Taenia solium Cysticercosis Hotspots Surrounding Tapeworm Carriers: Clustering on Human Seroprevalence but Not on Seizures

Abstract

BackgroundNeurocysticercosis accounts for 30%–50% of all late-onset epilepsy in endemic countries. We assessed the clustering patterns of Taenia solium human cysticercosis seropositivity and seizures around tapeworm carriers in seven rural communities in Peru.MethodologyThe presence of T. solium–specific antibodies was defined as one or more positive bands in the enzyme-linked immunoelectrotransfer blot (EITB). Neurocysticercosis-related seizures cases were diagnosed clinically and had positive neuroimaging or EITB.Principal FindingsEleven tapeworm carriers were identified by stool microscopy. The seroprevalence of human cysticercosis was 24% (196/803). Seroprevalence was 21% >50 m from a carrier and increased to 32% at 1–50 m (p = 0.047), and from that distance seroprevalence had another significant increase to 64% at the homes of carriers (p = 0.004). Seizure prevalence was 3.0% (25/837) but there were no differences between any pair of distance ranges (p = 0.629, Wald test 2 degrees of freedom).Conclusion/SignificanceWe observed a significant human cysticercosis seroprevalence gradient surrounding current tapeworm carriers, although cysticercosis-related seizures did not cluster around carriers. Due to differences in the timing of the two outcomes, seroprevalence may reflect recent T. solium exposure more accurately than seizure frequency.

Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management

“…Another approach may be a more focally directed treatment as clustering of human cysticercosis around tapeworm carriers has been shown to be present. 103,107,108 However, the uncertainty of the occurrence of undesirable neurological side effects still remains, although their detection seems more favourable in a focal setting rather than in whole communities. Considering transmission dynamics, chemotherapy of human taeniosis seems a crucial step towards control of NCC and definitely deserves further evaluation, whereas treatment of porcine cysticercosis (e.g.…”

Prevention and control ofTaenia soliumtaeniasis/cysticercosis in Peru

“…5,6 It follows that after a control intervention, a few surviving tapeworms would probably reinstate endemicity in a reasonably short period if control pressure abates. As per other parasites, probably after a few years of successful control, one can change the strategy to one of maintenance.…”

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

“…Whether reinfection is possible in human T. solium infection is not known and has not been reported. The life span of T. solium tapeworms was claimed to be decades, but later epidemiological analysis suggested a few years (2,17,19). Thus, considering a life span of 3 years, the natural death of well-established tapeworms in a 2-week period could not account for more than 1 of the 75 (1.3%) tapeworms.…”

“…Tapeworm carriers are a source of infection for themselves, their households, and their villages (19,20). The effectiveness of treatment must be maximized, and thus, a rapid confirmation of cure (or treatment failure) is important.…”