Effectiveness of health education in improving knowledge, attitude and practice related to foodborne zoonotic trematodes in Vietnam, with a particular focus on Clonorchis sinensis.

OBJECTIVE: Foodborne zoonotic trematodes (FZT), which infect the liver, lungs and intestines of humans, are an emerging public health concern in tropical countries including Vietnam. In northern Vietnam, Clonorchis sinensis is recognised as the most important species of the FZT. Up to now, small-scale studies conducted in the country have indicated that health education could improve participants' knowledge and practices related to clonorchiasis, however strong evidence is still lacking. We conducted an intervention trial between 2020 and 2021 in four communes in Yen Bai and Thanh Hoa province, aiming to evaluate the impact of an extended educational package on knowledge, attitude and practices related to clonorchiasis, as well as on knowledge on the large liver fluke and minute intestinal flukes. METHODS: To this end, baseline and post-intervention questionnaires were conducted. Generalised estimating equations models were run to analyse the impact of the intervention on knowledge, attitudes and practices over time in the intervention versus control group. Finally, 172 people in the intervention group and 162 in the control group were included for analysis. RESULTS: Results demonstrated that the intervention significantly improved clonorchiasis knowledge, attitudes and practices, with higher odds for a correct knowledge response (odds ratio (OR) = 2.80, 95% confidence interval (CI) = 1.84-4.27, p-value < 0.001), increased average mean attitude score (mean = 0.363, 95%CI = 0.182-0.544, p-value < 0.001), and a reduced odds of consuming raw fish (OR = 0.15, 95%CI = 0.06-0.40, p = 0.002) in the intervention group compared to the control group post-intervention versus baseline. Additionally, participants in the intervention group exhibited enhanced basic knowledge of the large liver fluke and minute intestinal flukes post-intervention. CONCLUSIONS: These findings demonstrate the potential of health education programs in preventing clonorchiasis in endemic areas, emphasising the importance of continued health education as a critical component of integrated control programs for clonorchiasis.

Incidence of fish-borne trematode infections and associated factors: results from a cohort study in highly endemic communities in northern Vietnam.

Fish-borne trematodes (FiBT) are an important group of zoonotic parasites negatively affecting human health, mainly in Asia. Most studies on FiBT have applied a cross-sectional design, which provides weaker evidence on potential risk factors for transmission than a cohort study. This cohort study aimed to estimate the incidence and identify associated risk factors for FiBT infection in Vietnam. Between April 2018 and May 2019, two communes in Yen Bai province, a highly endemic area for FiBT, were visited for sampling. Participants with a negative stool result for FiBT at baseline, were invited for follow-up and data collection, at months 4, 9, and 13. Stools were examined using Kato-Katz and formalin-ethyl acetate concentration techniques to detect FiBT eggs, whereas a questionnaire was used for interviewing participants to determine the risk factors for FiBT infection during each follow-up period. The incidence risk and the incidence rate were calculated, and univariate and multivariable models were run to identify the risk factors for FiBT. A total of 194 people, negative for FiBT eggs at the baseline survey, were invited to participate in the study, and 111 people agreed to enroll in the follow-up. The incidence risk at months 4, 9, and 13 was 9.0%, 6.4%, and 5.1%, respectively. We finally used data from 95 participants for the risk factor analysis, excluding 16 people lost for the follow-up. Overall, 20 people became infected with FiBT (IR = 21.1%). The incidence rate of FiBT infection was 21.4/100 person-year. In the univariate analysis, consumption of raw fish was the main risk factor (RR = 4.59, 95%CI = 1.95-10.82), followed by being male (RR = 3.41, 95%CI = 1.56-7.45) and drinking alcohol (RR = 3.25, 95%CI = 1.49-7.11). In the multivariable analysis, only consumption of raw-fish dishes was significantly associated with FiBT infection. The people who consumed raw fish were 3.44 (95%CI = 1.11-10.70) times more at risk of infection with FiBT as compared to individuals who did not consume raw fish. It can be concluded that the FiBT incidence is high in the study area. More awareness campaigns are needed to stop eating raw fish in these areas to reduce FBT infection.

Copper, iron, zinc and tannin concentrations throughout the digestive tract of tropical goats and sheep fed a high-fibre tannin-rich diet.

The dry season in tropical regions urges livestock to feed on nutritionally very poor diets. It has not been explored how tropical sheep-assumed grazers-and tropical goats-intermediate browsers-cope with a high-fibre tannin-rich diet. This study was designed to determine the effects of a high-fibre and tannin-rich diet on the flow of important microminerals iron (Fe), zinc (Zn) and copper (Cu) throughout the digestive tract of tropical sheep and goats. The feeding trial was set up with twelve adult male animals, six sheep with mean body weight (BW) of 30.3 ± 1.6 kg and six goats with mean BW of 26.4 ± 2.2 kg. The feed consisted of 36% leaves of Millettia ferruginea, 61% hay and 3% concentrate and was offered at 3% of BW (all on dry matter (DM) basis). The total faecal collection was carried out for 7 consecutive days. At the end of the experimental period, the animals were slaughtered to collect liver and digesta samples from the gastrointestinal tract. Feed, digesta and faecal samples underwent analysis of Fe, Zn, and Cu and total tannins (TT). Goats had significantly higher reticulum Cu concentrations expressed on DM as compared to sheep. Faecal Cu concentrations were higher for goats compared to sheep. Reticulum and colon digesta Zn levels were higher in goats than sheep. Abomasum and colon Fe levels were higher in sheep than goats when expressed on DM. These results suggest differences in feed intake, micromineral absorption, secretion and excretion between sheep and goats, pointing to a divergent mineral metabolism as an adaptation to the challenge of a dry season diet having very low nutritive value.

Epidemiology and surveillance of human (neuro)cysticercosis in Europe: is enhanced surveillance required?

OBJECTIVES: To report on relevant national surveillance systems of (N)CC and taeniasis (the infection with the adult tapeworm) in the European Union/European Economic Area and to assess the magnitude of (N)CC occurrence by retrieving information on cases for the period 2000-2016. METHODS: (N)CC cases were retrieved via national reporting systems, a systematic literature search, contact with clinicians and a search for relevant 'International Statistical Classification of Diseases and Related Health Problems' (ICD)-based data. RESULTS: Mandatory notification systems for (N)CC were found in Hungary, Iceland and Poland. Ten cases were reported in Poland and none in Hungary and Iceland. Through the systematic literature review and information given by clinicians, 263 individual and 721 aggregated (N)CC cases from 19 European countries were identified. ICD-based data were obtained from five countries. From 2000 to 2016, a total of 3489 cases (N)CC cases were coded: 832 in Italy, eight in Latvia, 357 in Portugal, 2116 in Spain and 176 in Sweden. CONCLUSION: Despite being classified as a possible eradicable disease, (N)CC is still diagnosed across Europe, yet its true extent and impact remain unclear.

OBJECTIFS: Rapporter sur les systèmes nationaux de surveillance pertinents de la (neuro)cysticercose (N)CC et de la téniase (infection par le ténia adulte) dans l'Union européenne/l'Espace économique européen, et évaluer l'ampleur de l'occurrence de la (N)CC en reprenant des informations sur les cas durant la période 2000-2016. MÉTHODES: Les cas de (N)CC ont été repris à partir des systèmes nationaux de notification, une recherche systématique de la littérature, des contacts avec des cliniciens et une recherche de données pertinentes basées sur la 'Classification Statistique Internationale des Maladies et Problèmes de Santé Connexes' (ICD). RÉSULTATS: Des systèmes de notification obligatoires pour la (N)CC ont été trouvés en Hongrie, en Islande et en Pologne. Dix cas ont été rapportés en Pologne et aucun en Hongrie et en Islande. Grâce à la revue systématique de la littérature et aux informations fournies par les cliniciens, 263 cas individuels et 721 cas agrégés de (N)CC de 19 pays européens ont été identifiés. Des données ICD ont été obtenues de cinq pays. De 2000 à 2016, un total de 3489 cas de (N)CC ont été codés: 832 en Italie, 8 en Lettonie, 357 au Portugal, 2116 en Espagne et 176 en Suède. CONCLUSION: Bien qu'elle soit classée comme une maladie pouvant être éradiquée, la (N)CC est toujours diagnostiquée à travers l'Europe, mais sa véritable ampleur et son impact restent incertains .

Mapping the pork value chain in Vietnam: a systematic review.

In Vietnam, pork is the most commonly consumed type of meat, and the demand is expected to rise even further. Nevertheless, food safety is a major concern, as the country bears a high burden of food-borne diseases, including these caused by pork products. Knowledge of the flows of pigs and pork from producers up to the consumers is important; however, up to now, a comprehensive overview is lacking. We addressed this by conducting a systematic review on the pork value chain (PVC) mapping for the country. Four international and three Vietnamese databases were searched for data on the pork value chain in Vietnam, and the results were reported according to the PRISMA guidelines. Data obtained from the retained records showed that 10 main PVC types are present in Vietnam, comprising of five main actors including: producers, middlemen, slaughter men, retailers and consumers. Among the identified chains, the one involving producers, slaughter men, retailers and consumers is the most common one, with up to 75% of pork following this route. In cities or export routes to other countries, middlemen and/or traders are important additional actors in the PVCs. The small scale of PVC linkages is prominent. The presence of middlemen, pig traders and pork traders is contributing to further distribution of pork products in geographical terms. Transactions between actors in the traditional PVCs in Vietnam are characterized by the absence of official contracts; therefore, the linkages in the chains are loose and the origin of pork is not traceable. More industrial forms of PVCs are slowly developing; however, the traditional PVCs are still prevailing in Vietnam. The weak linkages between actors and poor hygienic practices in these chains form a risk to pork safety.

Cysticercosis and taeniasis cases diagnosed at two referral medical institutions, Belgium, 1990 to 2015.

BackgroundFew case reports on human infections with the beef tapeworm Taenia saginata and the pork tapeworm, Taenia solium, diagnosed in Belgium have been published, yet the grey literature suggests a higher number of cases.AimTo identify and describe cases of taeniasis and cysticercosis diagnosed at two Belgian referral medical institutions from 1990 to 2015.MethodsIn this observational study we retrospectively gathered data on taeniasis and cysticercosis cases by screening laboratory, medical record databases as well a uniform hospital discharge dataset.ResultsA total of 221 confirmed taeniasis cases were identified. All cases for whom the causative species could be determined (170/221, 76.9%) were found to be T. saginata infections. Of those with available information, 40.0% were asymptomatic (26/65), 15.4% reported diarrhoea (10/65), 9.2% reported anal discomfort (6/65) and 15.7% acquired the infection in Belgium (11/70). Five definitive and six probable cases of neurocysticercosis (NCC), and two cases of non-central nervous system cysticercosis (non-CNS CC) were identified. Common symptoms and signs in five of the definitive and probable NCC cases were epilepsy, headaches and/or other neurological disorders. Travel information was available for 10 of the 13 NCC and non-CNS CC cases; two were Belgians travelling to and eight were immigrants or visitors travelling from endemic areas.ConclusionsThe current study indicates that a non-negligible number of taeniasis cases visit Belgian medical facilities, and that cysticercosis is occasionally diagnosed in international travellers.

The assessment and the farmers' perceived ranking of feed resources and coping strategies with feed scarcity in smallholder dairy farming in selected district towns of Jimma Zone, Ethiopia.

Inadequate quantity and quality of feed resources are major constraints limiting milk production and reproductive performance of dairy cattle in Ethiopia. The aim of this study was to assess dairy cattle feed resources, feeding practices, the farmers' perceived ranking of feed resources, causes of feed shortage, and coping strategies to feed scarcity in smallholder dairy system in selected district towns of Jimma Zone, Ethiopia. Data were obtained by interviewing 52 randomly selected smallholder dairy farmers using structured questionnaires and through direct observations. Results showed that 20 main feed types used by dairy farmers were identified and categorized into natural pastures, crop residues, green feeds, hay, agro-industrial by-products, concentrate mix, and non-conventional feeds. Overall, natural pasture (mean rank = 0.453), non-conventional feeds (0.307), cut green feeds (0.086), conserved hay (0.076), crop residues (0.049), and concentrate feeds (0.029) were ranked as the main feed resources in decreasing order of importance. Natural pasture grazing (92.2% of the respondents), hay (35.6%), and green feeds (29.4%) were the most important conventional basal feeds used. Wheat bran (11.7% of the respondents) followed by commercial concentrate mix (9.4%), Noug seedcake (8.3%), grain (7.8%), and molasses (6.1%) were the concentrate supplements used. Overall, bulule-flour mill leftovers (67.2% of the farmers), bean and pea hulls (57.2%) and atella-local brew by-product (37.2%), enset (Ensete ventricosum, 34.4%), and sugarcane top (32.2%) were the non-conventional feeds available and used during feed scarcity. Barley and teff (Eragrostis teff) straws and maize and sorghum stovers were the main crop residues used in the dry seasons. Overall, 73.9, 12.2, 12.2, and 1.7% of the respondents practiced free grazing, zero grazing, semi-zero, and a combination of zero- and free-grazing systems, respectively. Over 84% of the respondents in the dry season and 50% in the wet season reported experiencing a shortage of feeds. Poor feed availability (73.9% of the respondents) was reported as the main causes of feed shortage followed by shortage of pastureland (7.8%). Increased use of bulule (55.6% of the respondents), crop residues (16.1%), non-conventional feed resources (14.4%), conserved hay (11.1%), purchased green feeds and concentrates (1.1%), and reducing herd size (1.1%) were the farmers' adopted coping strategies to mitigate feed shortage. It is suggested that technical intervention to improve the quality and efficient utilization of the existing feed resources is crucial to enable sustainable feed supply and boost milk production. Technologies that are easy to adopt, feasible, and low cost are also needed to be developed in participatory manner.

Serum protein capillary electrophoresis and measurement of acute phase proteins in a captive cheetah (Acinonyx jubatus) population.

Renal and gastrointestinal pathologies are widespread in the captive cheetah (Acinonyx jubatus) population but are often diagnosed at a late stage, because diagnostic tools are limited to the evaluation of clinical signs or general blood examination. Presently, no data are available on serum proteins and acute-phase proteins in cheetahs during health or disease, although they might be important to improve health monitoring. This study aimed to quantify serum proteins by capillary electrophoresis in 80 serum samples from captive cheetahs, categorized according to health status and disease type. Moreover, serum amyloid A concentrations were measured via a turbidimetric immunoassay validated in domestic cats, whereas haptoglobin and C-reactive protein were determined by non-species-specific functional tests. Cheetahs classified as healthy had serum protein and acute phase protein concentrations within reference ranges for healthy domestic cats. In contrast, unhealthy cheetahs had higher (P < 0.001) serum amyloid A, alpha2-globulin, and haptoglobin concentrations compared with the healthy subgroup. Moreover, serum amyloid A (P = 0.020), alpha2-globulin (P < 0.001) and haptoglobin (P = 0.001) concentrations in cheetahs suffering from chronic kidney disease were significantly greater compared to the reportedly healthy cheetahs. Our study indicates that serum proteins in the cheetah can be analyzed by routine capillary electrophoresis, whereas acute-phase proteins can be measured using available immunoassays or non-species-specific techniques, which are also likely to be applicable in other exotic felids. Moreover, results suggest that serum amyloid A and haptoglobin are important acute-phase proteins in the diseased cheetah and highlight the need to evaluate their role as early-onset markers for disease.

An investigation into Toxoplasma gondii at the human-livestock-wildlife interface, South Africa.

Interface areas shared by humans, domestic and wild animals may serve as high transmission contexts for Toxoplasma gondii. However, knowledge about the epidemiology of T. gondii in such areas is currently limited. The present study assessed the seroprevalence of T. gondii in different hosts from Mpumalanga, South Africa. Furthermore, we investigated the local knowledge and related practices about T. gondii by conducting a questionnaire study in the community. Blood samples were obtained and analysed for T. gondii antibodies using a commercial multispecies latex agglutination kit. The seroprevalence detected in humans (n = 160; patients showing signs of acute febrile illness), cats (n = 9), chickens (n = 336) and goats (n = 358) was 8.8%, 0.0%, 4.2% and 11.2%, respectively. Seroprevalence in impalas (n = 97), kudus (n = 55), wild dogs (n = 54), wildebeests (n = 43), warthogs (n = 97) and zebras (n = 68) was calculated at 5.2%, 7.3%, 100.0%, 20.9%, 13.4% and 9.1%, respectively. The questionnaire revealed that 63.0% of household owners were subsistence farmers, and 35.9% were pet owners. A high level of female participation was found (75.3%) when compared to male participation (24.7%). The results show a low circulation of T. gondii in the domestic cycle and suggest the presence of possible bridges between the wildlife cycle and the surrounding domestic cycle.Contribution: The study contributes to identifying transmission patterns and risk factors of T. gondii within human and animal populations. This topic fits within the scope of the journal presenting original research in veterinary science, with the focus on wild and domestic populations on the African continent on a topic of universal importance.

Epidemiology of Echinococcus granulosus sensu lato in the Greater Horn of Africa: A systematic review.

BACKGROUND: Cystic echinococcosis (CE) is a neglected zoonotic disease that is caused by Echinococcus granulosus sensu lato (s.l.), the life cycle of which involves multiple hosts. We conducted a systematic review (SR) on E. granulosus s.l. in the Greater Horn of Africa (GHA), to provide a picture of its recent epidemiology across all hosts. METHODS: For this SR, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, five electronic databases, as well experts in the region were consulted to retrieve records published between 2000 and 2022, reporting the presence of E. granulosus s.l. infections in any natural host in the GHA (Djibouti, Eritrea, Ethiopia, Kenya, Sudan, Somalia, South Sudan, Tanzania and Uganda). PRINCIPAL FINDINGS: A total of 247 records were retained, describing the presence of E. granulosus s.l. throughout the GHA, except for Djibouti. Only few population surveys on human CE were conducted in the area, with the prevalence ranging between 0.3 and 11.3%. In animals, the reported prevalence ranged up to 61.6% in camels, 88.4% in cattle; 65.2% in goats, 9.9% in pigs, 67.8% in sheep and 94.5% in dogs. In addition, E. granulosus s.l. was also reported in wildlife. A total of five species were reported in the different hosts, namely E. granulosus sensu stricto (G1, G3, GOmo), E. canadensis (G6/7), E. ortleppi (G5), E. felidis, and E. equinus (G4). CONCLUSIONS: We confirm that E. granulosus s.l. is prevalent throughout the GHA. Nevertheless, despite our efforts to screen grey literature, an accurate assessment of the epidemiology in GHA remains challenging, due to the lack of combined host, in-depth risk factor and behavioural studies, as well as the wide diversity in subpopulations studied and diagnostic tools used. Interdisciplinary and transboundary partnerships would be essential for the design of effective control strategies, tuned to the GHA setting.

Fasciola spp. in Southeast Asia: A systematic review.

BACKGROUND: Fasciolosis is an emerging public health threat in a number of regions worldwide. To date, we lack an overview of both its occurrence and distribution in Southeast Asia across all actors involved in the life cycle, which impedes the development of disease control measures. Therefore, our objective was to collect recent information on the distribution and the prevalence of Fasciola spp. and the associated risk factors for infection in humans, animals, snails and plant carriers in Southeast Asia. METHODOLOGY: Bibliographic and grey literature databases as well as reference lists of important review articles were searched for relevant records published between January 1st, 2000, and June 30th, 2022. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews. A total of 3,887 records were retrieved, of which 100 were included in the final analysis. PRINCIPAL FINDINGS: The studies focused mainly on one host species (96.0%), with Fasciola spp. infection in animals being the most studied (72.0%), followed by humans (21.0%). Based on the used inclusion and exclusion criteria, reports were retrieved describing the presence of Fasciola spp. infection in seven out of 11 countries in Southeast Asia. Depending on the diagnostic tool applied, the prevalence of Fasciola spp. infection ranged between 0.3% and 66.7% in humans, between 0% and 97.8% in animals, and between 0% and 66.2% in snails. There were no studies reporting the presence of metacercariae on plant carriers. CONCLUSIONS/SIGNIFICANCE: Our study reconfirms that Fasciola spp. infections are widespread and highly prevalent in Southeast Asia, but it remains difficult to accurately assess the true occurrence of Fasciola spp. in absence of well-designed surveys covering all hosts. As next steps we propose to assess the occurrence of the infection across all actors involved in the transmission, to identify associated risk factors and to estimate the burden of the disease to support national and international decision makers.

Mineral deficiency status of ranging zebu (Bos indicus) cattle around the Gilgel Gibe catchment, Ethiopia.

Mineral deficiencies in cattle, widespread in East Africa, impair optimal health and production and consequently place a great burden on the farmers' income. Therefore, detection of shortages and imbalances of specific minerals is essential. Our objective was to evaluate the mineral status of grazing cattle around the Gilgel Gibe catchment in Ethiopia and associated factors. In study I, individual animal plasma and herd faecal Ca, P, Mg, Na, K, S, Fe, Zn, Mn and Cu concentrations were determined in adult zebu cattle (Bos indicus; n=90) grazing at three altitudes around the catchment, whilst recording body condition score and sex. In study II, liver samples of adult male zebu cattle (n=53) were analysed for Cu, Zn, Fe, Se and Mo concentrations and inspected for parasitic infections. Plasma and liver analyses revealed a Cu deficiency problem in the area, since 68 and 47 % of cattle, respectively, were Cu deprived according to diagnostic criteria for Bos taurus cattle. High hepatic Mo concentrations in 17 % of cases might reflect excessive dietary Mo intake. Liver Se and plasma Na concentrations were too low in 92 and 80 % of cattle. Plasma Mn concentrations were largely below the detection limit. Plasma Cu as well as Ca concentrations were lower in the lowest altitude compared to the highest altitude group (P<0.05), whereas lean to medium cattle had lower plasma Cu concentrations (P<0.05). No differences in hepatic mineral concentrations were detected between cattle with different types of parasitic infection. In conclusion, bovine mineral deficiencies were present in the Gilgel Gibe area and were associated with grazing altitude and body condition score.

Geostatistical analysis of active human cysticercosis: Results of a large-scale study in 60 villages in Burkina Faso.

Cysticercosis is a neglected tropical disease caused by the larval stage of the zoonotic tapeworm (Taenia solium). While there is a clear spatial component in the occurrence of the parasite, no geostatistical analysis of active human cysticercosis has been conducted yet, nor has such an analysis been conducted for Sub-Saharan Africa, albeit relevant for guiding prevention and control strategies. The goal of this study was to conduct a geostatistical analysis of active human cysticercosis, using data from the baseline cross-sectional component of a large-scale study in 60 villages in Burkina Faso. The outcome was the prevalence of active human cysticercosis (hCC), determined using the B158/B60 Ag-ELISA, while various environmental variables linked with the transmission and spread of the disease were explored as potential explanatory variables for the spatial distribution of T. solium. A generalized linear geostatistical model (GLGM) was run, and prediction maps were generated. Analyses were conducted using data generated at two levels: individual participant data and grouped village data. The best model was selected using a backward variable selection procedure and models were compared using likelihood ratio testing. The best individual-level GLGM included precipitation (increasing values were associated with an increased odds of positive test result), distance to the nearest river (decreased odds) and night land temperature (decreased odds) as predictors for active hCC, whereas the village-level GLGM only retained precipitation and distance to the nearest river. The range of spatial correlation was estimated at 45.0 [95%CI: 34.3; 57.8] meters and 28.2 [95%CI: 14.0; 56.2] km for the individual- and village-level datasets, respectively. Individual- and village-level GLGM unravelled large areas with active hCC predicted prevalence estimates of at least 4% in the south-east, the extreme south, and north-west of the study area, while patches of prevalence estimates below 2% were seen in the north and west. More research designed to analyse the spatial characteristics of hCC is needed with sampling strategies ensuring appropriate characterisation of spatial variability, and incorporating the uncertainty linked to the measurement of outcome and environmental variables in the geostatistical analysis. Trial registration: ClinicalTrials.gov; NCT0309339.

Clinical characteristics and management of neurocysticercosis patients: a retrospective assessment of case reports from Europe.

OBJECTIVES: Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe. METHODS: We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000-2019) and extracted demographic, clinical and radiological information on each case, if available. RESULTS: Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases. CONCLUSIONS: Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.

Foodborne Parasites and Their Complex Life Cycles Challenging Food Safety in Different Food Chains.

Zoonotic foodborne parasites often represent complex, multi host life cycles with parasite stages in the hosts, but also in the environment. This manuscript aims to provide an overview of important zoonotic foodborne parasites, with a focus on the different food chains in which parasite stages may occur. We have chosen some examples of meat-borne parasites occurring in livestock (Taenia spp., Trichinella spp. and Toxoplasma gondii), as well as Fasciola spp., an example of a zoonotic parasite of livestock, but transmitted to humans via contaminated vegetables or water, covering the 'farm to fork' food chain; and meat-borne parasites occurring in wildlife (Trichinella spp., Toxoplasma gondii), covering the 'forest to fork' food chain. Moreover, fish-borne parasites (Clonorchis spp., Opisthorchis spp. and Anisakidae) covering the 'pond/ocean/freshwater to fork' food chain are reviewed. The increased popularity of consumption of raw and ready-to-eat meat, fish and vegetables may pose a risk for consumers, since most post-harvest processing measures do not always guarantee the complete removal of parasite stages or their effective inactivation. We also highlight the impact of increasing contact between wildlife, livestock and humans on food safety. Risk based approaches, and diagnostics and control/prevention tackled from an integrated, multipathogen and multidisciplinary point of view should be considered as well.

The prevalence of Taenia spp. in pigs slaughtered in Kinshasa.

Taenia hydatigena is a non-zoonotic worm that has dogs and wild canids as definitive hosts. Its presence induces cross reactions in certain diagnostic tests for porcine cysticercosis caused by T. solium, the occurrence of which has a considerable public health and economic impact. In the Democratic Republic of the Congo (DR Congo), T. solium is considered endemic, however, the prevalence of T. hydatigena has not been estimated yet. The objective of the study was therefore to estimate the prevalence of T. hydatigena cysticercosis by serological and molecular diagnostic tools in pigs slaughtered in DR Congo. A total of 480 pigs slaughtered in 6 slaughter slabs in Kinshasa, DR Congo, were examined. The thoracal and abdominal cavity organs were inspected for cysts, which were analyzed using PCR-RFLP. Furthermore, 480 sera were collected, and analyzed for the presence of circulating Taenia spp. cysticercus antigens, using the B158/B60 Ag-ELISA. Upon inspection of the carcass, 41 cysts suspected to be metacestodes of Taenia spp. were collected, from the following viscera: spleen (24/41, 59%), liver (13/41, 32%), intestine (3/41, 7%) and lung (1/41, 2%). Molecular analyses revealed a T. hydatigena prevalence of 0.2% (95% CI: 0.0001-0.0116), based on a single lesion (1/480), taken from the spleen. Out of the 480 sera collected, the presence of circulating Taenia spp. cysticerci antigens was detected in 32 (6.7%; 95% CI: 4.5-11.2). The results of this study revealed that T. hydatigena is present in pigs sold in markets in the city of Kinshasa in DR Congo, albeit at a very low prevalence, thus the impact on the interpretation of the B158/B60 seems low in this setting. Detection of circulating antigens in porcine sera by Ag-ELISA, shows that pigs slaughtered in Kinshasa, DR Congo, were infected with viable cysticerci of Taenia spp. which in turn can infect humans.

Toxoplasma gondii in African Wildlife: A Systematic Review.

Toxoplasma gondii (T. gondii) is a protozoan parasite, which infects a wide variety of mammals and bird species globally. In large parts of the world, this parasite is relatively well documented in wildlife species, however, this topic is poorly documented in Africa. The current review systematically explores the presence and distribution of T. gondii in African wildlife species through a key word search in PubMed, Web of Science and CAB Direct. A total of 66 records were identified and included in the qualitative analysis, of which 19 records were retained for the quantitative synthesis. The presence of T. gondii was reported in a wide range of wildlife species, found in twelve countries, spread over the African continent. The retained records report a prevalence range of 6-100% in herbivores, 8-100% in omnivores and 14-100% in carnivores. In wild felines (cheetahs, leopards, and lions) a prevalence range of 33-100% was found. Reports from South Africa, and on the presence of T. gondii in lion were most common. Overall, the results indicate the scarcity of information on T. gondii in Africa and its circulation in wildlife. The lack of knowledge on the parasite in Africa, especially in areas at the human-livestock-wildlife interface, prevents us from understanding how prevalent it is on the continent, what strains are circulating in wildlife and what the most common routes of transmission are in the different habitats in Africa.

Fasciola spp. in Southeast Asia: a systematic review and meta-analysis protocol.

BACKGROUND: Fascioliasis is an emerging public health threat in a number of regions worldwide, including Southeast Asia. Up to now, a summary of current knowledge on the occurrence and the distribution in Southeast Asia is lacking. We therefore aim to gather recent information on the distribution and prevalence of and the associated risk factors for Fasciola spp. infections in humans, animals, and plant carriers in Southeast Asia. METHODS: Bibliographic and gray literature databases as well as reference lists of important review articles will be searched for relevant records that are published between January 1, 2000, and the search date. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews. The primary outcomes will be both the prevalence of Fasciola spp. in the human and animal hosts, and on plant carriers in Southeast Asia, and the risk factors for occurrence of Fasciola spp. Secondary outcomes are the prevalence of Fasciola spp. in subpopulations (e.g., children and patients visiting clinics), the mapping of different diagnostic tests used, and the occurrence of the different Fasciola spp. in the study region. A descriptive statistical analysis will be conducted, and a meta-analysis will be run to estimate the prevalence of human and animal fascioliasis respectively, in Southeast Asia. DISCUSSION: This systematic review will summarize the current knowledge on the epidemiology of Fasciola spp. infections in Southeast Asia. SYSTEMATIC REVIEW REGISTRATION: This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), reference number: CRD42021261104 .

Diagnosing Human Fascioliasis Using ELISA Immunoassays at a Tertiary Referral Hospital in Hanoi: A Cross-Sectional Study.

Infections with the zoonotic liver flukes Fasciola gigantica and Fasciola hepatica may result in severe disease in humans. In Vietnam, an emergence of fascioliasis cases has been observed from the late 1990s onwards. Various diagnostic tools are used in the country, but the agreement between these tools has not been critically evaluated. We aimed to describe the clinical presentation and diagnostic outcomes in fascioliasis patients in Vietnam. A retrospective, cross-sectional study was conducted on the medical records of a group of 145 patients diagnosed with fascioliasis at a tertiary referral hospital in Hanoi. Based on the review, sociodemographic background and clinical presentation were recorded. These patients all received standard routine serologic tests, including internal antibody (Ab)-ELISA, an enzyme-linked immunosorbent assay (ELISA), and commercial coproantigen (cAg)-ELISA. The majority of cases were between 30 and 59 years old (68.3%), and about half of them were male (51.0%). Upper quadrant and epigastric pain were the most commonly reported symptoms (61.4% and 35.2%, respectively). All but one patient had liver lesions upon ultrasound examination (99.3%), and eosinophilia was present in most of the patients (89.7%). A high number of patients were positive in the in-house and the commercial Ab-ELISA (95.9% and 87.4%, respectively), yet only a slight agreement was observed between the two tests (kappa coefficient, 0.06). A further 47.4% of cases were positive for the commercial cAg-ELISA, whereas stool microscopy indicated the presence of Fasciola spp. eggs in 25.7% of patients. The current study emphasizes the challenges related to the diagnosis of human fascioliasis in Vietnam.

Helminth infections in dogs in Phu Tho Province, northern Vietnam.

Helminths are among the most-commonly encountered disease-causing agents in dogs all over the world, including Vietnam. A cross-sectional survey was carried out between March and December 2019 in four dog slaughter-slabs in Yen Lap District, Phu Tho Province, northern Vietnam, aiming to reveal the occurrence of gastrointestinal helminths in dogs. Worms were collected from 350 dog samples and identified by morphological techniques followed by molecular methods for tapeworms and hookworms. Nine species, including Taenia hydatigena, Spirometra erinaceieuropaei, Dipylidium caninum, Spirocerca lupi, Ancylostoma ceylanicum, Ancylostoma caninum, Toxocara canis, Toxascaris leonina and Trichuris vulpis, were found to occur in this area. Infection with at least one worm species was found in 272 dogs (77.7%; 95% Wilson score CI: 73.1-81.8%). The most common species was A. ceylanicum, with a prevalence of 45.1% (95% Wilson score CI: 40.0-50.4%) while T. hydatigena had a very low prevalence of 0.3% (95% Exact CI: 0.0-1.6%). Co-infection with hookworms and D. caninum was common. Five of the recovered helminth species have a zoonotic potential. Control of these parasites is necessary in order to protect human and animal health.