Abstract
Background Taenia solium is a major cause of preventable epilepsy in developing nations. Screening and treatment of human intestinal stage infection (taeniasis) within high-risk foci may reduce transmission and prevent epilepsy by limiting human exposure to infective eggs. We piloted a ring-strategy that involves screening and treatment for taeniasis among households located nearby pigs heavily-infected with the larval stage (cysticercosis). These pigs mark areas of increased transmission and can be identified by tongue examination.MethodologyWe selected two villages in northern Peru for a controlled prospective interventional cohort pilot study. In the intervention village (1,058 residents) we examined the tongues of all pigs every 4 months for nodules characteristic of cysticercosis. We then screened all residents living within 100-meters of any tongue-positive pig using enzyme-linked immunosorbent assay to detect Taenia antigens in stool. Residents with taeniasis were treated with niclosamide. In both the intervention and control (753 residents) we measured incidence of exposure by sampling the pig population every 4 months for serum antibodies against cysticercosis using enzyme-linked immunoelectrotransfer blot.Principal FindingsBaseline seroincidence among pigs born during the study was 22.6 cases per 100 pigs per-month (95% confidence interval [CI] 17.0–30.0) in the intervention and 18.1 (95% CI 12.7–25.9) in the control. After one year we observed a 41% reduction in seroincidence in the intervention village compared to baseline (incidence rate ratio 0.59, 95% CI 0.41–0.87) while the seroincidence in the control village remained unchanged. At study end, the prevalence of taeniasis was nearly 4 times lower in the intervention than in the control (prevalence ratio 0.28, 95% CI 0.08–0.91).Conclusions/SignificanceRing-screening reduced transmission of T. solium in this pilot study and may provide an effective and practical approach for regions where resources are limited. However, this strategy requires validation in larger populations over a greater period of time.
Highlights
Taenia solium, commonly known as the pork tapeworm, is a zoonotic parasite responsible for the cysticercosis/taeniasis duo of neglected tropical diseases
Taenia solium is a zoonotic parasite which infects humans and pigs resulting in the cysticercosis/taeniasis duo of neglected tropical diseases
Infection of pigs is a food-safety issue, as consumption of contaminated pork results in intestinal tapeworm infection in humans who may transmit the parasite to others
Summary
Commonly known as the pork tapeworm, is a zoonotic parasite responsible for the cysticercosis/taeniasis duo of neglected tropical diseases. Humans are the definitive host capable of harboring the adult egg-producing stage of the parasite in the intestine, a disease called taeniasis. Pigs acquire the larval stage of infection in their tissues, a disease called cysticercosis, by consuming human feces containing T. solium eggs. Screening and treatment of human intestinal stage infection (taeniasis) within high-risk foci may reduce transmission and prevent epilepsy by limiting human exposure to infective eggs. We piloted a ring-strategy that involves screening and treatment for taeniasis among households located nearby pigs heavily-infected with the larval stage (cysticercosis). These pigs mark areas of increased transmission and can be identified by tongue examination
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