Abstract
Background Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania.Methods and FindingsA cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0.05).ConclusionThe present study indicates T. solium infection in humans is highly endemic in the southern highlands of Tanzania.
Highlights
Taeniosis and cysticercosis are different stages of Taenia solium infection involving swine as intermediate hosts and humans as definitive and/or intermediate hosts
The present study indicates T. solium infection in humans is highly endemic in the southern highlands of Tanzania
A World Health Organization (WHO)commissioned systematic review of studies reporting the frequency of neurocysticercosis (NCC) worldwide done by [5] estimated the proportion of NCC among people with epilepsy of all ages to be 29.0%, indicating epilepsy is consistently associated with NCC in over one quarter of patients residing in Cysticercosis caused by the zoonotic pork tapeworm, Taenia solium, is emerging as a serious public health and agricultural problem in sub-Saharan Africa
Summary
Taeniosis and cysticercosis are different stages of Taenia solium infection involving swine as intermediate hosts and humans as definitive and/or intermediate hosts. Ingestion of infective eggs passed by a person with taeniosis either by autoinfection, direct contact with another tapeworm carrier or indirectly via ingestion of contaminated food, water, or hands may lead to cysticercosis in humans whereby larval tapeworm cysts develop in the muscles, eye and central nervous system. Pigs get cysticercosis by ingesting T. solium eggs primarily as a result of eating feces of a human tapeworm carrier. Human cysticercosis causes a variety of neurological symptoms, most commonly seizures due to cysts in the brain, a condition known as neurocysticercosis [1,2]. Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania
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