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[Studies of secretory activity and pathomorphology of the gastric mucosa in taeniasis (Taenia saginata)].

Studies were performed on 149 patients, aged 18 to 50, hospitalized in the Department of Parasitic and Tropical Diseases, Medical Academy in Poznań. The following examinations were performed: gastric contents testing with histamine stimulus according to Kay, the histological and cytological examination of gastric mucosa biopsies. Among patients with Taenia saginata invasion, disturbances in secretory activity of gastric mucosa were demonstrated in 57.7% of studied patients. Hypoacidity was found in 49.7% of patients; it appeared both in the oldest group, over 40 years (71.4%), as well as in two younger, although at two times lower frequency (38.2 and 39.6%, respectively). At set of histological and cytological studies was performed on gastric mucosa biopsies in a chosen group of 30 patients (average age of 26.2 years) with taeniasis and hypoacidity, before and after the treatment of the invasion. Before the treatment cellular infiltrates consisting of mononuclear cells were observed in gastric mucosa biopsies; cytological analysis of gastric gland cross-sections demonstrated 3 to 4 times lower number of parietal cells as compared to that of mucous cells. After the treatment of taeniasis, secretory activity of gastric mucosa returned to the normal level in 20 patients (66.7% of total). At the same time, the histological and cytological analysis of the biopsies showed decreased intensity of cell infiltrates in the glandular layer of the mucosa and an increased number of parietal cells as compared to the number of mucous cells. In 10 patients (33.3% of total), hypoacidity of the gastric juice as well as gastric mucosa lesions persisted despite the elimination of T. saginata. No relation could be found between the duration of T. saginata invasion on the one hand and secretory disturbances on the other. The subsidance of functional disturbances in gastric mucosa and of their morphological exponents in 2/3 of patients after taeniasis treatment indicates a causal relationship between time of taeniasis and secretory disturbances and histological lesions in gastric mucosa.

Adolescent↗

[Taeniasis and primary care].

OBJECTIVE: To evaluate the therapeutic guidelines used in evaluating taeniasis in primary care (mebendazole, pyrantel pamoate) and to show the low availability of first choice drugs (niclosamide, praziquantel). DESIGN: A retrospective, descriptive study. SETTING: A clinic for travellers abroad in the Tropical Medicine section (Infectious Diseases Service) of the Hospital Clínic, Barcelona. PARTICIPANTS: 68 medical histories of cases of Taeniasis seen at this clinic between 1984 and 1994. RESULTS: 72.3% had not travelled to the tropics (autochthonous Taeniasis). The most common symptoms were epigastralgia, anal pruritus, diarrhoea, weight loss and bulimia. 71.2% had previously attended other medical services and all had been correctly diagnosed. 91.8% had received ineffective treatment (the most common treatment was with mebendazole and pyrantel pamoate), sometimes on different occasions. Time elapsed between diagnosis and correct treatment varied from 1 day to 36 months. CONCLUSION: Taeniasis is an easily diagnosed infestation. Its treatment is comfortable and effective, with an average cure period of 24 hours. However, the particular medicines are not available in primary care, which hampers and delays treatment.

Adolescent↗

Sociocultural factors and local customs related to taeniasis in east Asia.

Taeniasis is an important medical and economic problem in many countries in East Asia. According to our estimation, there is an annual loss of US$18,673,495, US$13,641,021, and US$2,425,500 due to taeniasis in the mountainous areas of Taiwan, Cheju Island of Korea, and Samosir Island of Indonesia, respectively. Although taeniasis and cysticercosis due to Taenia solium have been reported, T. saginata asiatica is the dominate species in part of the world, especially in the mountainous and remote areas where the inhabitants are fond of eating raw or undercooked meat and/or viscera of domestic or wild animals. Therefore, sociocultural factors and local customs are the determinants in the transmission of taeniasis. In this paper, local customs and sociocultural factors including local dishes, accidental infection during dish preparation, and treatment for anaemia of children in the countries of East Asia were reviewed.

Adolescent↗

Efficacy of low doses of praziquantel in taeniasis.

Early experimental studies suggested that doses of 1 to 5 mg of praziquantel (PZQ) per kg are effective against several intestinal cestodiases. The usually recommended single dose of PZQ in human taeniasis is 5 or 10 mg/kg. A study in T. saginata taeniasis showed a full efficacy at a dose of 2.5 mg/kg. A field study confirmed that a dose between 3.4 and 7.5 mg/kg was effective in expulsion T. solium tapeworms in man. A dose of 2.5 mg of PZQ per kg would be safer and more economical in population-oriented interventions aiming at control of T. solium taeniasis in man.

Animals↗

High prevalence of Taenia saginata taeniasis and status of Taenia solium cysticercosis in Bali, Indonesia, 2002-2004.

An epidemiological survey of taeniasis/cysticercosis was carried out in one semi-urban and two urban villages in three districts of Bali, Indonesia in 2002 and 2004. In total, 398 local people from 247 families were diagnosed by anamnesis and clinical examinations, and 60 residents were suspected to be taeniasis carriers. Among 60 suspected carriers, 56 persons expelled a total of 61 taeniid adult worms after praziquantel treatment. From 398 residents, 252 stool samples were available for analysis of taeniid eggs, coproantigens or copro-DNA for identification of taeniid species, and 311 serum samples were available for detection of antibodies against Taenia solium cysticercosis. Taeniasis prevalences were highly variable among three villages (1.1-27.5%), and only one case of cysticercosis due to T. solium infection was detected. All expelled tapeworms were confirmed to be Taenia saginata by mtDNA analysis. There was no Taenia asiatica human case in Bali. Case control analysis of 106 families chosen at random from 179 families in 2004 and another 106 families from non-endemic areas revealed that risk factors of T. saginata taeniasis for families were: level of education (P<0.01); consumption of beef lawar (P<0.01); and the source of lawar (P<0.01).

Adolescent↗

Human Taeniasis and cysticercosis in Asia.

CONTEXT: Human Taeniasis caused by the pork, Taenia solium, or beef, T saginata, tapeworm arises after eating pork or beef contaminated with metacestodes, the larval stage of these parasites. Taeniasis with T solium can lead to neurocysticercosis and threaten others by accidental ingestion of eggs released from asymptomatic Taeniasis patients. The 2003 World Health Assembly declared that T solium is of worldwide public-health importance, and that it is an eradicable parasitic disease worldwide. Adult taeniid tapeworms expelled from people in almost all Asian countries appeared to be T saginata (the so-called Asian Taenia), even though they ate pork. The organism is now named T asiatica, and has been found in Taiwan, Korea, China, Vietnam, and Indonesia. But it has been difficult to differentiate T saginata from beef and Asian Taenia from pork. STARTING POINT: Marshall Lightowlers and colleagues (Int J Parasitol 2003; 33: 1207-17) recently demonstrated that recombinant oncosphere vaccines against several taeniid cestodes, including T ovis, T saginata, T solium, and Echinococcus granulosus, are highly effective. Protection was almost 100%, in the laboratory and in the field. These researchers found several common features, including a predicted secretory signal sequence, and one or two copies of a fibronectin type III domain, each encoded by separate exons within the associated gene. WHERE NEXT? Molecular and immunological techniques, including vaccine research and development of animal models for differentiation of taeniid species in humans, have greatly advanced over the past decade. The clinical importance of infections by these taeniids, including T asiatica, in humans, and the potential for cysticercosis attributable to T asiatica in humans, needs further study.

Animals↗

Antigens and antibodies in sera from human cases of epilepsy or taeniasis from an area of Mexico where Taenia solium cysticercosis is endemic.

Human neurocysticercosis is an important parasitic disease in developing countries. Most epidemiological studies on the disease have used antibody-based assays that allow the detection of transmission 'hot spots' and the identification of the main risk factors for transmission. However, such assays have low predictive value in the detection of active cases of neurocysticercosis. The screening potential of the most commonly used antibody-detection technique, the electroimmunotransfer blot assay (EITB), has now been compared with an antigen-capture assay, in an endemic region of Mexico. The subjects were 68 patients with late-onset epilepsy, 35 cases of taeniasis and a randomly selected, control group of 133 individuals from the same region. Parasite-specific antibodies and antigens were more common among the epileptics and taeniasis cases than among the controls. The antigens appeared to be associated with late-onset epilepsy and the antibodies with the presence of subcutaneous nodules. The sensitivities of both tests, to detect epilepsy or taeniasis, were low, but the specificity and the positive predictive value of the antigen-capture assay was high when used with the epileptics. As late-onset epilepsy and neurocysticercosis seem to be associated in endemic regions, antigen-capture assays are probably the most reliable method of detecting active cases of neurocysticercosis in epidemiological studies.

Adult↗

Ultrasonographic appearance of colon taeniasis.

We present the case of a 50-year-old woman with abdominal pain, nausea, loss of appetite, and frequent stools in whom the routine ultrasonographic examination demonstrated a double-reflective, ribbon-like structure in the lumen of the initial segment of the ascending colon, which suggested colon taeniasis. Because the initial parasitologic analysis yielded negative results and application of albendazol did not have any therapeutic effect, the diagnosis was confirmed by barium enema and subsequently by parasitologic examination of proglottids passed in the stool after application of niclosamide. The double-reflective, ribbon-like structure in the lumen of the intestine seems to be specific to the ultrasonographic appearance of intestinal taeniasis. Transcutaneous ultrasonography of the gastrointestinal tract, performed as a screening method before conventional radiologic or endoscopic examination, can point to the ultimate diagnosis of colon taeniasis.

Colon↗

Taeniasis and cysticercosis in Asia and the Pacific: present state of knowledge and perspectives.

Several topics on taeniasis and cysticercosis in Asia and the Pacific are overviewed. In Asia and the Pacific, three human taeniid species have been recognized: Taenia solium, Taenia saginata and Taenia asiatica. The first topic is on evolution of T. solium. Mitochondrial DNA polymorphisms of T. solium worldwide are discussed with emphasis of two specific genotypes: American-African and Asian. The second topic is recent major advances in sero- and molecular-diagnosis of T. solium cysticercosis in humans, pigs and dogs. The third is the present situation of T. solium taeniasis/cysticercosis in Papua (Irian Jaya), Indonesia. The forth is the present situation of T. solium cysticercosis and T. saginata taeniasis in Bali, Indonesia. The fifth is the present situation of T. asiatica taeniasis in Asia and the Pacific and in North Sumatra, Indonesia. The sixth is on the debate of the exact definition of T. asiatica. Because T. asiatica can not be differentiated from T. saginata morphologically, it is time to re-evaluate T. saginata in Asia and the Pacific. New and broad-based surveys across this region are necessary from epidemiological and public health perspectives, based on evidence.

Animals↗

[Seroprevalence of cysticercosis, taeniasis and swine infection on Réunion Island in 1992].

Cysticercosis is a parasitic disease commonly observed in developing countries in Latin America, Africa, and Asia. Many cases involving cerebral injury have been reported on Reunion Island, a French department in the Indian Ocean. The present article describes the findings of a seroprevalence survey performed from September 1990 to May 1992 using an ELISA technique. Out of a total of 1010 individuals randomly selected from the voter registration records of the island's 24 polling districts, 993 agreed to be interviewed and undergo blood testing. Samples from 14 individuals were positive for cysticercosis, indicating a seroprevalence of 1.4% with 95% confidence interval from 0.7 to 2.1%. Seropositive individuals were evenly distributed throughout the island with no statistical difference regarding sex and age. A retrospective study showed that diagnosis of taeniasis was uncommon (less than 0.02% of stool examinations for parasites). Meat inspection records showed that no pork had be seized due to taeniasis since 1993 but raising of pigs by private citizens without veterinarian control is still widespread. Living conditions are improving and eradication of endemic cysticercosis seems achievable by enforcing zoning codes and educating people about the need for proper meat handling and treatment of taeniasis.

Adult↗

Epidemiological investigation of Taenia solium taeniasis and cysticercosis in a rural village of Michoacan state, Mexico.

We performed a survey for taeniasis and cysticercosis among persons living in a Mexican village where Taenia solium infection in pigs was known to be enzootic. A standardized questionnaire was administered in all 577 households to obtain medical histories and information on demographic and environmental factors and on risk factors associated with transmission of infection. Serum and/or stool specimens were obtained from 1005 volunteers and examined for cysticercosis antibodies and intestinal parasites. Faecal examination of 828 participants revealed infection by Taenia sp. in 2 (0.2%). Three additional cases of taeniasis were detected in individuals who evacuated proglottids after treatment with praziquantel. Of 1005 human serum specimens, 49 (4.9%) were positive in the cysticercosis immunoblot assay. Seropositivity increased with age and reached a peak in subjects aged 46-55 years (P < 0.05). A history of seizures was significantly associated with seropositivity (P < 0.05); approximately 25% of persons with such histories were seropositive. Histories of headache, dizziness, trembling, blurred vision, and vomiting were also significantly associated with positive immunoblot assays. This study has demonstrated previously undiagnosed morbidity associated with T. solium neurocysticercosis and identified community behavioural and environmental practices that must be modified to prevent continued transmission of cysticercosis and taeniasis.

Adolescent↗

Eating habits of east Asian people and transmission of taeniasis.

In order to understand the role of raw meat and viscera eating habits in the transmission of taeniasis in Asian countries, 1502 infected aborigines in ten mountainous districts/towns of six counties in Taiwan, 58 infected persons in two villages on Cheju Island, Korea, and 97 cases in Ambarita District on Samosir Island, North Sumatra, Indonesia were studied during the field surveys. All infected Taiwan aborigines had the habit of eating raw meat and viscera of wild and/or domestic animals. Among these aborigines, 73% ate wild boar, 66% flying squirrel, 65% wild goat, 56% muntjac, 49% wild rats, 46% monkey, 38% hare, 20% civet-cats, 18% weasel, 17% pheasant, 14% squirrel, 4% grouse, 1% deer, 1% snake, less than 1% bamboo partridge, less than 1% frog, less than 1% bear, less than 1% dog, and less than 1% fox. Of the 58 infected persons with Taenia on Cheju Island, Korea, 72% ate raw meat and/or viscera of pig and cattle, 19% raw pork only, and 9% raw beef only. Among 12 infected persons infected with T. saginata-like tapeworms, 7 had eaten raw pork, 2 raw beef and pork and 3 raw pork. Almost all of the 97 cases of taeniasis on Samosir Island of North Sumatra, Indonesia, had eaten only undercooked pork. Eleven of 15 cases were found to be infected with T. saginata-like tapeworms. Eating habits observed suggest an unusual way of transmission of Taenia in East Asia.

Adolescent↗

Poor efficacy of albendazole for the treatment of human taeniasis.

In order to evaluate the efficacy of albendazole for the treatment of taeniasis, regimens of 400 mg x 1 day, 800 mg x 2 days, 800 mg x 3 days, 1200 mg x 2 days, and 1200 mg x 3 days were compared. Of 66 cases treated and investigated 7-14 days after treatment, 52 were still expelling proglottids. Three months posttreatment, these cases were re-treated with atabrine at 1.2 g per case for males and 1.0 g per case for females. Fifty-seven patients expelled worms or parts of tapeworms. The nine negatives may represent the number cured by the treatment with albendazole. The cure rates with albendazole for various regimens were up to 50% for 800 mg x 3 days, 1200 mg x 2 days or 1200 mg x 3 days, 14.3% for 800 mg x 2 days, and 0% for 400 mg x 1 day or 800 mg x 1 day. This study shows that albendazole is not very effective in the treatment for taeniasis.

Adolescent↗

Taeniasis-cysticercosis in Honduras.

Data on human taeniasis and human and animal cysticercosis from Honduras were gathered from laboratory, medical and slaughterhouse records, proglottid identification and surveys. The infection rate for human taeniasis was 2.7/1000 individuals at the University Hospital, 10/1000 in the southern provinces of Choluteca and Valle, and 0.6/1000 in Cortes and Atlantida in the north. In surveys, the rates found ranged from 14 to 62/1000 in 9 of 15 communities studied. Taenia solium was identified in 135 of 181 individuals (74.5%) who submitted proglottids for speciation, 23 of whom were children 0-5 years old. The male:female ratio of infection rate was 1:2. The rates of infection with cysticercosis in pigs and cattle at one abattoir in 1981-1986 were 5% and 0.05% respectively. Diagnosis of human cysticercosis at the University Hospital increased five-fold with the introduction of computerized tomography and an enzyme-linked immunosorbent assay: 22 cases were diagnosed in 1980-1984 and 107 cases in 1985-1988. Rates at the neurosurgical ward were higher (29/1000 patients) than in the general hospital census (1.6/1000 patients). aeniasis-cysticercosis may be a serious health problem in some areas of Honduras.

Adolescent↗

Mitochondrial DNA diagnosis for taeniasis and cysticercosis.

Molecular diagnosis for taeniasis and cysticercosis in humans on the basis of mitochondrial DNA analysis was reviewed. Development and application of three different methods, including restriction fragment length polymorphism analysis, base excision sequence scanning thymine-base analysis and multiplex PCR, were described. Moreover, molecular diagnosis of cysticerci found in specimens submitted for histopathology and the molecular detection of taeniasis using copro-DNA were discussed.

Animals↗

Role of chemotherapy of taeniasis in prevention of neurocysticercosis.

Neurocysticercosis (NC) is a serious public health problem in Taenia solium endemic areas and in some immigrants and international travelers. A key intervention in preventing NC is elimination of taeniasis by chemotherapy. Currently, two safe and effective taenicides, namely niclosamide and praziquantel, are available. Both are on WHO Essential Drug list, but are often inaccessible in T. solium endemic areas. Natural remedies, still widely used in some endemic areas, are frequently carcinogenic or highly toxic and as such should be discontinued. Chemotherapeutic intervention to control T. solium taeniasis/cysticercosis, whilst theoretically feasible, has several practical obstacles. These include poor public awareness, problems with diagnosing Taenia carriers, poor availability of taenicides where needed and low priority afforded to the control of NC. These can be overcome, respectively, by effective health education, wider use of newly developed coproantigen tests, strengthening of health services infrastructure and essential drugs distribution, and increasing the priority given to prevention of NC, as a leading cause of epilepsy in T. solium endemic areas. Information is accumulating on rational approaches to population-based short-term chemotherapeutic control measures. These are: widely available modern diagnostic tools and taenicides, treatment of any case of taeniasis, confirmed or probable, focus-oriented chemotherapy, irrespective of Taenia species implicated, improved sanitation, cooperation of veterinary and medical services, linkage with programs against epilepsy and cooperation of better educated communities. Now, it remains to take an advantage of existing tools and experience.

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Taeniasis, cysticercosis and echinococcosis in Thailand.

Taeniasis is one of the major food-borne parasitic zoonoses in Thailand. During the years 1957-1997, the prevalence was low in most parts of the country. Recent (2000-2005) country prevalence was lower than 1%. A high prevalence (5.9%) was found among 1450 villagers from 30 villages in the North, and among 1233 stool samples from 19 provinces in the Northeast (2.8%). Taenia saginata was the dominant species. Cysticercosis in Thailand is somewhat under-reported/recorded. During the period 1965-2005, diagnosis was based on techniques other than serodiagnosis, giving a total of cysticercosis cases of less than 500. However, an immunoblot technique using delipidized cyst antigen showed 314 positive cases out of 754 samples tested in 2000-2005. Reports of neurocysticercosis appeared more often than cutaneous cysticercosis. A total of 24 cases of echinococcosis, mostly hydatid cysts (only 2 cases of alveolar cysts), were recorded during 1936-2005. These records included 3 cases of foreigners seeking surgery in hospitals in Bangkok. Most Thai patients were migrant workers from the Middle East, and only a few cases were indigenous. The prevalence of cysticercosis and echinococcosis is increasing resulting from sensitive modern diagnostic tests. Taeniasis will persist in Thailand as the consumption of raw/half-cooked meat dishes is still a normal practice for Thai people.

Adolescent↗

Immunodiagnostic tools for taeniasis.

Most diagnostic work conducted on the Taenia species zoonoses has been carried out on the larval stage of Taenia solium in man, reflecting the relative severity of the pathology caused by this stage of that organism. This review will, however, concentrate on the immunodiagnosis of the adult intestinal stages of these parasites in humans. Diagnosis of T. solium will be examined in most detail because of the relative importance of this parasite but relevant work from other cestodes of man and animals will also be discussed. In addition both classical and molecular approaches to diagnosis will be briefly covered. There have been a number of advances in immunodiagnosis of taeniasis over recent years that have improved both diagnostic sensitivity and specificity. Techniques for the detection of Taenia specific coproantigens in human taeniasis infections have been shown to more than double the numbers of T. solium cases accurately diagnosed in epidemiological studies. More recently, work on the serological diagnosis of T. solium have led to the development of a sensitive and specific enzyme linked immuno-transfer blot for the detection of species and stage specific circulating antibodies to adult worm excretory-secretory antigens. Work is ongoing to further improve these assays.

Animals↗