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Sero-prevalence of Taenia solium cysticercosis and Taenia solium taeniasis in California, USA.

OBJECTIVES: Taenia solium Cysticercosis is a leading cause of epilepsy and neurological disability in the developing world. It is caused by ingestion of the eggs of the tapeworm, T. solium Taeniasis. The prevalence of either T. solium Cysticercosis or T. solium Taeniasis in the United States in populations at risk is poorly understood. The primary objectives of this study are to perform the first study of the sero-prevalence of T. solium Cysticercosis and T. solium Taeniasis in an at-risk community in the USA, specifically rural Southern California; identify T. solium Taeniasis positive individuals, and treat positive individuals for the tapeworm T. solium Taeniasis. METHODS: Community based sero-prevalence study of antibodies to T. solium Cysticercosis and T. solium Taeniasis in 449 subjects living in a federally funded, predominantly Hispanic residential community; and in two migrant farm worker camps in rural Ventura County, California, USA. For this study, fingerstick blood samples were obtained. Serum immunoblots for both T. solium Cysticercosis and T. solium Taeniasis were performed. RESULTS: The sero-prevalence of T. solium Cysticercosis was 1.8% and the sero-prevalence of T. solium Taeniasis by serum immunoblot was 1.1%. Taenia solium Cysticercosis and T. solium Taeniasis antibodies were not detected in children. The sero-prevalence of T. solium Taeniasis was highest in the migrant farm worker community. Handwashing frequency was correlated with T. solium Taeniasis sero-positivity. CONCLUSION: The sero-prevalence of T. solium Cysticercosis and T. solium Taeniasis in this population, as detected by serum immunoblot, approximates the prevalence in some endemic areas of Latin America. Importantly, most patients likely had prior exposure, not active infection. This study establishes for the first time, the relative sero-prevalence of T. solium Cysticercosis and T. solium Taeniasis in at-risk populations in the United States.

Adolescent↗

Orbital cysticercosis.

BACKGROUND: Human cysticercosis is secondary to an infestation by cysticercus cellulosae, the larval form of Taenia solium. Cysticercosis is endemic to regions with poor sanitation. The purpose of this report is to present a large series of patients with orbital cysticercosis and to discuss the current treatment. METHODS: A retrospective chart analysis of all patients with orbital cysticercosis from an urban practice in southern India was performed. The clinical features, the results of investigations, the therapies instituted, and the outcomes realized were recorded. RESULTS: Twenty patients diagnosed with orbital cysticercosis were identified (11 female and 9 male). Their ages ranged from 5 to 25 years with a mean age of 12.5 years. Nine patients manifested subconjunctival cysts. Eight were excised and 5 of these were densely adherent to the adjacent extraocular muscle (EOM). The remaining 11 patients had a cyst in a single EOM. The EOM cysts had proptosis, restricted motility, recurrent inflammation, and blepharoptosis. Two of the EOM cysts were excised surgically and four extruded spontaneously. Six patients with EOM cysts were treated medically: they all received oral corticosteroids and, additionally, five were given oral albendazole and one was given oral praziquantel. CONCLUSIONS: Excisional biopsy is recommended for subconjunctival cysticercosis. Idiopathic cystic myositis can present like EOM cysticercosis, but is differentiated by resolution with corticosteroid treatment. Medical therapy in orbital cysticercosis with oral albendazole and corticosteroids can arrest recurrent inflammation and improve ocular motility.

Adolescent↗

Intramedullary cysticercosis cured with drug treatment. A case report.

STUDY DESIGN: A report of a patient with cervical intramedullary cysticercosis is presented. OBJECTIVES: To report the first case of intramedullary. cysticercosis cured with drug management only, which supports the hypothesis that management with anthelmintics might be successfully used in this form of cysticercosis. SUMMARY OF BACKGROUND DATA: Intramedullary cysticercosis is a rare manifestation of neurocysticercosis. Every treated patient reported to date has undergone surgery, frequently necessary for diagnosis. Since the anthelmintics praziquantel and albendazole were shown to be effective in parenchymal brain cysticercosis, these drugs have been considered potentially useful in patients with intramedullary cysticercosis. Nevertheless, no case yet had been reported to be cared with only medical therapy. METHODS: The treatment of a patient who suffered multiple cysticercal reinfestations of the nervous system is presented. RESULTS: The patient received prolonged treatment with albendazole because of superimposed cerebral reinfestations. During this treatment, she suffered acute paraparesis, and cervical magnetic resonance imaging showed cyst-like lesions with linear gadolinium enhancement and perilesional edema, indicative of dying cysticerci and inflammatory host reaction. Dexamethasone was added, and progressive neurologic improvement followed with complete resolution of intramedullary lesions. CONCLUSIONS: A preoperative diagnostic suspicion of cysticercosis is important in patients with intramedullary cystic lesions because specific drug treatment is available. Treatment with anthelmintics, particularly albendazole, should be considered in patients with intramedullary cysticercosis before surgery. Corticosteroids may be added to the therapeutic regimen because this may reduce the perilesional edema and prevent neurologic deterioration during the course of anthelmintic treatment.

Adult↗

Current status of cysticercosis in Vietnam.

This English review concerning the current status of cysticercosis in Vietnam has been compiled from various reports of studies conducted over the past 15 years, which have appeared in national publications in Vietnamese, in order to make the information available to the international community. Hospital surveys indicate that cysticercosis is emerging as a serious health problem in the country though most of the information comes from the Hanoi area. Many more men than women are being treated for cysticercosis with most patients being young to middle-aged adults though several juvenile cases have been seen in the south. Clinical manifestations of the disease in humans include subcutaneous nodules, epileptic seizures, severe headache, impaired vision and memory loss. Albendazole has been found to be the best drug for treating cysticercosis though it does not appear to be totally effective for curing cerebral cysts. Information concerning porcine and bovine cysticercosis is very limited and based mostly on passive surveillance at Hanoi slaughterhouses. Surveys for human taeniasis in central and northern provinces indicate a prevalence of 0.2-7.2%. However, techniques of low sensitivity were used and the results are inconclusive since it is unknown with which species of tapeworm the people were infected. In addition to Taenia solium which causes human cysticercosis, T. saginata and T. asiatica are also known to be present in Vietnam. Risk factors investigated thus far with regard to transmission of T. solium suggest that consumption of raw pork, inadequate or absent meat inspection and control, poor sanitation in some areas, and the use of untreated human waste as fertilizer for crops may play important roles in Vietnam but this remains to be validated. The evidence thus far collected suggests that a national surveillance program for cysticercosis is a great need for Vietnam. The authors recommend further research on the epidemiology and impact of cysticercosis in both human and pig hosts in order to determine whether a prevention and control program in Vietnam would be merited and cost effective.

Adolescent↗

[Musculocutaneous and visceral cysticercosis: a rare disease?].

The aims of the present study were to measure the frequency of cutaneous, muscular and visceral forms of cysticercosis in anatomopathological examinations and necropsies in the Federal District and to study the clinical aspects of this disease. In 64.911 protocols of anatomopathological examinations reviewed, 30 (0.05%) had the diagnosis of cysticercosis, 90% had cysticerci in the subcutaneous tissue, skeletal muscle or mucous membrane, 3.3% in lymph node and 6.7% in the central nervous system. Two (7.4%) patients had cysticerci in the tongue. In 1520 autopsies protocols reviewed, 25 (1.6%) autopsies with cysticercosis were found. 96% had cysticerci in the central nervous system, 8% in the heart, 8% in the skeletal muscle and 4% in the liver, either isolated or associated with cysticerci in other viscera. 1122 people were also examined. Indirect immunofluorescence and ELISA were the serological tests used in all patients for the diagnosis of cysticercosis. The radiological investigation of the skull and soft tissues was also performed. 59 (5.3%) patients had both serological tests positive (10 had also biopsies with the diagnosis of cysticercosis). The muscular form was found in 42.4%, subcutaneous cysts were present in 20.3% and the visceral form was found in 3.4% of cases. In patients with visceral cysticercosis, the cysts were localized in the heart, pleura, kidney and ovary. Calcifications in the skull and/or soft tissues were demonstrated radiologically in 32 (2.8%) patients with negative serological tests for cysticercosis. The present study suggests a high frequency of subcutaneous and muscular forms of cysticercosis in the Federal District. The visceral form of the disease is also found in various organs, without clinical manifestations of importance.

Adolescent↗

[Seroprevalence of cysticercosis in the lacustrian community of Vekky, Atlantic district (Benin)].

Cysticercosis is a parasitic disease due to the infection of man with Cysticercus cellulose, the larva of Taenia solium. This disease is frequent in countries with low socio-economic development and is linked to sanitary conditions. The aim is to assess the seroprevalence of cysticercosis in the lacustrine vicinity of Vekky, located on the lake Nokoué, District Atlantic, south Benin, an epidemiological survey was undertaken in April and May 1994. The lacustrian vicinity of Vekky comprises 12 villages including 16, 142 inhabitants. Population has been sampled using cluster sampling method (n = 30) at two levels (village and household). The whole samples consisted in 319 adults (123 females and 196 males, mean of ages: 32.8 +/- 18.3). Titration of cysticercosis antibodies has been made using ELISA. Eleven patients (3 females and 8 males) showed a positive ELISA response for cysticercosis, i.e. the seroprevalence of cysticercosis was 3.5% (CI 95%:1.3-8%). There was no significant difference according to age and sex. The seroprevalence of cysticercosis reached 9.1% in patients who presented history of epilepsy. We failed to find any linkage between seropositivity and i) clinical history of epilepsy or taeniasis, or ii) several studied environmental factors such as consumption of pork, wandering of pigs, lack of veterinary supervision, religion and occupation. Human seroprevalence of cysticercosis reaches 3.5% in vicinity of Vekky, which denotes a high endemic level. Further epidemiological studies are necessary to precise the factors involving cysticercosis in this area.

Adolescent↗

Computed tomography (CT) in parenchymatous cerebral cysticercosis.

Cysticercosis is an infection with a larval or a bladder-worm stage of the species of Taenia. Cysticerci have a predeliction for the nervous system where they may be found in the meninges, the ventricles and within the brain itself. Brain involvement or parenchymatous form has an acute and chronic phase. Before the advent of CT scanning radiology was of little value in the acute parenchymatous cysticercosis, but with CT the changes within the brain can be recognised. In reviewing 14 cases of acute parenchymatous cysticercosis three CT patterns were found. 1. A diffuse low density pattern with no or little change after contrast medium 2. Multiple low densities with small rounded central areas of enhancement. 3. Large cystic lesions which may become ring lesions after contrast medium. We conclude that in an endemic area for cysticercosis, when one of these CT patterns is present, cysticercosis should be considered in the differential diagnosis. In a child where the clinical features are suggestive, the CT pattern may be diagnostic of cysticercosis. In the chronic parenchymatous stage the cysts have calcified and this may occur within one year of the acute onset. In 11 cases of chronic parenchymatous cysticercosis where the calcification was visible on the plain skull radiographs the CT scan added very little additional information. It may however be of value in confirming intracranial calcifications where their presence on the plain skull radiograph is in doubt.

Acute Disease↗

Spinal intramedullary cysticercosis.

OBJECTIVE: Spinal intramedullary cysticercosis is an uncommon manifestation of neurocysticercosis. We review our experience with eight cases of intramedullary cysticercosis. METHODS: Eight patients who were surgically treated for spinal intramedullary cysticercosis between 1982 and 1991 were retrospectively reviewed, and the final outcomes were assessed. RESULTS: In six patients, the cysticercosis involved the thoracic cord, whereas in the other two, the cysticercosis was cervical in location. Only one patient had multiple soft tissue calcifications, as revealed by plain radiography. Myelography indicated an intramedullary lesion in each of seven patients; two of the seven patients had partial myelographic block, suggesting the segmental nature of the lesion. Cerebrospinal fluid studies were noncontributory. One patient had three cysts, whereas the other seven had one cyst each. Four patients had adjacent soft purulent materials, which were revealed by histopathological examination to be granulation tissue. The neurological statuses of seven patients improved after surgery. Six patients were followed up for a mean of 30.6 months (3 mo-5 yr). Three could resume their previous occupations, two others could manage their daily activities, and one required only minimal assistance for daily activities. CONCLUSION: The outcome of intramedullary cysticercosis is not as dismal as reported earlier, and patients with paraplegia also have favorable outcomes. A preoperative diagnosis of cysticercosis can be suspected in an endemic area in the presence of multiple soft tissue calcifications and segmental lesions revealed by myelography or magnetic resonance imaging studies.

Activities of Daily Living↗

Cerebral cysticercosis and stroke.

BACKGROUND AND PURPOSE: In 1985 we initiated a protocol for examining the relationship between cerebral cysticercosis and stroke. METHODS: In 420 stroke patients admitted to our department, our standard protocol of tests included blood tests, cardiac investigations, angiography, and immunologic cerebrospinal fluid measures. We assessed the following possible risk factors: arterial hypertension, diabetes, cardiopathy, high levels of cholesterol and triglycerides, smoking, alcohol abuse, and cerebral cysticercosis. RESULTS: Of the 420 patients with stroke, we found cerebral cysticercosis in 31, five of whom were greater than 65 years of age and 26 of whom were less than or equal to 65 years. We determined that cerebral cysticercosis was the only possible risk factor for stroke in one of the five older patients and 15 of the 26 younger and middle-aged patients. Cortical infarctions were found in five of the 31 patients, with cerebral cysticercosis and lacunar infarctions in nine of these patients. One patient had intracystic hemorrhage. In 16 cases, neurological deficit was related to single or multiple cysts, colloids, granulomas, diffuse lesions, or pericystic edema. All patients with cerebral cysticercosis quickly recovered from their neurological deficit, except one who had a hemorrhagic cyst and died and another who remained disabled. CONCLUSIONS: We established that, in patients with neurocysticercosis, occlusion of the small cortical or penetrating vessels at the base of the brain caused by arteriopathy was the most common mechanism of the stroke. Moreover, there is a probable association between cerebral cysticercosis and the susceptibility to stroke, particularly among young and middle-aged patients.

Adolescent↗

[Occurrence of encephalic and cardiac cysticercosis (Cysticercus cellulosae) in necropsy].

OBJECTIVE: To review the incidence and pathologic findings of cysticercosis diagnosed at autopsies, with emphasis on the most common organs affected. METHODS: Reports of 1.596 autopsies performed between 1974 and 1997 at a school hospital in Uberaba, MG, Brazil were studied. The following data were obtained: age, sex, ethnic group, body mass index, and the site of the cysticercosis. RESULTS: The study found diagnosis of cysticercosis in 53 autopsies (3.3%). The average age of patients with cysticercosis was 50 (range: 15 to 86 years); 62.3% were male, and 64.1% Caucasian. The most affected organs were: brain (79.2%), heart (22.6%), skeletal muscle (11.3%), and other organs (5.7%). No statistical differences were found comparing age, gender, ethnic group, and body mass index of the affected and the non-affected patients. In two cases of neurocysticercosis the lesions were located in the ventromedial nucleus of the hypothalamus. CONCLUSION: Both the overall incidence of cysticercosis and the incidence of cardiac cysticercosis were greater in the study than in other autopsy series from the same geographic areas. In two cases there was an association between hypothalamic cysticercosis and obesity

Adolescent↗

Prevalence and comparison of serologic assays, necropsy, and tongue examination for the diagnosis of porcine cysticercosis in Peru.

Swine cysticercosis, a severe zoonotic disease which is part of the Taenia solium life cycle, causes major economic losses in pig husbandry. Throughout South America, farmers diagnose cysticercosis by examining the tongues of their pigs for cysticercus nodules. Farmers do not bring pigs believed to be infected to the slaughterhouse for fear of confiscation. Therefore, reliable statistics on porcine cysticercosis can only be acquired at the household level. We examined the utility of the tongue test as a diagnostic tool for porcine cysticercosis. The results of the tongue test was compared with 2 serologic methods for the detection of cysticercosis, the enzyme-linked immunosorbent assay (ELISA) and the enzyme-linked immunoelectrotransfer blot assay (EITB), and with necropsy results. We examined 11 animals from an endemic area (Huancayo) and 42 animals from an area free of cysticercosis (Lima). The tongue test has a sensitivity of 70% and a specificity of 100%, the EITB a sensitivity and specificity of 100%, and the ELISA a sensitivity of 79% and a specificity of 75%. Thus, the tongue examination, being a test essentially without cost and having fair sensitivity and high specificity, can be useful in epidemiological surveys. Prevalence for porcine cysticercosis in Huancayo is 23.4% by tongue examination, 31.2% by necropsy, 37.7% by ELISA, and 51.9% by EITB.

Animals↗

Cysticercosis surveillance: locally acquired and travel-related infections and detection of intestinal tapeworm carriers in Los Angeles County.

A surveillance system for cysticercosis was initiated in January 1988 in Los Angeles County to measure the incidence of the disease, to more accurately assess the level of locally acquired and travel-related infection, and to evaluate household contacts for intestinal tapeworm infection. In three years of surveillance (1988-1990), 138 incident cases were reported for an average crude annual incidence rate of 0.6 per 100,000 population. The highest rates were among Hispanics (1.6/100,000), most of whom were Mexican immigrants. Eight (5.8%) cases were fatal. Nine (6.5%) probable travel-associated cases occurred among persons born in the United States who had traveled to Mexico. Ten (7.2%) autochthonous cases of cysticercosis were documented. Taenia eggs were recovered more commonly in specimens from contacts with cysticercosis cases (1.1%) than in specimens from noncontact patients (0.2%). At least one Taenia tapeworm carrier was found among contacts of five (6.9%) of 72 cysticercosis patients. Carriers were more likely to be found among contacts of patients born in the United States (22.2%) than among those of foreign-born (4.8%) patients (odds ratio = 5.4) Cysticercosis causes appreciable morbidity and mortality in Los Angeles County, principally among Hispanic immigrants. However, these results indicate that both travel-acquired and locally acquired cysticercosis may be more common than previously recognized. Public health followup of cysticercosis cases, including screening of household contacts, can identify tapeworm carriers, who can be treated and removed as potential sources of further infection.

Adolescent↗

[The positivity index of the immunoenzyme reaction (ELISA) for cysticercosis in the cerebrospinal fluid (CSF) and in the serum of epilepsy patients].

Fifty patients with epilepsy seen in three Londrina Neurological Services, in Paraná, were studied. The positivity prevalence of the enzyme-linked immunosorbent assay (ELISA) for cysticercosis in the cerebrospinal fluid (CSF) and in the serum of these patients was 34.0% and 20.0%, respectively. There was statistically significant difference when these two rates were compared with the reaction positivity in the CSF and the serum in the control group, formed by individuals without neurological diseases. There was no association between the type of seizure (generalized or partial) and the positivity index of ELISA for cysticercosis in the CSF. A greater number of patients with positive ELISA for cysticercosis in the rural area dwellers was found, in relation with the urban area dwellers. From the obtained results in our study we came to the following conclusions: 1. The high positivity ELISA rates for cysticercosis in the CSF and in the patients serum with epilepsy indicate that neurocysticercosis is an important seizure cause in Londrina, PR. 2. The positivity prevalence of ELISA for cysticercosis in CSF was greater in epileptic patients from the rural area than the ones from the urban area. 3. There was no association between the type seizure (generalized or partial) and the ELISA cysticercosis positivity rate in the CSF. 4. The high positivity prevalence of ELISA in the CSF and in the epileptic patients serum in Londrina indicates the priority of performing epidemiologic inquiry to establish the real cysticercosis prevalence in the city. ELISA may be used with this finality due to its high sensibility, its low cost and its simple performance.

Adolescent↗

[The current epidemiological situation of cysticercosis in Madagascar].

Being associated to fecal-oral transmission, cysticercosis is contracted either by auto-infection or by ingestion of food contaminated with eggs from the pork tape worm (Taenia solium). In the stomach, the larvae named cysticercus (Cysticercus cellulosae) hatches from the eggs and invades the host through the mucosa membrane. Human cysticercosis occurs in highly prevalent proportions in many developing countries including Madagascar where hygiene conditions are deplicable. Serology tests applicable to epidemiological surveillance of cysticercosis and associated pathology in the Malagasy population have been developed: an enzyme-linked immunosorbent assay (ELISA) for screening purpose, and an enzyme-linked immunoelectrotransfer blot assay (EITB) for confirmative testing. Two specific bands (13 and 14 kDa) have been identified as significant markers of the cysticercus in an active (vesicle) stage of the infection when cestocidal treatment is strongly indicated. The same bands may on the other hand be absent at early (cyste) as well as late (calcified) stages of the infection. Series of studies, including 4,375 serum samples, have been undertaken from 1994 until 1999 aiming at determinating the cysticercosis sero-prevalence in different provinces of Madagascar. It was confirmed that cysticercosis is highly frequent on the island, and that there exists a marked variation in the prevalence from 7 to 21% between the different provinces: less than 10% in coastal regions (Mahajanga and Toamasina) increasing to 20% in central regions (Ihosy, Ambositra and Mahasolo). It has also been observed that cysticercosis may occur in individuals at any age, and that it is equally distributed in urban as in rural areas. However, it is more frequently detected in women than in men. Madagascar is an endemic country for cysticercosis, which causes major and severe disease with implications in the public health sector. A national control program is, therefore, urgently warranted.

Adolescent↗

A serological study of human cysticercosis in Pondicherry, South India.

The present study was carried out to determine the extent of the problem of cysticercosis in Pondicherry by assessing the antibody response to porcine cysticercus antigen by the indirect haemagglutination (IHA) in people residing in and around Pondicherry and in patients clinically suspected to have cysticercosis. Serum samples were collected from 1442 persons apparently normal in respect to cysticercosis, 91 cases of clinically suspected cases of cysticercosis, and 100 normal healthy students and blood donors. These sera were tested for cysticercus antibodies by IHA test using whole porcine cysticercus antigen sensitised RBCs. An antibody titre of 1:64 and above by the IHA was considered to be diagnostic of cysticercosis. At this diagnostic titre, 88 (6.10 %) of 1442 apparently normal population sera were seropositive. Of these 88 seropositive subjects, 16 (18.18 %), 33 (37.5 %) and 32 (36.36 %) were in the age groups of 1-13 yrs, 14-40 years and above 40 years respectively. 52 (59.1%) were males and 36 (40.9 %) were females. Twenty (21.97%) out of 91 clinically suspected cases were found to be seropositive out of which 14 (70 %) were males and 6 (30 %) females. 4 cases were in the age group of 6-13 years, 14 cases in 14-40 years and 2 cases were in the age group of 40 years and more. Cysticercus antibodies were not detected in any of the sera from healthy peoples including students. A positive antibody response in 6.1 % of population residing in and around Pondicherry and in 21.97 % of patients clinically suspected cases of cysticercosis show that cysticercosis may be more common in Pondicherry than believed.

Adolescent↗

Cysticercosis in chronic psychiatric inpatients from a Venezuelan community.

Cysticercosis due to Taenia solium infection is endemic in developing countries of the Americas, Asia, and Africa. This study was designed to establish the prevalence of cysticercosis in 158 inpatients of a psychiatric institution in the state of Tachira (Venezuela) and in 127 healthy control subjects. Positive blood tests for cysticercosis by Western blotting were recorded in 18.35% of the patients and in 1.57% of the controls. Individuals with mental retardation were found to carry an increased risk of cysticercosis (RR: 2.92; 1.22 < 2.92 > 7.0; P < 0.05) compared with patients with other psychiatric disorders. Taeniasis by Taenia spp. was not demonstrated in the patient group, although a high incidence of infection by other helminths (95.1%) was detected. The high prevalence of cysticercosis in the psychiatric inpatient group, compared with healthy individuals, and the lack of a differential diagnosis of neurocysticercosis suggest cerebral cysticercosis in a large proportion of these patients. Cysticercosis could be the origin of the psychiatric disorders of these patients and may also be due to contact with the parasite in an environment with poor hygiene conditions and a deficient health care system.

Adult↗

Co-agglutination test for cysticercus antigen detection in the serum for the diagnosis of cysticercosis.

The objective of the study was to develop the co-agglutination (Co-A) test, a rapid slide agglutination test for the diagnosis of cysticercosis. The present study included 21 cases of cysticercosis, which comprised seven cases of clinico-radiologically definite cases of neurocysticercosis (NCC) proven with either computed tomography (CT) scan or magnetic resonance imaging (MRI), eight cases of clinically strong NCC, six cases of extraneural cysticercosis in muscle and eye; 40 non-cysticercal parasitic infection controls; and 20 healthy controls. Hyperimmune cysticercus antiserum was raised in rabbits and was used to coat Staphylococcus aureus (Cowan strain-I) bearing protein A (SAPA) cells, and the Co-A was standardized to detect cysticercal antigen in the serum. Serum samples from 12 out of 21 (57%) cases of cysticercosis were positive for cysticercal antigen by the Co-A test. Of the 12 positive samples, eight were from cases of neurocysticercosis and four from cases of extra-neural cysticercosis. Serum samples from seven out of 40 non-cysticercal parasitic infection controls and serum samples from one out of 20 (5%) healthy controls showed a false-positive reaction for the antigen by the Co-A test. There was a statistically significant difference between the antigen detection rates among cysticercosis patients on one hand, and the patients with other parasitic diseases (P = 0.0014), and healthy controls (P=0.0003) on the other. The Co-A test appears to be a moderately sensitive and specific test for the diagnosis of cysticercosis.

Agglutination Tests↗

Taeniasis and cysticercosis in housemaids working in affluent neighborhoods in Lima, Peru.

Taenia solium taeniasis/cysticercosis is endemic in most developing countries, where it is an important cause of epileptic seizures and other neurologic symptoms. In industrialized countries, cysticercosis results from travel or immigration of tapeworm carriers from endemic areas. In both endemic and nonendemic countries, housemaids commonly immigrate from cysticercosis-endemic areas and can transmit the infection if they carry the adult tapeworm. Between July 2001 and July 2002, 1,178 housemaids (961 of them work in the top five most affluent districts of Lima, a metropolis of 8 million inhabitants considered nonendemic for cysticercosis) were evaluated for serum antibodies to Taenia solium and stool microscopy for taeniasis and cysticercosis. The serosurvey revealed a prevalence of cysticercosis-specific antibodies of 14.6% (95% CI: 12.6-16.6%), and stool microscopy detected 12 T. solium tapeworm carriers, for a prevalence of taeniasis of 1.2% (95% CI: 0.6-1.8%). A nonrandom sample of 26 seropositive housemaids was examined by brain CT and 50% of them had brain lesions compatible with neurocysticercosis, mainly calcifications. From the families who used a tapeworm-carrier housemaid, cysticercosis antibodies were detected in 6 (23%) of 26 persons who agreed to participate. One seropositive member of the employer families was symptomatic for seizures and had brain calcifications. The prevalence of tapeworm infections in this housemaid group is similar to levels in endemic areas, constituting a source of neurocysticercosis infection.

Adolescent↗