Diagnóstico e fatores de risco do complexo teníase-cisticercose bovina no município de Salinas, Minas Gerais / Diagnosis and risk factors of bovine taeniasis-cysticercosis complex in Salinas, Minas Gerais, Brazil

Com o objetivo de diagnosticar a situação do complexo teníase-cisticercose bovina no município de Salinas, Minas Gerais, foram coletadas amostras de sangue de 355 bovinos distribuídos em 18 propriedades rurais, sorteadas aleatoriamente. Em cada propriedade, foi aplicado um questionário socioeconômico para a análise de fatores que favorecem a manutenção do complexo teníase-cisticercose bovina. Foi realizado também um levantamento epidemiológico dos casos de teníase diagnosticados nos laboratórios credenciados pela Secretaria Municipal de Saúde de Salinas, no período de 2007 a 2010. A prevalência de cisticercose bovina foi de 4,70% enquanto as prevalências de teníase, encontradas durante os quatro períodos avaliados, foram de 0,29%, 0,36%, 0,24% e 0,24%. Entre os fatores de risco para a manutenção do complexo teníase-cisticercose analisados, foi observada uma relação estatisticamente significativa entre a ocorrência de cisticercose bovina e a ingestão de carne malpassada pelos entrevistados. Foi concluído que a cisticercose bovina está presente no município de Salinas, Minas Gerais, sendo o tratamento térmico ineficiente da carne bovina o principal fator de risco para a manutenção do complexo teníase-cisticercose, o que reforça a necessidade da adoção de medidas de controle com contínua vigilância epidemiológica e sanitária.(AU)

In order to diagnose the situation of bovine taeniasis-cysticercosis complex in the municipality of Salinas, Minas Gerais, Brazil, blood samples were collected from 355 cattle in 18 randomly selected farms. A socioeconomic questionnaire was filled in each farm for the analysis of factors which favor the maintenance of the taeniasis-cysticercosis complex. An epidemiological survey of human taeniasis was performed through analyses of the Municipal Health Department in the 2007-2010 period. A prevalence of 4.7% for bovine cysticercosis and the frequency of 0.29, 0.36, 0.24 and 0.24% for human taeniasis, during the evaluated period, was found. Among the risk factors, a statistically significant correlation was found between the occurrence of bovine cysticercosis and the ingestion of undercooked meat. It was concluded that bovine cysticercosis is present in the municipality of Salinas, due to inefficient heat treatment of the meat as the main risk factor for maintenance of the taeniasis-cysticercosis complex, reinforcing the need to adopt control measures with continuous epidemiological and health surveillance.(AU)

Taenia eggs in a stabilization pond system with poor hydraulics: concern for human cysticercosis?

The objective of this study is to compare the removal of Taenia eggs to the removal of Ascaris eggs in a wastewater stabilization pond system consisting of three ponds in series, where the hydraulic residence time distribution has been characterized via a tracer study supported by computational fluid dynamics modeling. Despite a theoretical hydraulic retention time of 30 days, the peak dye concentration was measured in the effluent of the first pond after only 26 hours. The smaller-sized Taenia eggs were detected in higher concentrations than Ascaris eggs in the raw wastewater. Ascaris eggs were not detected in the pond system effluent, but 45 Taenia eggs/L were detected in the system effluent. If some of these eggs were of the species Taenia solium, and if the treated wastewater were used for the irrigation of crops for human consumption, farmers and consumers could potentially be at risk for neurocysticercosis. Thus, limits for Taenia eggs in irrigation water should be established, and precautions should be taken in regions where pig taeniasis is endemic. The results of this study indicate that the theoretical hydraulic retention time (volume/flow) of a pond is not always a good surrogate for helminth egg removal.

Do interleukin-6 and macrophage-migration inhibitory factor play a role during sex-associated susceptibility in murine cysticercosis?

In murine Taenia crassiceps cysticercosis, females sustain larger intensities of infection than males. However, during chronic infection, this difference disappears and males show a feminization process. To further study the role of two cytokines, interleukin-6 (IL-6) and macrophage-migration inhibitory factor (MIF), known to be involved in immunoendocrinological processes during sex-associated susceptibility in cysticercosis, IL-6 and MIF gene knockout (KO) mice were infected, and the number of parasites and serum sex-steroid levels were measured. Results show that IL-6 and MIF KO mice of both genders infected with T. crassiceps cysticerci harbor similar numbers of parasites, with no change in sex-hormone levels. However, in wild-type strains, females have twice as many parasites as males. At the same time, there is a decrease of 80% in testosterone and dihydrotestosterone serum levels, and a 100-fold increase in the levels of estradiol in infected male mice. These results suggest a role for both IL-6 and MIF genes in sex-associated susceptibility in murine T. crassiceps cysticercosis.

Serological evidence for recent exposure to Taenia solium in Venezuelan Amerindians.

This study examined the seroprevalence and serum antibody isotype profile for Taenia solium cysticercosis in an Amerindian community in the Amazonas state of Venezuela. An antigen-trapping enzyme-linked immunosorbent assay (Ag-ELISA) was used to detect viable cysticercosis. Indirect ELISA (Ab-ELISA) and enzyme-linked immunoelectrotransfer blot (EITB) was performed by using antigens prepared from T. solium metacestodes to detect anti-parasite antibodies. The Ag-ELISA and Ab-ELISAs revealed 64.7% and 79.0% seropositivity, respectively, in the Amerindian population. Immunoglobulin (Ig) M was the predominant antibody class, suggesting recent infection. In comparison sera from, clinically defined, hospital neurocysticercosis cases revealed only 27% seropositivity by Ag-ELISA, compared with 86-92% seropositivity by Ab-ELISA, and IgG4 was the predominant antibody subclass detected. The EITB antigen recognition patterns of the hospitalized patients were very similar to that of the Amerindians, confirming exposure to the parasite. These results, combined with the predominance of IgM antibody responses and the marked detection of secreted products of viable parasites, strongly suggest that recent exposure to T. solium had occurred in the Amerindian population.

Investigation of risk factors for porcine Taenia solium cysticercosis: a multiple regression analysis of a cross-sectional study in the Yucatan Peninsula, Mexico.

A cross-sectional survey for seropositivity to cysticercosis of pigs in the Yucatan Peninsula, Mexico, was carried out in 1996 together with a standardized questionnaire on predetermined individual pig and household risk factors for porcine infection. Serum samples from 697 pigs were analysed by immunoblot for antibodies to Taenia solium cysticercosis and questionnaires from 227 households in 18 villages were collected. All the data were analysed using multivariate analytical techniques taking household clustering into account. The overall porcine seroprevalence in the area was found to be 29%. The most important risk factors for seropositivity in pigs were presence versus absence of a toilet (adjusted odds ratio [adj. OR] 2.37, P = 0.005), crowded households (adj. OR 1.75, P = 0.034) and both corralling (adj. OR 2.14, P = 0.017) and letting pigs loose (adj. OR 2.32, P = 0.035) versus tying them up. There was evidence of clustering at household level and that possible risk factors at municipal or village level may also interact with higher risk management practices such as allowing pigs to run loose.

Características clínicas epidemiológicas, diagnóstico y tratamiento de la neurocisticercosis en el Hospital Militar Escuela Dr. Alejandro Dávila Bolaños en el período comprendido 1993-1999

En este trabajo se hizo una revisión de 30 expedientes clínicos de pacientes con diagnóstico de cisticercosis cerebral, lo que ingresaron al centro Médico referidos del Servicio de Consulta Externa o del servicio de Emergencias, ante la sospecha de .neurocisticercosis. El estudio es retrospectivo-prospectivo, transversal. El objetivo de este estudio fue el de conocer las características clínicas epidemiológicas, diagnóstico y tratamiento de la enfermedad en los años 1993-1999. Encontramos de forma general que la mayoría de pacientes tenían edades comprendidas entre los 20-40 años, sin predominio por el sexo. La crisis convulsiva fue la forma de presentación clínica más común (18 pacientes) seguida de la forma apoplectiforme (10 pacientes). La tomografía axial computarizada fue el medio auxiliar más empleado y el más útil para aproximación diagnóstica de los pacientes no contándose hasta este momento con una gran disposición de la técnica de inmunoensayo, ligado a Enzimas (ELIZA) como prueba confirmativa. La punción lumbar solo fue realizada en 4 pacientes no obteniédose en ninguno de los casos resultados sugestivos. La radiografía simple de cráneo no fue útil como elemento diagnóstico, pero los estudios de partes blandas fueron positivos para calcificaciones (2 pacientes). La forma encefalitica única fue la lesión más frecuente por tomografía. Dos pacientes diagnosticados con la forma Meníngea activa con aracnoiditis cicatrizal fueron sometidos a implante valvular (Derivación Ventrículo Atrial). De las complicaciones médicos-quirúrgicas fueron encontrados 5 pacientes: hidrocefalia obstruida, convulsión recurrente, hipertensión intracraneal, obstrucción valvular, reemplazo valvular. Luego de su egreso los pacientes fuerón remetidos a la consulta de Medicina Neurológica o Neurocirugía

Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil.

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Foi realizado inquérito epidemiológico em 3344 indivíduos da área urbana de Lagamar, Minas Gerais, Brasil, durante 1992-1993 para avaliar os principais fatores de risco relacionados com teníase e cisticercose. Foram visitadas 875 (78,9%) casas e examinados clinicamente 1080 (32,3%) indivíduos. As condições sanitárias deficientes estiveram associadas estatisticamente com história anterior ou atual de teníase ou de convulsões entre os membros de cada família (p < 0,05). A correlação entre teniase e convulsões foi evidenciada tanto no inquérito domiciliar como durante a avaliação clínica dos indivíduos (p < 0,0001). O risco relativo de convulsões foi de 2,3 entre os moradores entrevistados no domicílio e 1,7 entre os indivíduos que compareceram para exame clínico, respectivamente. A criação de suínos no peridomicílio e os portadores crônicos de teníase são fatores determinantes na perpetuação do elo epidemiológico teníase-cisticercose nas áreas endêmicas.

Cisticercosis del septum pellucidum: reporte de un caso y revisión de la literatura / Septum pellucidum cysticerosis: report of case. review of the literature

En la literatura Nacional e Internacional no existen reportes relacionados a cisticercosis del septum pellucidum. Se trata de un paciente de 18 años de edad, natural y procedente de Cajamarca que venía presentando desde fines de 1993 cefalea y vómitos en forma episódica; hospitalizandose el 30/09/94 en estado lúcido, sin déficit neurológico focal. En el TAC cerebral revelaba imágenes ligeramente hipodensas a nivel del septum pellucidum y parafalx izquierdo con dilatación de las astas ventriculares frontales. Mediante abordaje transfrontal -córtico ventricular derecho se extirparon 2 quistes de cisticerco del área septal; confirmandose con el estudio anatomopatológico. La lesión del parafalx izquierdo fue tratado con albendazol 15 mg/Kg diario por 30 días; mostrando remisión parcial a los 19 meses postratamiento según control tomográfico. Su evolución a los 20 meses postoperatorio es excelente, laborando a la fecha sin dificultad. Es importante tener en cuenta esta patología en pacientes con cefalea y vómitos con y sin cambios de conducta episódicos

Neurocisticercose - artigo de revisäo / Neurocysticercosis: review article

Os autores fazem uma revisäo atualizada sobre a neurocisticercose. Foram revisados os aspectos epidemiológicos, patológicos, as manifestaçöes clínicas, diagnóstico, tratamento, prognóstico e a profilaxia desta importante doença neurológica

Experimental intravitreous cysticercosis.

BACKGROUND: Cysticercosis is one of the parasitic diseases that most frequently affects the eye. The most common and severe manifestations of ocular infection are secondary to posterior segment involvement, which often leads to blindness and atrophy of the eye. The pathogenesis of ocular injury in this disease is poorly understood. The authors have developed an experimental animal model for intravitreous cysticercosis using New Zealand rabbits and Taenia crassiceps cysticerci. METHODS: Twelve rabbits were divided into two groups. Rabbits in group I were inoculated with one living cysticercus in the vitreous cavity. Rabbits in group II received an intramuscular dose of steroids prior to inoculation of parasites. RESULTS: An intense inflammatory reaction, which lead to a severe ocular injury, was observed in rabbits of group I, while rabbits in group II had minimal inflammatory changes. Histopathological studies showed a severe histiocytic infiltrate with generalized retinal damage in group I, and a mild inflammatory infiltrate, limited to the area of direct contact with the parasite in group II. The ocular lesions found in rabbits which did not receive steroids (group I) resembled those found in human ocular cysticercosis. CONCLUSION: These observations indicate that ocular damage in this parasitic disease might be directly related to inflammatory changes produced by the presence of cysticerci. This model appears to be useful for future investigations.

Calcificaçöes de neurocisticercose em tomografias computadorizadas no Hospital Universitário Säo Vicente de Paulo / Neurocysticercosis calcifications foun in computed tomography: a report of the Department of Radiology of HSVP

Realizou-se um estudo transversal e prospectivo em tomografias compputadorizadas, analisando calcificaçöes encefálicas de Neurocisticercose no período de 18/10/93 a 21/03/94 no Hospital Universitário Säo Vicente de Paulo - Passo Fundo, RS, no Serviço de Radiologia. Tentou-se determinar a prevalência da patologia na regiäo. Foram avaliadas 1.088 Tomografias computadorizadas do crânio-encéfalo, observando-se que 146 apesentaram calcificaçöes encefálicas compatíveis com Neurocisticercose, determinando uma prevalência de 13,41 por cento e indicando que esta regiäo deve ser incluida entre as zonas endêmicas da doença no Brasil

Aspectos clínicos de la neurocisticercosis

Se estudiaron prospectivamente 340 pacientes con neurocisticercosis (NC.) durante el período comprendido entre julio de 1986 y julio de 1990. Se proponen criterios de diagnóstico de las diferentes formas de NC. basados en aspectos biológicos y clínicos con la ayuda de los métodos de diagnóstico que se disponen en la actualidad. Los resultados de este trabajo demuestran que no se puede hablar de manifestaciones clínicas como la edad, sexo, sintomatología, indicaciones terapéuticas y pronóstico, si previamente no se diferencia el tipo de NC. de acuerdo con una clasificación que sea completa, pero a la vez simple. Proponemos una clasificación que se basa en conceptos anatómicos clásicos de localización y se agregan aspectos radiológicos y fisiopatológicos de la relación huésped-parásito, con el fin de facilitar el manejo clínico de los pacientes. Se propone también un nuevo enfoque terapéutico de la NC y se insiste en la necesidad de implantar medidas preventivas para erradicar la cirrosis.

Clinical, radiological and cerebrospinal fluid presentation of neurocysticercosis: a prospective study.

The wide clinical spectrum of neurocysticercosis has led to many attempts at clinical, radiological, CSF and other classifications. Based on an objective review of the relevant literature and on a prospective study of 42 patients with active neurocysticercosis, a new classification is proposed, based on clinical, tomographic, magnetic resonance and CSF evidence of viability of cysts. The first step is to define whether the disease is active or not. Inactive disease may be parenchymal calcifications or hydrocephalus. Active disease may be intraparenchymal, extraparenchymal or mixed. Statistical analysis of 42 cases with active disease shows intraparenchymal disease to occur in younger patients, perhaps more frequently in females, and to have a better prognosis than extraparenchymal of mixed disease. The latter appears to have the worst prognosis. Therapeutic implications are that only active disease warrants etiological therapy. There remain doubts about the best therapy for some infrequent subtypes of extraparenchymal and mixed disease.