Taeniosis/Neurocysticercosis Control as a Medical Problem—A Discussion Paper

Abstract

Taenia solium taeniosis is a zoonosis transmitted by cysticerci from pigs. Neurocysticercosis is a fecal-borne infection spread exclusively by T. soliumeggs in a tapeworm carrier or around. Neurocysticercosis is frequently fatal and debilitating disease and a common cause of late epilepsy. Taeniosis/neurocysticercosis (t/nc) can be prevented both by control of meat-borne zoonosis, which is a traditional responsibility of veterinarians, and by chemotherapy of human taeniosis, which is usually underestimated by medical profession. Elimination of T. solium taenosis is not only the matter of organized control projects but also of routine, daily medical and veterinary services. In order to promote more effective control by treatment of human T. solium carriers the following suggestions are proposed to be discussed: 1) accept that leaving untreated any detected human carrier of T. soliumtaeniosis, the only source of neurocysticercosis, is a medical error. This statement concerns both clinical settings and field interventions; 2) accept as the clinical and public health standards a search for T. solium carrier in any possible t/nc foci and treat both detected and suspected cases of taeniosis; 3) make the diagnosis and treatment of T. solium infections in humans widely accessible and possibly free; 4) improve easy applicable tools detecting T. solium taeniosis; 5) make modern and traditional taenicides available. There is a need to improve the stability and efficacy of niclosamide and elaborate an instruction how to avoid neurological side- effects of praziquantel; 6) include prevention of t/nc into professional training, especially in mental health, public health and primary health care professions; 7) intensify preventive education adapted to the local endemic situation.