A Review of Human Cysticercosis and Diagnostic Challenges in Endemic Resource Poor Countries

Abstract

Human cysticercosis is a neglected tropical parasitic zoonotic disease with high public health concerns. Infection of Taenia solium cysticerci in the brain commonly known as neurocysticercosis is a cause to over 29% of all epileptic cases in endemic countries. Unfortunately, this infection can go unnoticed for over 10 years. The objective of this review was to characterize the diagnostic approaches accessible in endemic poor resource countries. The review sought literature from library catalogues and public databases for studies on epidemiology and diagnosis challenges of human cysticercosis. The search key words included "Taenia solium, T. solium cysticercosis, human cysticercosis, neurocysticercosis and diagnosis". Most of the diagnostic procedures rely on serology. Neuroimaging tools which would confirm and thus enable the assessment of the burden of the disease in endemic countries are rarely used. Therefore assessing the estimate on prevalence and burden of the disease fallacious is owing to the low sensitivity of serological tools and the inhibition of humoral, cellular immune responses, inflammatory reaction and cytokines by the living cysticerci.

The Pandemonium of Cysticercosis in Humans

“…It is well documented that the detection of human cysticercosis is key to the management of the disease and identification of proglottids or eggs of T. s o l i u m have both low sensitivity and specificity, though, a confirmatory of the infection by the adult stage of parasite is made possible macroscopically [11,12]. However, deoxyribonucleic acid (DNA) based techniques are sensitive and specific [13].…”

<i>Taenia solium</i> Cysticercosis in Sub-Saharan Africa: Perspectives for a Better Control

“…Some of the difficulties that contribute to the extent that eradication of TSC still being a long way might be limitations on facilities required for diagnosis; the unnoticed long-life of the parasite in the human body and low public awareness on the transmission drivers for the disease [119].…”

Proposition of Fine Needle Aspiration Cytology as a Diagnostic Tool in Cases of Cysticercosis by

“…To travel to a tertiary health care center where these facilities are available may even take several days at times, thus adding to an already expensive diagnostic procedure. 4 The sensitivity and specificity of serological tests for the detection of antibodies against cysticercosis are 41.5% and 98.4%, respectively, with a positive and negative predictive value of 92.3% and 81.8%, respectively; although useful if positive, a negative test result does not necessarily rule out the disease in a patient. 7 Past infection by T solium itself or even cross-reactivity with other helminths can give a false-positive result, 8 and despite the presence of infection, if the lesion is solitary or is old and calcified, antibodies may not even be detected by serology.…”

“…In some regions of Africa, mainly in Western Africa, it ranges from 1.3% to 2.4%. 4 Several countries, such as Vietnam, China, Korea, and Indonesia, seem to have a high exposure to the parasite as indicated by seroprevalence studies, ranging from 0.02% to 12.6%. Also, infection rates determined by the examination of stool for ova and parasite range from 0.1% to 6% in India, Vietnam, and Indonesia.…”