Abstract
Cysticercosis is a parasitic infection caused by the metacestode larval stage (cysticercus) of Taenia solium. In humans, cysticercosis may infect the central nervous system and cause neurocysticercosis, which is responsible for over 50,000 deaths per year worldwide and is the major cause of preventable epilepsy cases, especially in low-income countries. Cysticercosis infection is endemic in many less developed countries where poor hygiene conditions and free-range pig management favor their transmission. A cross-sectional study was conducted in 680 children from a rural primary school in Gakenke district (Northern province of Rwanda). Stool samples were collected from participants and analyzed using the Kato-Katz method (KK), formol-ether concentration (FEC), and/or copro-antigen enzyme-linked immunosorbent assay (CoAg-ELISA) to detect taeniasis. Blood samples were collected and analyzed using enzyme-linked immunoelectrotransfer blot (EITB) and antigen enzyme-linked immunosorbent assay (Ag-ELISA) to detect human cysticercosis. The overall proportion of taeniasis positivity was 0.3% (2/680), and both cases were also confirmed by CoAg-ELISA. A total of 13.3% (76/572) of the children studied were positive to cysticercosis (T. solium-specific serum antibodies detected by EITB), of whom 38.0% (27/71) had viable cysticercus (T. solium antigens by Ag-ELISA). This study provides evidence of the highest cysticercosis prevalence reported in Rwanda in children to date. Systematic investigations into porcine and human cysticercosis as well as health education and hygiene measures for T. solium control are needed in Gakenke district.
Highlights
In Taenia solium parasitic infections, humans are the only natural definitive host while pigs are the intermediate hosts of larval stage [1]
In two children [2/680 (0.3%)], eggs of taeniid tapeworm were identified by both methods: Kato-Katz technique [2/675 (0.3%)] and formol-ether concentration [2/673 (0.31%)]
Two strobiles were recovered from both children and the morphologic study under a magnifying glass after injection with India ink revealed
Summary
In Taenia solium parasitic infections, humans are the only natural definitive host (taeniasis) while pigs are the intermediate hosts of larval stage (swine cysticercosis) [1]. Human cysticercosis results when people become intermediate hosts after ingestion of microscopic viable eggs via the fecal–oral route from T. solium tapeworm carriers [2]. The embryo is released (oncosphere), and it traverses the intestinal mucosa after ingestion. Later, it is transported by the circulatory system and dispersed by the organism producing cysts (cysticerci). Many individuals with cysticercosis have central nervous system involvement (neurocysticercosis) resulting in headache, epileptic seizures, blindness, mental disturbance, and even death [3, 5]. Neurocisticercosis (NCC) is the most common parasitic disease in the human nervous system and the most common cause of epilepsy in low-income countries [6]
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