Seroprevalence of human cysticercosis in Jataí, Goiás state, Brazil

ABSTRACT The Taenia solium cysticercosis affects millions of people worldwide and is considered a public health problem, especially in developing countries. The diagnosis of neurocysticercosis is complex and involves the analysis of epidemiological, clinical, neuroimaging, and immunological host data. Neurocysticercosis is endemic in Brazil, and is related to the cause of death mainly in the Southeast, South, and Central-West regions. The objective of this study was to determine the seroprevalence of cysticercosis in inhabitants of the city of Jataí, Goiás, in the Central-West region of Brazil from April to August 2012. A total of 529 serum samples were analyzed by enzyme-linked immunosorbent assay for detecting IgG antibodies against T. solium larvae, and Western blotting was used for confirming the diagnosis through the recognition of at least two specific peptides from their serum antibodies. The 351/529 (66.3%) reactive samples were analyzed by enzyme-linked immunosorbent assay and Western blotting confirmed the diagnosis in 73 samples that recognized at least two of the following peptides specific IgG antibodies for cysticercosis: 18, 24, 28-32, 39-42, 47-52, 64-68, and 70 kDa. The seroprevalence of cysticercosis was 13.8% (95% CI 5.9-21.7), demonstrating that the studied area is endemic to this disease.

Evaluación de las pruebas dot blot y aglutinación de látex para el diagnóstico de cisticercosis en Perú / Assessment of dot blot tests and latex agglutination for cysticercosis diagnostic in Peru

Con el objetivo de evaluar las pruebas dot blot y aglutinación de látex para la detección de cisticercosis humana con antígeno de líquido de cisticerco de Taenia solium, se usaron 125 sueros humanos, de los cuales 60 procedían de personas con cisticercosis confirmada por Western Blot, 45 de personas con otras enfermedades parasitarias y 20 de personas aparentemente sanas. La concentración óptima del antígeno para impregnar las tiras dot blot fue de 0,01 ug/uL, y para impregnar las partículas de látex fue de 0,092 ug/uL. Para la prueba dot blot se encontró una sensibilidad del 100% y especificidad del 87,7%; para la aglutinación de látex una sensibilidad del 93,3% y especificidad del 89,2%. Ambas pruebas podrían ser de utilidad y factibles de implementar como alternativas de diagnóstico serológico en laboratorios de áreas endémicas del Perú.

In order to evaluate dot blot tests and latex agglutination for the detection of human cysticercosis with liquid antigen of Taenia solium cysticerci, 125 human sera were used, of which 60 were from people with cysticercosis confirmed by Western Blot, 45 with other parasitic diseases and 20 apparently healthy. The optimal concentration of antigen to impregnate dot blot strips was 0.01 ug/uL, and to impregnate the latex particles was 0.092 ug/uL. For the dot blot test, a sensitivity of 100% and specificity of 87.7% was found. For latex agglutination, a sensitivity of 93.3% and specificity of 89.2% was found. Both tests may be useful and feasible to implement alternatives of serological diagnosis in laboratories in endemic areas of Peru.

Usefulness of serological ELISA assay for Taenia saginata to detect naturally infected bovines / Utilização de teste sorológico ELISA para a detecção de bovinos naturalmente infectados por Taenia saginata

Bovine cysticercosis, a cosmopolitan disease caused by Taenia saginata, leads to economic losses due to carcass devaluation at slaughter. Sanitary inspection at slaughterhouses, the routine diagnostic method in Brazil, lacks the necessary sensitivity to detect the mildly infected cattle that are typically encoutered in Brazil. In this study we have tested cattle sera from animals diagnosed as positive and negative by veterianry inspection for (1) anti-parasite antibodies using metacestodes antigens (T. solium vesicular fluid and T. saginata secretions) and (2) the HP10 secreted antigen of viable metacestodes. The cut-off values were calculated by ROC curve for intense and mild infections conditions, and by the classical method ( X + 2DP for negative samples). The sensitivity and specificity of these diagnostic tests were different depending on the assumed cut-off value and, importantly, whether the infection was mild or intense. In spite of these observations, however, such ELISA assays for serum antibodies and parasite antigens constitute an important tool for epidemiological porposes, and in establishing priorities for the control of bovine cysticercosis.

A cisticercose bovina, uma doença cosmopolita causada pela Taenia saginata, resulta em perdas econômicas devido á desvalorização de carcaças durante o abate. A inspeção sanitária nos frigoríficos, método de diagnóstico de rotina no Brasil, não possui sensibilidade necessária para detectar animais levemente infectados, os quais são tipicamente encontrados no Brasil. Neste estudo testou-se soro de animais diagnosticados positivos e negativos pela inspeção veterinária por (1) anticorpos anti-parasita usando antígenos de metacestóides (fluido vesicular de T. solium e secreções de T. saginata) e (2) antígeno secretado de metacestóides viáveis. Os pontos de corte foram calculados pela curva ROC, considerando condições de intensa e leve infeção, e pelo método clássicoo ( X + 2DP das amostras negativas).. A sensibilidade e a especificidade dos testes diagnósticos foram diferentes dependendo do valor de ponto de corte assumido e, sobretudo, se a infecção era intensa ou leve. Apesar destas observações, no entanto, tanto o ensaio ELISA para anticorpos séricos quanto para antígeno de parasita constituem importante ferramenta para propósitos epidemiológicos e no estabelecimento de prioridades no controle da cisticercose bovina.

Prevalencia de teniosis y seroprevalencia de cisticercosis humana en Pampa Cangallo, Ayacucho, Perú 2008 / Taeniosis prevalence and human cysticercosis seroprevalence in Pampa Cangallo, Ayacucho, Peru 2008

Para estimar la prevalencia de teniosis y la seroprevalencia de cisticercosis humana en la población del distrito de Pampa Cangallo, en la sierra central de Perú (Ayacucho); se realizó un estudio transversal en el año 2008, con 368 personas de 5 a 70 años de edad. El diagnóstico de teniosis se efectuó mediante la prueba coproparasitológica (sedimentación rápida) mientras que para el diagnóstico de cisticercosis se realizó un tamizaje con la prueba de ELISA, y los casos positivos fueron confirmados por inmunoblot. Se encontró cinco casos positivos a huevos de Taenia sp, lo que representa una prevalencia de teniosis de 1,4 por ciento (IC95 por ciento: 0,2 - 2,5 por ciento), siendo los individuos entre los 20 a 49 años los que presentan la mayor proporción. Se encontró una seroprevalencia de cisticercosis de 3,3 por ciento (IC95 por ciento: 1,4 - 5,1 por ciento) por 12 casos positivos, siendo más frecuente en mujeres. No se encontró asociación con ninguno de los factores estudiados. Si bien la prevalencia es baja, se confirma la existencia de la teniosis y cisticercosis en esta población, por lo que se sugiere el establecimiento de estrategias de prevención y control, con énfasis en la educación comunitaria.

To estimate the taeniosis prevalence and human cysticercosis seroprevalence in a rural town from the Peruvian central Andes (Pampa Cangallo, Ayacucho), we performed a cross sectional study in 2008, included 368 people between 5 and 70 years. Fast sedimentation technique and direct examination of stool samples were used to taeniosis diagnosis, and ELISA are used as screening test to cysticercosis, positives cases were confirmed with immunoblot. We found five positives cases to Taenia sp. eggs, which represents a 1.4 percent (95 percentCI: 0.2 - 2.5 percent) of a taeniosis prevalence, being individuals between the 20 to 49 years those which presented high proportion. We found 3.3 percent (95 percentCI: 1.5 - 5.1 percent) of cysticercosis prevalence for 12 positives cases, being most frequent in women. No association with evaluated factors was found. Though the prevalence is low, the existence of the taeniosis and cysticercosis is confirmed in this population, by what there is suggested the establishment of prevention and control strategies, emphatically in the community education.

Conocimiento y prácticas sobre Teniasis-cisticercosis en una comunidad colombiana / Knowledge and practices concerning taeniasis-cysticercosis in Colombian pig-breeders

Objetivo Determinar los conocimientos y prácticas sobre teniasis-cisticercosis y la frecuencia de anticuerpos contra Taenia solium en habitantes de la localidad de Andagoya, Colombia. Métodos Se realizó un estudio cualitativo-cuantitativo. Las poblaciones de estudio fueron los criadores de cerdos y sus familias, población local y cerdos. Resultados La población tiene un conocimiento parcial del complejo teniasis-cisticercosis. Identifica la cisticercosis como una enfermedad sólo del cerdo y no del humano, considera la teniasis como una enfermedad de transmisión fecal y no ocasionada por el consumo de carne de cerdo con cisticercosis. La crianza de cerdos no se hace en confinamiento y aunque se conocen los hábitos higiénicos para el control de enfermedades parasitarias su cumplimiento no es adecuado. La presencia de anticuerpos contra T. solium en los criadores de cerdos y sus familiares fue del 8,7 por ciento y en los cerdos del 20,9 por ciento. Conclusión Se debe desarrollar un programa educativo sobre teniasis-cisticercosis que permita sensibilizar a la población para el conocimiento y la aplicación de medidas de control.

Objective Describing knowledge and practices regarding taeniasis-cysticercosis and cysticercosis prevalence in the village of Andagoya, Colombia. Methods The study design was qualitative and quantitative. The study population consisted of pig breeders and their families, local groups and pigs. Results Study participants had partial knowledge of the taeniasis-cysticercosis complex. They considered taeniasis to be an illness resulting from faecal transmission and not caused by becoming infected with cysticercosis after consuming pork. Pig breeding is not carried out in confined conditions and, although breeders know the right measures for controlling some parasitic illnesses, these practices are not observed. There was 8.7 percent presence of T. solium antibodies in pig breeders and their relatives and 20.9 percent in the pigs. Conclusions An educational programme aimed at raising the population's awareness of the taeniasis-cysticercosis complex cycle should be developed; this will facilitate control measures being applied.

Risk factors for epilepsy in rural Lao PDR: a case-control study.

The objective of this study was to assess the major etiologic categories of epilepsy in a rural district of the Lao PDR. Thirty-one newly identified patients with confirmed active epilepsy were compared with 124 controls, matched for gender, age and village residence. Risk factors for epilepsy were investigated with particular focus on cysticercosis serology. A history of head trauma (OR=4.7, p=0.05), family history of epilepsy (OR=12.8, p=0.03), and the use of human feces to fertilize domestic vegetable gardens (OR=4.9, p=0.04) were significantly associated with epilepsy. The study did not confirm any direct relation between epilepsy and cysticercosis serology. The cysticercosis seroprevalence was nil in the epilepsy group. This is the first study in the Lao PDR on epilepsy risk factors representing important data for the subregion. Parasitic, environmental, and behavioral factors of this traditional population deserve further studies to explain the missing link between epilepsy and cysticercosis.

Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools

Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA) in 2.25 percent of the human population, whereas intestinal taeniasis was detected in 1.46 percent by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56 percent of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB) was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74 percent of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

Cysticercus antibodies and antigens in serum from blood donors from Pondicherry, India

O objetivo do presente estudo foi examinar o soro de doadores de sangue que são aparentemente saudáveis e residentes em Pondicherry ou seus distritos vizinhos do estado de Tamil Nadu, para a detecção específica dos antígenos e anticorpos de Cysticercus. Um total de 216 amostras de sangue foram coletadas de doadores de sangue do "Central Blood Bank, JIPMER Hospital", Pondicherry, Índia, durante janeiro e fevereiro de 2004. ELISA foi usado para demonstrar anticorpos anti-Cysticercus e co-aglutinação (CoA) foi utilizada para detectar antígenos no soro. 14 (6.48%) homens foram positivos para antígenos e anticorpos anti-Cysticercus. Destes, oito soros foram positivos para anticorpos anti-Cysticercus e seis positivos para antígenos. Os resultados do presente estudo mostram que a detecção de antígenos de Cysticercus no soro pode ser um adjunto útil para o teste de anticorpos para estudos de soroprevalência de cisticercose na comunidade. O presente estudo é o primeiro do tipo, realizado para determinar tanto anticorpos de Cysticercus como antígenos nas amostras de soro coletadas de doadores de sangue aparentemente saudáveis.

Cysticercosis: IgG-ELISA evaluations of peak1 antigen and <30 kDa antigen of delipidized extract of Taenia solium metacestodes.

The antigenicity of ether-delipidized Taenia solium metacestode extract (DLPAg) was investigated by IgG-ELISA. The antigen showed higher antigenicity than that of non-delipidized antigen (NDLPAg). Then the DLPAg was subjected to Sephacryl S-200 gel chromatography and a partially purified antigen (DLPP1Ag) was identified as the promised antigen by IgG-ELISA using 25 sera from cysticercosis cases, 177 cases of 24 heterologous infections, and healthy controls. Sensitivity was 52% and specificity was 91.8% at the cut-off value (X + 7SD), 0.399. Cross-reactivity occurred with 17 cases of eight diseases: cystic echinococcosis (7/11), taeniasis (1/16), gnathostomiasis (2/8), strongyloidiasis (1/12), angiostrongyliasis (1/12), paragonimiasis heterotremus (2/15), opisthorchiasis (1/9) and fascioliasis (2/7). When DLPP1Ag was fractionated through Ultra free centrifugal tube (retained 30 kDa) and Amicon (PM10), MWCOP1Ag (<30-10> kDa) was obtained; the antigen showed better results than DLPP1Ag with 88% sensitivity and 95.6% specificity at the cut-off value (X + 4SD), 0.264. Nine cases of six diseases cross-reacted with this antigen: cystic echinococcosis (2/11), gnathostomiasis (2/8), trichinellosis (2/12), toxocariasis (1/5), schistosomiasis (1/6), and fascioliasis (1/7). MWCOP1Ag gave higher sensitivity than that of DLPP1Ag but some cross-reactivity occurred.

A serological study of human cysticercosis in Pondicherry, South India.

The present study was carried out to determine the extent of the problem of cysticercosis in Pondicherry by assessing the antibody response to porcine cysticercus antigen by the indirect haemagglutination (IHA) in people residing in and around Pondicherry and in patients clinically suspected to have cysticercosis. Serum samples were collected from 1442 persons apparently normal in respect to cysticercosis, 91 cases of clinically suspected cases of cysticercosis, and 100 normal healthy students and blood donors. These sera were tested for cysticercus antibodies by IHA test using whole porcine cysticercus antigen sensitised RBCs. An antibody titre of 1:64 and above by the IHA was considered to be diagnostic of cysticercosis. At this diagnostic titre, 88 (6.10 %) of 1442 apparently normal population sera were seropositive. Of these 88 seropositive subjects, 16 (18.18 %), 33 (37.5 %) and 32 (36.36 %) were in the age groups of 1-13 yrs, 14-40 years and above 40 years respectively. 52 (59.1%) were males and 36 (40.9 %) were females. Twenty (21.97%) out of 91 clinically suspected cases were found to be seropositive out of which 14 (70 %) were males and 6 (30 %) females. 4 cases were in the age group of 6-13 years, 14 cases in 14-40 years and 2 cases were in the age group of 40 years and more. Cysticercus antibodies were not detected in any of the sera from healthy peoples including students. A positive antibody response in 6.1 % of population residing in and around Pondicherry and in 21.97 % of patients clinically suspected cases of cysticercosis show that cysticercosis may be more common in Pondicherry than believed.

Estandarización y evaluación de Elisa en eluidos de sangre seca recolectada en papel de filtro para el diagnóstico de cisticercosis / Standarization and evaluation of Elisa in eluates of dried blood collected on filter paper for cysticercosis diagnosis

Se estandarizó y evaluó la prueba inmunoenzimática Elisa para la detección de anticuerpos contra larva de Taenia solium usando eluidos de sangre seca obtenida por punción digital y recolectada en papel de filtro. La dilución óptima de muesta fue de 1:400, la cual es equivalente a la obtenida a partir de suero. El Elisa mostró una sensibilidad de 100 por ciento y una especificidad de 97 por ciento, lo cual permite su utilización tanto para diagnóstico como para encuestas seroepidemiológicas

Comparison of cysticercus extract, cyst fluid and Taenia saginata extract for use in ELISA for serodiagnosis of neurocysticercosis.

Cysticercus cellulosae extract (CS), cyst fluid (CF), and an extract of Taenia saginata adult worm (TS) were evaluated for use in an enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of human neurocysticercosis in Thai patients. ELISA sensitivity was found to be 78.13%, 81.25% and 62.50%, respectively. False positivity was 6.66% with CS and 0% with other antigens. CF gave positivity with a pooled visceral gnathostomiasis serum and 3 of 10 (30%) of angiostrongyliasis sera. CS produced weakly positive ELISA with pooled opisthorchiasis and visceral gnathostomiasis sera. TS gave weak positive ELISA with a pooled opisthorchiasis serum. It was concluded that CF was the best antigen for use in ELISA for serodiagnosis of human neurocysticercosis.

El diagnostico actual de la cisticercosis / Current diagnosis of cysticercosis

La cisticercosis es la parasitosis que mas comunmente afecta el sistema nervioso central. En el sistema ocular puede llevar a la perdida visual. El diagnostico actual de la cisticercosis cuenta con la clinica, examenes de laboratorio, estudio radiologicos, e histopatologicos. El diagnostico de la cisticercosis que en el pasado se fundamentaba en la sospecha clinica y en la confirmacion quirurgica se ha revolucionado en los ultimos anos con el advenimiento de nuevas tecnicas serologicas como la prueba inmunoenzimatica (ELISA) e imagenologicas como la tomografia axial computarizada (TAC) y la resonancia magnetica (RH). Un paciente proveniente de zona endemica como Colombia, con presentacion clinica sugestiva, acompanado de deteccion de anticuerpos y una TAC caracteristica son confirmacion casi segura del diagnostico de la cisticercosis

Concentración de IgE en el suero sanguíneo de enfermos con neurocisticercosis / IgE concentration in sera of patients with neurocysticercosis

Se cuantificó la IgE total en el suero de 50 pacientes con neurocisticercosis. En 52 por ciento de los casos las concentraciones de IgE fueron elevadas. Se propone que su elevación se debe al fenómeno de activación policlonal de linfocitos B