Detection of Taenia solium Taeniasis Coproantigen Is an Early Indicator of Treatment Failure for Taeniasis

Abstract

<jats:title>ABSTRACT</jats:title><jats:p><jats:named-content content-type="genus-species">Taenia solium</jats:named-content>causes taeniasis and cysticercosis, a zoonotic complex associated with a significant burden of epilepsy in most countries. Reliable diagnosis and efficacious treatment of taeniasis are needed for disease control. Currently, cure can be confirmed only after a period of at least 1 month, by negative stool microscopy. This study assessed the performance of detection by a coproantigen enzyme-linked immunosorbent assay (CoAg-ELISA) for the early evaluation of the efficacy of antiparasitic treatment of human<jats:named-content content-type="genus-species">T. solium</jats:named-content>taeniasis. We followed 69 tapeworm carriers who received niclosamide as standard treatment. Stool samples were collected on days 1, 3, 7, 15, 30, and 90 after treatment and were processed by microscopy and CoAg-ELISA. The efficacy of niclosamide was 77.9% (53/68). Thirteen patients received a second course of treatment and completed the follow-up. CoAg-ELISA was therefore evaluated for a total of 81 cases (68 treatments, 13 retreatments). In successful treatments (<jats:italic>n</jats:italic>= 64), the proportion of patients who became negative by CoAg-ELISA was 62.5% after 3 days, 89.1% after 7 days, 96.9% after 15 days, and 100% after 30 days. In treatment failures (<jats:italic>n</jats:italic>= 17), the CoAg-ELISA result was positive for 70.6% of patients after 3 days, 94.1% after 7 days, and 100% after 15 and 30 days. Only 2 of 17 samples in cases of treatment failure became positive by microscopy by day 30. The presence of one scolex, but not multiple scolices, in posttreatment stools was strongly associated with cure (odds ratio [OR], 52.5;<jats:italic>P</jats:italic>&lt; 0.001). CoAg-ELISA is useful for the assessment of treatment failure in taeniasis. Early assessment at day 15 would detect treatment failure before patients become infective.</jats:p>

Elimination ofTaenia soliumTransmission in Northern Peru

“…Furthermore, we collected post-treatment stool samples in the first round of mass treatment and followed persons who had results that indicated that they had a tapeworm with the most sensitive test available to verify that the parasites were killed. 22 …”

Taenia solium Taeniasis and Cysticercosis Control and Elimination Through Community-Based Interventions

“…It may be that the absence of a gold standard to diagnose taeniasis makes it difficult to know who is infected, leading to a challenge in assessing efficacy. An estimated efficacy of 77.9% (95%CI: 66.7%-86.2%) of niclosamide is probably the best available [30]. According to a review [31], the efficacy of praziquantel (5mg/kg) ranges between 67% and 94% while a dose of 10 mg/kg would be 100% efficacious, but the assessment of taeniasis in these studies were problematic.…”

Neglected Parasitic Infections in the United States: Cysticercosis

“…cannot be differentiated, but a species determination may be possible if mature, gravid proglottids or the scolex are present. Recently developed coproantigen and molecular assays are more sensitive than stool examination, but neither is widely available 26,27. Serologic methods, which are available only in research settings, may be used to identify T. solium tapeworm carriers; however, because antibody persists for an unknown period after treatment, serologic testing may produce false-positive results if a patient has been treated for taeniasis in the recent past 28…”