Neurocysticercosis is a common disease in underdeveloped countries. Its diagnosis is based on clinical, imaging (tomography or magnetic resonance), epidemiological, and laboratory data. Several methods based on the detection of antibodies against cysticerci in cerebrospinal fluid or serum have been tested. Among them, an enzyme-linked immunosorbent assay (ELISA) based on the use of a crude parasite antigen has been used by the laboratory network of cysticercosis in Mexico, which has given support to clinicians for up to 7 years. A Taenia solium-specific glycoprotein-based electroimmunotransfer blot (EITB) assay was reported to be highly sensitive and specific for this purpose. In order to compare both techniques, we studied 100 neurocysticercosis patients and 70 neurological noncysticercosis controls and searched for specific antibodies in paired samples of serum and cerebrospinal fluid using both techniques. We found that the EITB assay is more sensitive than the ELISA, especially when serum is being tested. Both techniques are more sensitive in cases with multiple living cysts than in cases with single cysts or calcified lesions. No global differences among cases with parasites located in different parts of the central nervous system were found. In the patients with cysts within the parenchyma, the sensitivity of the EITB assay was higher with serum than with cerebrospinal fluid. The immunodominant bands were found to be the same as those previously reported, i.e., GP-39 to -42, GP-24, and GP-13. Based on these results, we suggest the use of the EITB assay in routine diagnosis of cysticercosis for clinical cases.Taeniasis and cysticercosis caused by Taenia solium, the pork tapeworm, are widespread infections in Latin America, Africa, and Asia (6). The disease in humans (neurocysticercosis [NC]) is caused by the metacestode, which develops within the central nervous system. It is often disabling and sometimes fatal. Diagnosis of cysticercosis is suggested by clinical, epidemiological, and serological findings (3), but magnetic resonance imaging or computed tomograpy (CT) scans are the most sensitive and specific diagnostic tools (14). To support them, several laboratory methods have been standardized, which are based on the detection of antibodies against cysticerci or parasite antigens in the cerebrospinal fluid (CSF) or the serum (2). Among them, the electroimmunotransfer blot (EITB) assay developed at Centers for Disease Control and Prevention (15) has the highest sensitivity in serum. This test develops up to seven glycoprotein bands which are specific for T. solium cysticercosis.In Mexico, NC was recognized as a problem of public health several years ago (7). The Central Laboratory of the National Network for Diagnosis of Cysticercosis (10) gives support to clinicians of second-and third-level hospitals of the country to diagnose this disease and to epidemiologists for field studies. The method that has been used up to now is an enzyme-linked immunosorbent assay (ELISA) which is based on the use of a crude...
Current diagnosis of neurocysticercosis relies mostly on computerized tomography and nuclear magnetic resonance, with detection of antibodies being confirmatory rather than decisive. An assay which detects parasite products in cerebrospinal fluid would conclusively demonstrate a current infection and could be important when decisions regarding treatment must be made. Cerebrospinal fluid from patients with neurocysticercosis was used in 4 enzyme immunoassay capture tests designed to detect parasite products. Of the systems tested, one, based on the use of a monoclonal antibody reactive with a surface and secretion component of the metacestode, was particularly promising, giving a sensitivity of 72%. The assay has the double advantage of a very low background and a proved specificity for the products of living cysticerci. The other 3 systems (monoclonal anti-vesicular fluid antibody, polyclonal antibody against a saline extract and polyclonal anti-antigen B antibody) were less sensitive. Results with the anti-antigen B system support the proposal that products of low immunogenicity are the most appropriate targets for the serological detection of the parasite.
Abstract. To determine markers of Taenia solium transmission and risk factors in an urban community, we studied 1,000 soldiers from a military camp in Mexico City and their relatives. Serum samples were used to detect antigens and antibodies and fecal specimens were examined for Taenia coproantigens and helminth eggs. Prevalences of 12.2% and 5.8% for cysticercosis were found among soldiers and their relatives, respectively. Taeniasis was found in 0.5% and none of the groups, respectively. Relatives of soldiers positive for cysticercosis and taeniasis markers ate more pork from street stores than restaurants or markets compared with relatives of soldiers without these indicators of infection. Also, 12.0% of the relatives of positive soldiers had a history of expelling tapeworm proglottids in the feces in contrast to 3.7% of the family members of the control group. Prevalence values and risk factors in this urban population are similar to those of previous studies performed in rural populations.Taeniasis and cysticercosis caused by the tapeworm Taenia solium are prevalent in humans in many developing countries of Latin America, Africa, and Asia that lack proper sanitary infrastructure and adequate hygienic conditions. 1,2 As a result of migration from endemic areas, an increase in neurocysticercosis cases has also occurred in developed countries. 3 Human neurocysticercosis is a disabling and occasionally fatal disease.
Although not considered as an endemic region, the Northeast of Brazil has the necessary conditions for the development of taeniasis-cysticercosis complex. In a previous paper, we demonstrated that Mulungu do Morro municipality, in the State of Bahia, has a high seroprevalence to cysticercosis in epileptic patients. OBJECTIVE: to determine the prevalence of taeniasis and positive cysticercosis serology in the population of Mulungu do Morro. METHOD: blood and stool samples were collected from a random sampling of the population, by family. The identification of antibodies against T. solium cysticerci was made by EITB and T. solium antigens were identified using a polyclonal antibody-capture ELISA. RESULTS: the cysticercosis seroprevalence was 1.6% (C.I. = 0.8 to 2.8%) and the taeniasis prevalence 4.5% (C.I. = 3.0 to 6.5%). Seropositivity to cysticercosis was higher among those who lived in a house of a person testing positive for coproantigen, p=0.017. CONCLUSION: our results demonstrate that the taeniasis-cysticercosis complex is endemic in Mulungu do Morro. We believe that all areas in the world with the same socio-economic and sanitary characteristics are likely to have high prevalence of this parasite.
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