-threatening condition caused by the zoonotic cestode, Taenia solium. Pigs are the typical intermediate hosts for T. solium but humans can become infected and develop NCC upon ingesting parasite eggs that are shed in the feces of an infected person. The objective of this study was to estimate the monetary burden of neurocysticercosis (NCC) on hospitalized patients from Muli County, China. Muli is an agricultural county in Liangshan Prefecture, Sichuan Province, China where pigs are raised and the zoonotic cestode, Taenia solium , is endemic. Demographic and treatment data were collected from the Muli County Health Insurance Department on hospitalized individuals with an NCC diagnosis between 2014 and 2021. These patients represent residents of Muli County that purchased health insurance and received treatment in a public hospital in Sichuan Province. Hospital costs were converted from Chinese renminbi (RMB) to United States dollars (US$) for month and year of hospitalization and adjusted for inflation. Individuals with missing hospital information were excluded from analysis. For indirect costs, annual average salary for Liangshan Prefecture working-age adults was obtained to calculate productivity losses based on number of hospitalization days and travel days to and from the hospital. Transportation costs were evaluated based on estimated bus fare to and from the hospital. Out of 70 patients identified from 2014 to 2021, 68 had complete records, of which 47.1% were male (n = 33) and the median age at first hospitalization was 34 years. Total estimated cost for these patients was US$228,341.98. Direct costs contributed 62.5% (US$142,785.25) and indirect costs were 37.5% (US$85,556.73) of the total cost. The estimated median cost per case was US$2,078.69. Individuals with a single hospitalization (n = 41) cost a median of US$1,572.03 and those with multiple hospitalizations (n = 27) cost a median of US$4,169.95. The median total cost per NCC case was 18.6% of the average wage for a Liangshan Prefecture resident in 2021. While the study was limited to those with insurance coverage, monetary burden on the local population is likely substantial. Public health policies aimed at reducing transmission should be implemented to decrease the economic burden of NCC on this region. [ABSTRACT FROM AUTHOR]

Low cost vaccines against cysticercosis are needed to fight this parasitosis, especially in developing countries. Herein polycistron arrangements were designed to accomplish the simultaneous expression of multiple protective antigens from Taenia solium in the plant cell as an attractive biofactory and delivery vehicle of vaccines. Transplastomic plants carrying synthetic polycistrons were able to simultaneously express the KETc1, KETc7, KETc12, GK1, and TSOL18/HP6-Tsol antigens; which retained their antigenicity and ability to induce humoral responses in BALB/c mice. These clones may be useful for the production of low-cost cysticercosis vaccine prototypes. [ABSTRACT FROM AUTHOR]

Neurocysticercosis is a major cause of epilepsy in countries where Taenia solium is endemic and the parasite is a major cause of food-borne disease globally. Pigs are the natural intermediate host involved in transmission of the parasite. T. solium is known to be endemic in Nepal, however there is limited reliable data about the prevalence of the disease in Nepal. The aim of this study was to determine accurately the prevalence of porcine cysticercosis in slaughter age pigs in an area of Nepal where pigs are known to be free-roaming. Pigs were obtained from the Udaypur Village Development Committee (VDC) and Hirminiya & Betahani VDC of the Banke district in Nepal. One hundred and ten animals of slaughter age (approximately 8–16 months old) were purchased, slaughtered and the heart, liver, brain and half the body skeletal musculature were sliced using hand knives and the number and viability of T. solium cysts determined. Thirty two of the 110 animals were found to harbour T. solium cysticerci (29%), of which 30 (27%) were found to have viable cysticerci (93% of the infected animals). This is one of the highest prevalences of porcine cysticercosis that has been reported to date from the results of necropsy on randomly selected animals. This study highlights a high rate of transmission of T. solium in the Banke District of Nepal. It encourages further investigation of human and porcine cysticercosis in Nepal, as well as implementation of efforts to reduce transmission of the parasite and the associated human disease. [ABSTRACT FROM AUTHOR]

Aside from brain injury and genetic causes, there is emerging information on brain infection and inflammation as a common cause of epilepsy. Neurocysticercosis (NCC), the most common cause of epilepsy worldwide, is caused by brain cysts from the Taenia solium tapeworm. In this article, we provide a critical analysis of current and emerging information on the relationship between NCC infection and epilepsy occurrence. We searched PubMed and other databases for reports on the prevalence of NCC and incidence of epilepsy in certain regions worldwide. NCC is caused by brain cysts from the T. solium and related tapeworms. Many people with NCC infection may develop epilepsy but the rates are highly variable. MRI imaging shows many changes including localization of cysts as well as the host response to treatment. Epilepsy, in a subset of NCC patients, appears to be due to hippocampal sclerosis. Serologic and brain imaging profiles are likely diagnostic biomarkers of NCC infection and are also used to monitor the course of treatments. Limited access to these tools is a key limitation to identify and treat NCC-related epilepsy in places with high prevalence of this parasite infestation. Overall, NCC is a common infection in many patients with epilepsy worldwide. Additional clinical and animal studies could confirm common pathology of NCC as a postinfectious epilepsy that is curable. [ABSTRACT FROM AUTHOR]

Background Neurocysticercosis (NCC) of Taenia solium has never been reported in Mongolia. A Mongolian traveler who visited China and India presented with epileptic seizures after his return to Mongolia. Magnetic resonance imaging showed multiple ring enhancing lesions with edema surrounding several lesions in his brain that were initially diagnosed to be viral encephalitis or NCC. Methods Serology for cysticercosis using diagnostic antigens partially purified by cation-exchange chromatography and chimeric recombinant antigens and DNA analysis of a proglottid found in the patient's stool were applied for differential diagnosis. Results Serology showed strong positivity for NCC, and mitochondrial cox1 gene analysis revealed Indian but not Chinese haplotype of T. solium . Conclusion This NCC case was considered to be caused by eggs released from adult tapeworm(s) established after eating uncooked or undercooked pork contaminated with cysticerci during his stay in India. This is a case report of taeniasis and secondary NCC associated with travel to India with an updated review of NCC in Asia. Molecular tracking of the specimen is highly informative as a way to identify where the infection was acquired. [ABSTRACT FROM AUTHOR]

From January 2011 until September 2016, screening of taeniasis carriers was carried out in a town in Gianyar District ( Taenia saginata ) and in villages which consisted of several Banjars (the smallest community units) on the eastern slope of Mt. Agung, Karangasem District ( Taenia solium ) in Bali, Indonesia. Fecal samples from all community members who chose to participate were examined microscopically for detection of taeniid eggs each person completedwith a questionnaire to determine if they had seen whitish, noodle-like proglottids (anamnesis) in their feces. Members with egg positive feces, and those with anamnesis, were treated with niclosamide (Yomesan ® , Bayer). A total of 39 T. saginata tapeworm carriers were confirmed in Gianyar after deworming based on anamnesis (100%, 39/39). Only three of them (3/39, 7.7%) and 3/173 participants (1.7%) were identified by fecal microscopy. In contrast, 20 T. solium carriers including one migrated to Gianyar were confirmed from 12 patients with eggs in their feces and from another 8 persons of 12 persons suspected to be infected due anamnesis only (8/12,66.7%) in Karangasem. The majority of carriers (12/20, 60.0%) identified by microscopy included 4 (33.3%) and 8 (66.7%) carriers confirmed microscopically with and without anamnesis, respectively. The prevalence rate was 12/1090 (1.10%) of participants. The results indicate that anamnesis is reliable for detection of T. saginata carriers, whereas it is not so reliable for detection of T. solium taeniasis (8/12, 66.7%) and that microscopy is more informative than anamnesis for T. solium . Eggs were detected more frequently in T. solium carriers (4/12, 33.3%) than in patients infected with T. saginata (3/39, 7.7%). T. solium carriers have so far been confirmed from nine of 13 Banjars examined in Karangasem. This study reveals that anamnesis is highly useful for screening of T. saginata carriers, whereas microscopy is a more valuable tool for detection of T. solium carriers. [ABSTRACT FROM AUTHOR]

Taenia solium taeniasis-cysticercosis and soil-transmitted helminths (STHs) are parasitic Neglected Tropical Diseases endemic throughout Southeast Asia. Within Lao PDR, a remote northern hill tribe village had previously been identified as a hyper endemic focus for T. solium . To reduce this observed prevalence, a One Health intervention covering both pigs and humans was implemented, which included two Mass drug administrations (MDA1 and MDA2) for village residents using a triple dose albendazole 400 mg treatment regime. In addition to the effect on T. solium levels, the dual impact of this anthelmintic regime on STHs within the community was also monitored. Faecal samples were collected pre and post MDA1 and MDA2 and analysed for the presence of Taenia species and the STHs Ascaris lumbricoides , Trichuris trichiura and hookworm species. The McMaster technique was used to measure the changes in both prevalence and intensity of infection. Molecular characterisation of Taenia and hookworm species was conducted to detect zoonotic species. The level of taeniasis within the sampled population decreased by 79.4% after MDA1, remained steady during the five month inter-treatment interval and decreased again by 100% after MDA2. The prevalence of STHs decreased by 65.5% and 62.8% after MDA1 and MDA2 respectively; however an increase to 62.1% of pre MDA1 levels was detected during the inter-treatment interval. Individually, hookworm prevalence decreased by 83.4% (MDA1) and 84.5% (MDA2), A. lumbricoides by 95.6% and 93.5% and T. trichiura by 69.2% and 61%. The intensity of infection within the sampled population also decreased, with egg reduction rates of 94.4% and 97.8% for hookworm, 99.4% and 99.3% for A. lumbricoides and 77.2% and 88.5% for T. trichiura. Molecular characterisation identified a T. solium tapeworm carrier from 21.6% (13/60) of households in the village. T. saginata was identified in 5% (3/60) of households. The zoonotic hookworm A. ceylanicum was detected in the resident dog population. These results suggest that the triple dose albendazole 400 mg treatment regime achieved a significant reduction in the level of taeniasis whilst simultaneously reducing the STH burden within the village. The increased STH prevalence detected between MDAs reflects the need for behavioural changes and a sustained chemotherapy programme, which may also need to include the resident dog population. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) are small non-coding RNAs that have emerged as important regulators of gene expression and perform critical functions in development and disease. In spite of the increased interest in miRNAs from helminth parasites, no information is available on miRNAs from Taenia solium , the causative agent of cysticercosis, a neglected disease affecting millions of people worldwide. Here we performed a comprehensive analysis of miRNAs from Taenia crassiceps , a laboratory model for T. solium studies, and identified miRNAs in the T. solium genome. Moreover, we analysed the effect of praziquantel, one of the two main drugs used for cysticercosis treatment, on the miRNA expression profile of T. crassiceps cysticerci. Using small RNA-seq and two independent algorithms for miRNA prediction, as well as northern blot validation, we found transcriptional evidence of 39 miRNA loci in T. crassiceps . Since miRNAs were mapped to the T. solium genome, these miRNAs are considered common to both parasites. The miRNA expression profile of T. crassiceps was biased to the same set of highly expressed miRNAs reported in other cestodes. We found a significant altered expression of miR-7b under praziquantel treatment. In addition, we searched for miRNAs predicted to target genes related to drug response. We performed a detailed target prediction for miR-7b and found genes related to drug action. We report an initial approach to study the effect of sub-lethal drug treatment on miRNA expression in a cestode parasite, which provides a platform for further studies of miRNA involvement in drug effects. The results of our work could be applied to drug development and provide basic knowledge of cysticercosis and other neglected helminth infections. [ABSTRACT FROM AUTHOR]

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-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD. [ABSTRACT FROM AUTHOR]

Cysticercosis, caused by metacestodes of Taenia solium , has a significant soci-economic impact and is of considerable importance in public health. However, there are no specific diagnostic antigens to distinguish between T. solim and Taenia hydatigena . In the present study, cAMP-dependent protein kinase regulatory subunit ( Ts PKA-r), an excretory/secretary (ES) antigen of T. solium , was used to establish a specific and sensitive diagnostic tool for detection of porcine cysticercosis. The full-length sequence encoding Ts PKA-r was amplified by PCR, sequenced and then identified by bioinformatics. The fusion protein with 6 × His-tags was expressed in E. coli , purified by Ni Sepharose™ 6 Fast Flow and used to test reactionogenicity by immunoblotting. Ts PKA-r based indirect enzyme-linked immunosorbent assays (iELISA) showed good performance in recognition of sera of pigs experimentally infected with T. solium metacestodes, with 93.88% sensitivity and 96.40% specificity. There were no cross-reactions against the sera from pigs experimentally infected with T. hydatigena , Toxoplasma gondii or Trichinella spiralis . These results indicate that the Ts PKA-r is a promising immunodiagnostic antigen for detection of porcine cysticercosis. [ABSTRACT FROM AUTHOR]

Neurocysticercosis is an important cause of epilepsy in many developing countries. The disease is a zoonosis caused by the cestode parasite Taenia solium . Many potential intervention strategies are available, however none has been able to be implemented and sustained. Here we predict the impact of some T. solium interventions that could be applied to prevent transmission through pigs, the parasite’s natural animal intermediate host. These include minimal intervention strategies that are predicted to be effective and likely to be feasible. Logical models are presented which reflect changes in the risk that age cohorts of animals have for their potential to transmit T. solium . Interventions that include a combined application of vaccination, plus chemotherapy in young animals, are the most effective. [ABSTRACT FROM AUTHOR]

• Panfungal PCR using NL1/NL4 primers cross reacts with eukaryotic DNA such as T. vaginalis. • Broad range PCR can use such crossreactivity to diagnose unsuspected pathogens. • In particular settings, it should be used to detect pathogens across kingdoms. We report the unusual diagnosis of trichomoniasis in an 18 year old patient suffering from salpingitis. Chlamydiae , Mycoplasma and Gardnerella vaginalis were diagnosed using classic laboratory procedures. However, T. vaginalis infection was assessed fortuitously by Polymerase Chain Reaction (PCR) followed by sequencing using panfungal primers (NL1 / NL4) on a vaginal swab. This cross-reactivity of panfungal primers was further confirmed using a specific T. vaginalis PCR as well as a reference strain of T. vaginalis isolated in culture. Such cross-reactivity of panfungal primers has been previously reported with non-fungal eukaryotes (Taenia solium , Strongyloides stercoralis or Toxoplasma gondii DNA). This case highlights the usefulness of broad range molecular tools that can take advantage of this cross-reactivity in order to diagnose unsuspected pathogens. In particular settings (e.g. immunosuppression, infection without etiology) it should be used to detect pathogens across kingdoms. Thus, such tools would help direct care providers toward appropriate treatment regimens and better management of unsuspected infection etiologies. [ABSTRACT FROM AUTHOR]

• We developed knowledge and practice surveys on the Taeniasis/Cysticercosis complex (TCC) in two prioritized municipalities in the north and south of Colombia. • We present differences in knowledge and practices present Mahates and Mercaderes inhabitants about Taenia solium transmission and symptoms as well as housing, pig farming practices and sanitation conditions. • Interventions in education, pig management, pig treatment and sanitation improvement must be considered in view of the differences in the target population knowledge and practices during the following phases of Colombia's National and Cross-sectoral Plan for TCC Elimination. The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination. Objectives: To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia. Methods: A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n = 152) (Atlantic Region) and Mercaderes, Cauca (n = 152) (Andean Region). Results: Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities. Conclusion: Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes. [ABSTRACT FROM AUTHOR]

Neurocysticercosis (NCC) is a disease caused by the zoonotic parasite Taenia solium lodging in the central nervous system. Both humans and pigs can get NCC. The impact of the disease in pigs has so far been little explored. The aim of this study was to describe the effect of NCC on social and feeding behaviours as well as the pattern of activity as indicators of reduced welfare in naturally infected sows. In total 13  T. solium naturally infected and 15 non-infected control sows were videotaped for 2 consecutive weeks using close circuit television cameras at research facilities at Sokoine University of Agriculture, Morogoro, Tanzania. Videos were analysed at the beginning, in the middle and at the end of the 2 week recording period. For each time point, videos were analysed during feeding, while the enrichment was provided, and by recording every half an hour the sows’ behaviours performed over the course of a whole day. Sows with NCC spent significantly less time at the feeding trough, especially during the second half of the feeding period. Infected sows were also more passive e.g. lying and standing still significantly more during a whole day period and showed social isolation compared to non-infected control sows by performing behaviours more distant to their nearest neighbour. Results of this study indicated that NCC changed the behaviour of infected sows. The behavioural changes are indicative of decreased welfare. Efforts to reinforce the animal welfare aspect are needed as this has so far been neglected. [ABSTRACT FROM AUTHOR]