Sympatric occurrence of Taenia saginata and Sarcocystis spp. in cattle from Narok County, Kenya: meat inspection findings with molecular validation.

The epidemiological picture of Taenia saginata infections in Kenya is fragmented with limited available data. Although Sarcocystis species are significant meat-borne parasites, few studies have explored their occurrence in Kenya. This study aimed to estimate the occurrence of bovine cysticercosis and screen for the presence of Sarcocystis spp. A meat inspection-based survey was conducted in ten abattoirs in Narok County, Kenya, and inspection for T. saginata cysticerci was limited to the Triceps brachii muscle. The apparent occurrence of the parasite was 5.4% (95% CI, 3.8, 7.6, n=573). Molecular confirmation of T. saginata was done via nested polymerase chain reaction targeting the mitochondrial 12S ribosomal RNA gene and restricted fragment length polymorphism. Sarcocystis species were identified using a multiplex polymerase chain reaction method targeting the 18S ribosomal RNA gene sequences and the mitochondrial cytochrome c oxidase subunit I gene. Of the 31 cystic lesions tested, 26/31 (83.9%) were confirmed to be T. saginata.Sarcocystis cruzi and S. hominis were detected in 8/31 (25.8%) and 1/31 (3.2%) of the cystic lesions, respectively. Co-infections of S. cruzi and T. saginata were found in 6/31 lesions (19.4%). The confirmation of bovine cysticercosis and S. hominis is suggestive of the presence of risky culinary and sanitation practices that facilitate transmission. This is the first report and molecular confirmation of Sarcocystis spp. in cattle in the country. The presence of both zoonotic S. hominis and pathogenic S. cruzi highlights an underexplored concern of veterinary and human health significance, warranting further epidemiological investigation.

Bovine cysticercosis epidemiology and the economic impact of the triceps brachii incision in a South African export abattoir.

Taenia saginata is a zoonotic tapeworm of humans with bovines as its intermediate host (bovine cysticercosis). Traditional meat inspection is the main measure to identify the larval stage in carcasses and prevent human infection, but has a notoriously low sensitivity, especially in low prevalence settings. The legislation in multiple African countries mandates an incision in both triceps brachii muscles to detect the parasite as part of the normal post-mortem inspection, but this has an economic cost and is not universally mandated in other countries. The primary aim of this study was to investigate the epidemiology of bovine cysticercosis at an export abattoir in South Africa and determine the validity and cost of the triceps incision. Risk factors were investigated, and the effect of additional heart incisions on the current inspection. Four incisions were made into the heart in addition to the normal post-mortem inspection in 3353 carcasses. The proportion of positive animals with and without the cardiac and triceps incisions were compared using McNemar's chi-square tests, while risk factors were assessed using binary logistic regression. The economic impact of the triceps incision was estimated using a stochastic economic cost model. Thirty-three positive carcasses were identified for an apparent prevalence of 0.98 % (95 %CI, 0.69-1.36 %), while the true prevalence was estimated at 6.6 % (95 %CI, 4.3-8.8 %). All cysts were confirmed as T. saginata on histopathology with 70 % (95 %CI, 53-83 %) located in the heart. The additional cardiac incisions resulted in the detection of significantly more cases compared to the normal inspection method prevalence of 0.72 % (95 %CI, 0.47-1.05 %; P < 0.001). The apparent prevalence of T. saginata when omitting the triceps incision was not significantly lower compared to the prevalence when included in the inspection (P = 0.480). External feedlots (OR= 4.17, 95 %CI: 2.04-8.54, P < 0.001) and older animals (OR=3.90, 95 %CI: 1.17-13.03, P = 0.027) were associated with a positive detection. The current median annual financial cost to the food business operator from the triceps incision was estimated at $30387 (95 %CI: $0-$130696), with the proportion of deboned meat exported identified as the most important factor affecting cost (Spearman's rho=0.853). The identification of risk factors could aid in the development of a more effective risk-based inspection system. The current inspection should be modified to increase exposure of the heart and remove the triceps incisions. The latter should especially be considered given the minimal contribution to cysticercosis detection, the unsupported requirement for its inclusion specifically in Africa, and its economic impact, especially as beef exports increase.

A meta-analysis on the prevalence of Taenia solium and Taenia saginata infections in India.

Tapeworm infections in humans are considered to be a significant public health menace. Despite its public health importance, the data on tapeworm infection remains fragmented and underutilised. The present study reviews the overall burden and distribution of taeniasis and cysticercosis caused by Taenia solium and Taenia saginata in India by conducting a systematic review of the scientific literature based on Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Data from 19 eligible articles were analysed and the prevalence of T. solium-associated taeniasis/cysticercosis was found to be 11.06% (95% confidence interval [CI] 6.856 to 16.119) and the prevalence of T. saginata-associated taeniasis was found to be 4.7% (95% CI 3.301 to 6.301). This systematic review and meta-analysis provides a comprehensive analysis of the available literature on tapeworm infections and assesses the burden of Taenia infection from India, identifying areas of high prevalence requiring active surveillance and public health interventions.

A rare case of human taeniasis caused by Taenia saginata with species undetermined cysticercosis.

Taeniasis and cysticercosis, which are caused by Taenia saginata, Taenia solium and Taenia asiatica, are zoonotic parasitic infections with a significant disease burden worldwide. There is consensus amongst experts that T. saginata is a common tapeworm that causes taeniasis in humans as opposed to cysticercosis. This case study of a middle-aged Tibetan man conducted in 2021 challenges the prevailing notion that T. saginata exclusively causes taeniasis and not cysticercosis by documenting symptoms and laboratory studies related to both taeniasis and multiple cysticercosis. The patient's medical record with the symptoms of taeniasis and cysticercosis was reviewed, and the tapeworm's proglottids and cyst were identified from the patient by morphological evaluation, DNA amplification and sequencing. The patient frequently experienced severe headaches and vomiting. Both routine blood screenings and testing for antibodies against the most common parasites were normal. After anthelmintic treatment, an adult tapeworm was found in feces, and medical imaging examinations suggested multiple focal nodules in the brain and muscles of the patient. The morphological and molecular diagnosis of the proglottids revealed the Cestoda was T. saginata. Despite the challenges presented by the cyst's morphology, the molecular analysis suggested that it was most likely T. saginata. This case study suggests that T. saginata infection in humans has the potential to cause human cysticercosis. However, such a conclusion needs to be vetted by accurate genome-wide analysis in patients with T. saginata taeniasis associated with cysts. Such studies shall provide new insights into the pathogenicity of T. saginata.

Knowledge, attitude, and practices of the community and meat industry workers towards Taenia saginata taeniosis and bovine cysticercosis in and around Jimma and Ambo towns of Ethiopia.

Taenia saginata taeniosis and bovine cysticercosis are prevalent in Ethiopia, however, data on the knowledge/attitude, and practice (KAP) of the community and meat industry workers in this regard is scarce. The present study aimed to investigate the KAP of the community and meat industry workers about T. saginata taeniosis/cysticercosis in Jimma and Ambo towns of Ethiopia. A cross-sectional KAP survey was performed on 293 community members selected using multistage random sampling and 97 meat industry workers from the two study towns. A questionnaire was constructed to collect sociodemographic variables, knowledge/attitudes about taeniosis/cysticercosis, raw meat consumption, latrine usage, and taeniosis treatment practices. Mixed effect (generalized) linear models were used to assess the association of self-reported taeniosis as well as the KAP scores with the demographic variables. The predicted proportion of self-reported taeniosis was 54% and 75% for Jimma and 44% and 70% for Ambo community and meat industry workers, respectively. The odds of self-reported taeniosis was higher for men (ORadj, 1.68, 95%CI, 0.97-2.93), and elementary/illiterate (ORadj, 1.46, 95%CI, 0.75-2.86) and high school education level (ORadj, 2.65, 95%CI, 1.45-4.93) compared to their counterparts. Most of the community members and the vast majority of the meat industry workers were knowledgeable about taeniosis but less conscious about cysticercosis. The knowledge/attitude score of the community was positively associated with the Jimma community (ßadj= 1.20, 95%CI 0.60-1.80), age (ßadj=0.03 points higher per year, 95%CI 0.00- 0.04), and men (ßadj = 1.20, 95%CI 0.64-1.76), while it was lower in elementary education/illiterate (ßadj = -1.60, 95%CI -2.31 to -0.95) and secondary/high school (ßadj = -0.83, 95%CI -1.46 to -0.23). The good practice scores of the community within both towns were negatively associated with increasing age (ßadj=-0.01 per year, 95%CI, -0.02 to 0.00), elementary/illiterate (ßadj = -0.60, 95%CI -1.01 to -0.19) and secondary/high school education (ßadj = -0.09, 95%CI -0.45 to -0.28), and urban community (ßadj = -0.47 95%CI, -0.82 to -0.12), while protestant/other (ßadj = 0.76, 95%CI 0.36 1.16) religion had higher scores compared to Orthodox religion. In conclusion, the predicted self-reported taeniosis proportion was moderately high, and the knowledge/attitude was substantial whereas, the practice was inferior. The association between the knowledge/attitude score and practice score was very weak. Therefore, public education to improve hygienic practices, risky culinary habits, taeniosis treatment, and backyard slaughtering were suggested.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Parasitic contamination of fresh vegetables sold in open markets: a public health threat / Contaminação parasítica de vegetais frescos vendidos em mercados abertos: uma ameaça para a saúde pública

Vegetables eating raw are a leading source of transmission of infective forms of pathogenic internal parasites among human beings. This research was conducted from April to October, 2017 to assess the parasitic contamination of vegetables sold at main vegetable markets in districts Lower Dir and Peshawar, Pakistan. Eight hundred specimens of different vegetables were purchased and soaked in physiological saline solution, shaken with a mechanical shaker for 20 minutes and processed by sedimentation concentration method. Results revealed that only 19.7% (n=158/800) of the vegetables were found to be contaminated with single or multiple parasite species. Ascaris lumbricoides (the large round worm) 12.3% (n=99/800) was the most commonly detected pathogen and Taenia saginata (the beef tapeworm) 1.62% (n=13/800) was the least frequently detected one. Interestingly, significant p value (p>0.05 at 95%CI) between the number of examined and contaminated for all the variables studied including education status of the vendors, markets location, type of vegetables, means of display, washed before display, washing source of water and market type. The findings of this study evidenced that consumption of raw vegetables possesses great risk of getting parasitic infections in Lower Dir and Peshawar districts, Pakistan. Instructing the sellers and the public about parasitic disease transfer and their hygiene can reduce the infection rate of parasites of human origin.

Os vegetais crus são a principal fonte de transmissão de formas infecciosas de parasitas internos patogênicos entre os seres humanos. Esta pesquisa foi realizada de abril a outubro de 2017 para avaliar a contaminação parasitária de vegetais vendidos nos principais mercados de vegetais nos distritos de Lower Dir e Peshawar, Paquistão. Oitocentos exemplares de diferentes vegetais foram adquiridos e embebidos em solução salina fisiológica, agitados em agitador mecânico por 20 minutos e processados pelo método de concentração por sedimentação. Os resultados revelaram que apenas 19,7% (n = 158/800) das hortaliças estavam contaminadas com uma ou várias espécies de parasitas. Ascaris lumbricoides (o verme redondo grande) 12,3% (n = 99/800) foi o patógeno mais comumente detectado e Taenia saginata (a tênia da carne) 1,62% (n = 13/800) foi o menos freqüentemente detectado. Curiosamente, valor de p significativo (p> 0,05 em IC de 95%) entre o número de examinados e contaminados para todas as variáveis estudadas incluindo escolaridade dos vendedores, localização dos mercados, tipo de vegetais, meios de exposição, lavado antes da exposição, fonte de lavagem de água e tipo de mercado. Os resultados deste estudo evidenciaram que o consumo de vegetais crus possui grande risco de contrair infecções parasitárias nos distritos de Lower Dir e Peshawar, no Paquistão. Instruir os vendedores e o público sobre a transferência de doenças parasitárias e sua higiene pode reduzir a taxa de infecção de parasitas de origem humana.

Case Report: Disseminated Cysticercosis due to Intentional Ingestion of Parasitic Worm Eggs for Weight Loss.

A 20-year-old female resident of Beijing intended to consume the eggs of the parasitic worm, Taenia saginata, for weight loss; however, she apparently inadvertently ingested Taenia solium (pork tapeworm) eggs, which resulted in disseminated cysticercosis. Cysticerci developed in the brain, tongue, muscles, liver, peritoneum, and subcutaneous tissues. She was administered oral albendazole and praziquantel. After four 10-day courses of treatment, most of the cysts disappeared and she recovered. After 3 years, the patient remains in good health.

Genetic Diversity of Taenia solium and its Relation to Clinical Presentation of Cysticercosis.

In this perspectives paper, we discuss fertilization strategies for Taenia saginata and Taenia saginata asiatica as well as heterogeneity in Taenia solium, the causative agent of human cysticercosis. Two different genotypes of T. solium (Asian and Afro/American) were confirmed by mitochondrial DNA analysis approximately two decades ago. Since then, outcrossings of the two genotypes have been identified in Madagascar where the two genotypes are distributed sympatrically. Outcrossings were confirmed by the presence of discordance between mitochondrial and nuclear DNA. Since multiple tapeworm infections are common in endemic areas, outcrossing events likely occur quite frequently. Therefore, mitochondrial DNA from T. solium specimens collected from humans and pigs in endemic areas should be analyzed. If variations are found between specimens, nuclear DNA analysis should be performed to confirm the presence of discordance between mitochondrial and nuclear genes. Additional outcrossings likely add complexity to understanding the existing genetic diversity. Serological surveys are also recommended since serodiagnostic glycoprotein can also differentiate between the two genotypes. Viable eggs from different genotypes or from hybrids of two different genotypes should be used for experimental infection of pigs or dogs in order to observe any pathological heterogeneity in cysticercosis development. Although genetic diversity of T. solium is expected to result in clinical heterogeneity of cysticercosis in humans and pigs, there is currently no evidence showing that this occurs. There are also no comparative experimental studies on this topic. Therefore, studies evaluating the link between parasite heterogeneity and clinical outcome are warranted.

A 27-Year-Old Lebanese Man with Stomach Perforation and Regurgitation of a Beef Tapeworm (Taenia saginata): A Case Report and Review of the Literature.

BACKGROUND The global burden of Taenia saginata (T. saginata), the beef tapeworm, includes economic loss, and its pathogenicity is considered mild. T. saginata can infect the human definitive host when people ingest larval cysts from raw or undercooked beef, as cattle are the intermediate host. This report is of a case of gastric perforation and pneumoperitoneum with regurgitation of T. saginata in a 27-year-old Lebanese man, and includes a review of previous cases of gastrointestinal perforation due to T. saginata. CASE REPORT We report a rare case of stomach perforation caused by T. saginata, in which the tapeworm was subsequently expelled orally. A computerized tomography (CT) scan was done, revealing pneumoperitoneum and abdominal fluid, which was consistent with evidence of a perforated hollow viscus. Three days after exploratory laparoscopy, the patient vomited a 3-meter tapeworm and the diagnosis was subsequently made. On the fourth day, a CT scan of the abdomen with oral contrast was performed and showed no leakage. A clear fluid diet was started on the fifth day. The patient was discharged home on the seventh postoperative day in good condition. One week after the discharge, the patient was examined; he was in a good condition and symptoms were completely relieved 1 week after worm expulsion. CONCLUSIONS This report shows that in countries or societies where eating raw beef is common, a diagnosis of infestation with T. saginata should be considered in patients who present with gastrointestinal symptoms.

Zoonotic Taenia infections with focus on cysticercosis due to Taenia solium in swine and humans.

Zoonotic taeniasis caused by the adult stage of Taenia solium, Taenia saginata or Taenia asiatica are considered neglected tropical diseases by the World Health Organization. The life cycle of these 3 metazoan species is very similar and includes an intermediate host: pigs in the case of T. solium and T. asiatica, and cattle in the case of T. saginata. By eating meat (pork/T. solium, T. asiatica; beef/T. saginata) containing live cysticerci, humans develop taeniasis, which is practically asymptomatic but is the main risk factor for intermediate hosts to become infected. T. saginata causes bovine cysticercosis, while T. solium and T. asiatica cause swine cysticercosis, of veterinary and economic importance. T. solium cysticerci cause neurological disease in humans: neurocysticercosis. Cysticerci develop after ingesting microscopic eggs released from a human tapeworm carrier. Here we describe the life stages of the parasites, diagnosis, pathogenesis, symptomatology of neurocysticercosis, and prevention and control measures. Highlighting the need to validate diagnostic tools, treatments and vaccination in endemic areas, with the challenge of addressing the most vulnerable populations that lack resources. If people understand the transmission route, avoid eating uncooked or insufficiently cooked meat and have adequate hygienic habits, the life cycle of the 3 zoonotic Taenia species may be interrupted. In addition, we describe the growing field of immune response and immunomodulation elicited by the parasites, which may provide essential tools for diagnosis, treatment, control of taeniasis/cysticercosis, as well as for identification of parasite-derived immunomodulators that could aid in the treatment of emerging inflammatory diseases worldwide.

Epidemiology of bovine cysticercosis and associated economic losses in the state of Rio Grande do Sul, Brazil.

Bovine cysticercosis (BCC) is the most frequently detected zoonosis in Brazilian slaughterhouses and is considered a problem for public health and beef production chain, requiring epidemiological studies focusing on evaluating its prevalence, spatial distribution, and economic losses in order to improve and adopt specific strategies for BCC control. Thus, this study focused to establish BCC prevalence and spatial distribution in the state of Rio Grande do Sul, Brazil, and estimate the economic losses for cattle farmers suppliers of one exporter slaughterhouse. A set of 70,591 bovine carcasses were postmortem inspected from 2019 to 2020, which came from 134 municipalities located in eight distinct regions in the state of Rio Grande do Sul. The prevalence found was 3.44% (C.I. 95% 3.30-3.57%), and animals infected with unviable cysticerci were more frequently detected (70.56%) than those carrying viable ones (29.44%). The most frequent destination of carcasses and viscera was non-export (65.48%), followed by freezing/salting (25.41%), heat treatment (8.74%), and rendering (0.37%), resulting in a total economic burden of at least US$ 167,868.53 for cattle farmers. Some regions had higher risk for BCC occurrence, such as Porto Alegre, Caxias do Sul, Santa Maria, Ijuí, and Passo Fundo (OR > 1, p < 0.05), respectively. These results highlight the need of adopting prophylactic measures, mainly in specific areas, in order to control BCC and reduce the economic losses for beef production chain.

Identification of risk areas and practices for Taenia saginata taeniosis/cysticercosis in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Bovine cysticercosis (BCC) is an infection of cattle with the metacestode stage of Taenia saginata, the beef tapeworm, which causes taeniosis in humans. BCC is responsible for considerable economic losses in the meat sector worldwide. This systematic review and meta-analysis summarizes the prevalence, risk factors and treatment efforts made so far on T. saginata infections in Ethiopia, providing a detailed analysis of different factors influencing the varying prevalence estimates in Ethiopia to gain more insight into the occurrence and risk factors of T. saginata taeniosis and cysticercosis to date. METHODS: A systematic review and meta-analysis was conducted on data collected from published and grey literature accessed through an electronic database and manual search. RESULTS: The literature search resulted in 776 outputs of which 132 conformed to the predefined criteria. The average zonal prevalence of meat inspection-based BCC ranged from 2% in Buno-Bedele to 24.6% in Sidama zone. The pooled prevalence of BCC was influenced by the number of muscle/organs inspected, ranging from 3.4% (95% CI: 1.7-5.1%) using fewer predilection sites to 19.4% (95% CI: 13.3-25.4%) using inspection of a maximum number of predilection sites. None of the tested variables were significantly associated with BCC. Questionnaire-based taeniosis ranged between 19.0% in Halaba special woreda to 70.0% in Gedeo zone and stool test-based taeniosis varied from 0.6% in central Tigray to 10.7% in Gurage zone. Questionnaire-based prevalence of taeniosis was higher in people with a frequent raw beef consumption habit (pooled OR, pOR: 10.5, 95% CI: 6.0-17.9), adults (pOR: 2.5, 95% CI: 1.7-3.6), men (pOR: 2.8, 95% CI: 2.1-3.6), and Christians (pOR: 2.0, 95% CI: 1.4-2.8) compared to less frequent raw beef consumers, younger people, women and Muslims, respectively. CONCLUSIONS: This review revealed a widespread but variable occurrence of BCC and taeniosis in Ethiopian regions and zones, urging for harmonized and enhanced detection for improved control of the parasite. Accurate prevalence estimates using more sensitive tests, detailed risk factor analysis, as well as data on financial losses are needed to develop effective control strategies for the Ethiopian epidemiologic condition.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in East, Southeast and South Asia.

BACKGROUND: Taenia saginata is an important zoonotic parasite, causing taeniosis in humans and cysticercosis in bovines, the latter being a significant concern for the global beef industry. Many countries in East, Southeast and South Asia are experiencing rapid economic growth, and an increasing number of people in these countries are dependent on the livestock industry. Currently, however, an overview of the prevalence of T. saginata in this region is lacking. In this review, we analysed the available literature on T. saginata taeniosis and bovine cysticercosis for East, Southeast and South Asia. METHODS: A systematic review was conducted, based on both published and grey literature. Articles published between 1990 and 2017 were mined for information on the occurrence, prevalence, and geographical distribution of T. saginata taeniosis and bovine cysticercosis in East, Southeast and South Asia. RESULTS: The presence of T. saginata was described in 15 of 27 countries of the region, including Afghanistan, Cambodia, China, India, Indonesia, Japan, Lao PDR, Malaysia, Mongolia, Nepal, Pakistan, Philippines, South Korea, Thailand and Vietnam. The only country that reported an absence of T. saginata is Japan, although sporadic reports of imported cases and unconfirmed reports of autochthonous infections were identified. Nationwide surveys of taeniosis with systematic sample collection and high sample numbers were available for Cambodia, China, Lao PDR, and South Korea, although speciation of Taenia was not always performed. Regional prevalence of taeniosis and bovine cysticercosis in endemic regions ranged between 0.02-42.6%, and 0.76-46.7%, respectively. However, data for bovine cysticercosis were only available for five countries (Japan, Lao PDR, Mongolia, Pakistan and Vietnam). CONCLUSIONS: The data indicate a widespread occurrence of T. saginata throughout East, Southeast and South Asia. Identification of Taenia spp. in human infections was frequently not performed, leading to gaps in knowledge about the distribution of human tapeworm infections, mainly in regions where different human Taenia species co-occur. A high prevalence of T. saginata taeniosis and bovine cysticercosis may reflect insufficiencies in sanitation, limited health education standards, and insufficient food safety measures. Therefore, there is a need to improve local surveillance, notification, and overall control systems.

Systematic review and meta-analysis of bovine cysticercosis in Brazil: current knowledge and way forward.

BACKGROUND: Taenia saginata taeniosis/cysticercosis has been well studied in several countries. Brazil is one of the most important beef exporting countries and has one of the highest cattle population size in the world. In this country, bovine cysticercosis (BCC) remains the most frequent reported zoonosis detected during post-mortem inspection, resulting in costs for the beef sector and public health. We performed a systematic literature review regarding data about BCC epidemiology in Brazil and meta-analyses for its prevalence in different administrative regions and the distribution over time, and based on this discussed possible control strategies. METHODS: A systematic review was conducted to obtain data about BCC in Brazil using the words "bovine cysticercosis" and "Brazil" to construct the search phrase. The inclusion criteria used to select articles were: (i) published from 2000 to 2018; (ii) full text available online in Portuguese or English; and (iii) contain information at least regarding one of the following aspects of BCC in Brazil: prevalence, incidence, spatial distribution, risk-factors, economic burden and measures for control. RESULTS: A set of 42 articles was included, covering the prevalence of BCC in Brazil, ranging between 0.01-18.75%. Prevalence results of 40 articles were included in a meta-analysis per administrative region. The highest prevalence was found in the South (3.4%; 95% CI: 2.0-5.2%), followed by the Southeast (2.7%; 95% CI: 1.9-3.6%), Northeast (1.5%; 95% CI: 0.6-2.7%), Central-western (0.9%; 95% CI: 0.3-1.7%) and North (0.0%; 95% CI: 0.0-0.6%) region. In addition, a reduction in prevalence over time was observed in all the evaluated states except for Alagoas and Pará. CONCLUSIONS: Besides the large availability of data, a critical lack of information about BCC epidemiology remains in Brazil. Nevertheless, the available data on prevalence, high risk-areas and risk factors should contribute to a better understanding of transmission and the formulation of recommendations for control. A One Health approach will be required to reduce T. saginata taeniosis/cysticercosis prevalence and the consequent economic burden for the beef sector in Brazil, one of the most important beef exporters in the world.

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.

A preliminary study to assess the use of a "Snakes and Ladders" board game in improving the knowledge of elementary school children about taeniasis.

The Snakes and Ladders board game was modified so that it contained information on taeniasis. A quantitative approach was used to evaluate if elementary school children were able to answer correctly more questions about Taenia saginata and Taenia solium transmission and control after playing the game compared to before playing the game. In total, 78 children (9-12 years of age) from Dukuh elementary school in Karangasem District, Bali, Indonesia, were evaluated. The children were asked to complete a pre- and post-test assessment before and after playing the game a single time. Overall proportion of correct answers was 40.3% before playing the game and 58.8% after playing the game. There was a greater proportion of correct answers for questions pertaining to the transmission route for T. saginata (p < 0.001) and T. solium (p < 0.001), human infection type with T. solium (p = 0.035) and T. saginata (p < 0.001), and animal infection type with T. solium or T. saginata (p < 0.001) after playing the game compared to before playing the game. However, there was no significant difference for any question for the youngest grade level. Use of this popular board game appears to be a promising tool for teaching older (10 years of age and above) children about taeniasis in endemic areas.

Taeniosis and cysticercosis in Serbia, 1990-2018: Significance of standard of living.

OBJECTIVES: As is the case for all of Southeast Europe, Serbia is an area traditionally endemic for Taenia saginata and Taenia solium infections. This study was performed to analyse the epidemiological data on taeniosis and cysticercosis in Serbia for the period 1990-2018. METHODS: Data on cases of T. saginata and T. solium infection were collected via a systematic search of published articles, the grey literature, and official reports, as well as by performing clinical observational studies of patients treated in the departments for infectious diseases of hospitals and university clinics in Serbia. RESULTS: A total of 212 cases of taeniosis were reported, all between 1997 and 2004 when taeniosis was notifiable (incidence range 0.04-0.9/100 000 population/year). From 1990 to 2018, 170 cases of cysticercosis (all but one of neurocysticercosis), were registered (incidence range 0-0.29/100 000 population/year), with a strong decrease since 2000 and a single case in the last 9 years. The annual number of cases of both taeniosis (Pearson's r = 0.914, p = 0.001) and cysticercosis (Pearson's r = 0.582, p = 0.014) correlated with the consumer price index. CONCLUSIONS: In Serbia, T. saginata and T. solium infections are autochthonous but occur only sporadically. However, the potential for re-emergence exists, depending on the socio-economic state of the country.