Abstract
BackgroundNeurocysticercosis is a leading cause of seizures and epilepsy in most of the world, and it occurs when Taenia solium larval cysts infect the central nervous system. T. solium tapeworm infection is endemic in much of Peru, but there are scarce data on the prevalence in many rural highland communities where it is likely to be hyper-endemic. Peace Corps Volunteers live and work in these communities; however, to our knowledge, they have not been used to facilitate public health research.Materials and MethodsWe utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. A convenience non-random sampling frame was used. Peace Corps Volunteers facilitated the collection of stool samples (N = 2,328), which were analyzed by sedimentation and microscopy. Niclosamide treatment and purgation preceded species identification, which was done by PCR-REA.Results Taenia sp. egg-positive stool samples were found in three of the seven communities we surveyed. The overall prevalence of Taenia sp. egg positivity was 2.1% (49/2,328) (95% CI = 1.6–2.8%) with prevalence up to 4.3% (42/977) (95% CI = 3.1–5.8%) by community. All 34 of the specimens tested by PCR-REA were T. solium. The overall prevalence of T. solium tapeworm infection was 1.5% (34/2,328) (95% CI = 1.0–2.0%). Prevalence up to 2.9% (28/977) (95% CI = 1.9–4.1%) by community was observed.Conclusion/SignificanceThis study recorded high T. solium tapeworm prevalence, and identified hyper-endemic rural communities. It demonstrates that synergy between researchers and Peace Corps Volunteers can be an effective means to conducting large-scale, community-based studies in remote areas of Peru.
Highlights
Taenia solium (T. solium) neurocysticercosis (NCC) is the leading cause of adultacquired epilepsy worldwide, and an increasingly important public health problem in developed countries with migrant populations. [1, 2] Cysticercosis has been shown to cluster around T. solium tapeworm carriers, [3] as T. solium tapeworm infection increases carriers’ risk for NCC, and places other household members at substantially elevated risks. [4, 5] T. solium tapeworm infection may be underreported and difficult to detect in rural, Andean communities due to a lack of awareness and diagnostic facilities. [4]
[4] Prevalence as high as 4.3% by community was observed. These findings are higher in comparison to the results of many community-based studies that estimated Taenia sp. tapeworm prevalence by microscopy, including studies performed in endemic areas of Peru [3, 4, 9] and other countries in Latin America [10,11,12,13,14,15] Africa [16,17,18] and northern Vietnam
[19] The overall prevalence of T. solium tapeworm infection was 1.5% with prevalence up to 2.9% by community. These findings are higher when compared to the results of previous studies which report T. solium tapeworm prevalence by microscopy and polymerase chain reaction (PCR);[18,19,20] they are lower when compared to the results of studies that used more sensitive diagnostic methods such as coproantigen ELISA and EITB assay.[4, 16,17,18]
Summary
Estimating the prevalence of T. solium infection in such communities is necessary to allow researchers and public health workers to address this health problem. Our group utilized an existing network of Peace Corps Volunteers (PCVs) who were integrated into their communities to perform epidemiologic screening and surveillance. Our consortium aimed to perform a large-scale, cross-sectional epidemiologic study to examine the feasibility of bringing together PCVs and researchers to perform a T. solium tapeworm prevalence study in multiple rural regions of northern Peru. Peace Corps Volunteers live and work in these communities; to our knowledge, they have not been used to facilitate public health research. Materials and Methods: We utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. All 34 of the specimens tested by PCR-REA were
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