Molecular diagnosis of Taenia saginata from two patients in Palestine: two case reports.

BACKGROUND: Taeniasis, is a worldwide foodborne zoonotic disease caused by two principal species; Taenia saginata and Taenia solium. The tapeworm infects the intestine causing taeniasis in humans. Taeniasis is a very rare parasitic infection in Palestine with very few annual cases of unknown species. The infection rate and the disease status are not clear due to the lack of reports about the actual number of patients. CASE PRESENTATION: Two Palestinian patients; one male of 22 years old from Hebron and the other is female of 33 years old from Ramallah were referred to Palestinian Health Services in the West Bank, Palestine, complained of weight loss, abdominal pain and presence of motile segments of creamy color in the their stool. Microscopic analysis of the stool samples from infected cases revealed Taenia eggs and proglottids, confirmed taeniasis infection. The parasite species was identified as T. saginata by polymerase chain reaction (PCR) amplification and sequencing of the cytochrome oxidase -1 (COX-1) gene. CONCLUSION: Taeniasis is an unusual parasitic infection in Palestine, there is a growing concern that the actual numbers of infected individuals are much higher and the occurrence of human taeniasis is principally due to people's eating habits in consumption of raw or undercooked beef meat. This report highlighted for the first time the existence of taeniasis infection in the country; which necessitates the need to conduct further research and surveillance to reveal the actual infection rate and the available Taenia species.

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.

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.

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.

Taenia saginata Infection Misdiagnosed as Acute Cholecystitis in a Tibetan Patient, in China.

The present study reports a rare case of Taenia saginata infection, which was initially diagnosed as acute cholecystitis in a Tibetan patient at the Qinghai-Tibetan Plateau pastoral area, China. A 45-year-old female was initially diagnosed with acute cholecystitis at a hospital in China. She had a slight fever, weight loss and constipation and complained of pain in the upper abdomen and left back areas. Increase of monocyte, eosinophil and basophil levels were shown. Taenia sp. eggs were detected in a fecal examination. An adult tapeworm approximately 146 cm in length, whitish-yellow color, was collected from the patient after treatment with traditional Chinese medicine. The adult tapeworm had a scolex and proglottids with genital pores. The scolex was rectangular shape with 4 suckers and rostellum without hooklet. The cox1 gene sequence shared 99.5-99.8% homology with that of T. saginata from other regions in China. The patient was diagnosed finally infected with T. saginata by morphological and molecular charateristics.

Occurrence of a Hybrid Between Taenia saginata and Taenia asiatica Tapeworms in Cambodia.

Human infection with Taenia asiatica or a hybrid between Taenia saginata and T. asiatica has not been reported in Cambodia. We detected for the first time a hybrid form between T. saginata and T. asiatica in Preah Vihear Province, Cambodia. An adult tapeworm specimen, i.e., 75 cm long strobila without scolex, was expelled from a 27-year-old man after praziquantel medication and purging. It was morphologically indistinguishable between T. saginata and T. asiatica. Several proglottids were molecularly analyzed to confirm the tapeworm species. The mitochondrial gene encoding cytochrome c oxidase subunit 1 (cox1) and nuclear genes encoding elongation factor-1α (ef1) and ezrin-radixin-moesin (ERM)-like protein (elp) were sequenced, and a single-allele analysis was performed to confirm the haploid genotype. The results revealed that our sample showed a discrepancy between the mitochondrial and 2 nuclear genes. It possessed homozygous sequences typical of T. saginata at cox1 and ef1 loci. However, it was heterozygous at the elp locus, with 1 allele in T. asiatica (elpA) and 1 in T. saginata (elpC), which indicates that it is a hybrid between T. saginata and T. asiatica. The present results confirmed the presence of a hybrid between T. saginata and T. asiatica in Cambodia and strongly suggest the existence of also 'pure' T. asiatica in Cambodia.

Epidemiology of Taenia saginata taeniasis with emphasis on its prevalence and transmission in a Kashmiri population in India: A prospective study.

BACKGROUND: Taeniasis, caused by two major Taenia species, T. solium and T. saginata, is a worldwide foodborne zoonotic disease. T. solium is found in people who habitually eat raw or undercooked pork, while T. saginata is found in people who habitually eat raw or undercooked beef. Cattle rearing and beef consumption is an important socio-cultural feature in the Kashmir valley, India. This study's objectives were to evaluate the prevalence of foodborne taeniasis in Kashmir and explore the various risk factors for its transmission. METHODS AND MATERIALS: A detailed survey of the population in selected rural and semi-urban sites of Kashmir valley was carried out based on previous information. A total of 12,404 subjects (males=6364; females=6040) ranging from one to 85 years of age (mean age: 28.96±17.68) were included in this study. The parasite diagnosis was made through stool analysis (egg morphology) and anatomical characteristics of gravid proglottids obtained from infected cases. The data obtained were compiled for the parameters studied and statistically analyzed. RESULTS: The observations as estimated coprologically and based on gravid proglottids' anatomy revealed the presence of T. saginata infection. The prevalence was 2.74% with males significantly (p<0.01) more infected (3.40%) than females (2.05%). Similarly, the age group of >60 years showed greater prevalence (7.21% among males and 2.68% among females) at a significance value of p<0.05. Rural populatios were slightly more infected (2.84%) than semi-urban populations (2.36%) with a statistically significant difference (p<0.01). CONCLUSION: Our findings indicate that the Kashmiri population who consume raw or undercooked beef, harbor T. saginata infection; its prevalence was influenced by food eating habits, age, sex, and living conditions.

Human Taeniases in Slovakia (2010-2019): Genetic Analysis of Taenia saginata Isolates.

Taenia saginata and Taenia solium, known as beef and pork tapeworm, are foodborne pathogens of global importance having a substantial impact on human health and economy. The study aimed to summarize the occurrence of human Taenia spp. infection in past 10 years in Slovakia based on reports of clinicians and diagnostic laboratories to Public Health Authority of the Slovak Republic. Altogether, 19 human cases were reported in Slovakia in 2010-2019, with the incidence of infection ranging from 0.00 to 0.12/100,000 inhabitants per year. In two patients T. saginata infection was confirmed molecularly. Nucleotide sequences of the analyzed nad1 gene fragments derived from both patients were identical and in a phylogenetic tree clustered together with T. saginata Tsa isolate (AM503345), as well as with a homologous sequence of the completely sequenced mitochondrial genome of T. saginata. Similarly, cox1 nucleotide sequences derived from one of the patients and isolates from Asia and/or Europe were identical. A cluster for cox1 partial gene sequence was placed separately from closely related Taenia asiatica and/or T. solium isolates in the phylogenetic tree.

Molecular Diagnosis of Taenia saginata Tapeworms from Two Residents of Northern Cambodia.

Taenia saginata infection has seldom been reported in Cambodia. In this study, we performed a survey of intestinal parasites in 1,156 residents of Preah Vihear and Stung Treng Provinces in 2018. The results revealed that 26 (2.4%) cases were positive for Taenia spp. eggs. In order to obtain the strobilae of the tapeworms, 2 patients in Preah Vihear were treated with praziquantel and purged with magnesium salts. The proglottids expelled after the medication were morphologically and molecularly analyzed to determine the species. The main uterine lateral braches in gravid proglottids were >15 in number suggesting that they are either T. saginata or Taenia asiatica. The sequences of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene and 2 nuclear loci, elongation factor-1 alpha (ef1) and ezrin-radixin-moesin-like protein (elp), were identical to the sequences of T. saginata available in GenBank but distant from Taenia solium, T. asiatica, and T. saginata-T. asiatica hybrid. This is the first report of the presence of T. saginata in the northern part of Cambodia bordering Lao PDR based on a molecular confirmation.

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.

Ten Cases of Taenia saginata Infection Confirmed by Analysis of the Internal Transcribed Spacer 1 rDNA Region in the Republic of Korea.

From October 2015 to August 2018, tapeworm proglottids were obtained from 10 patients who were residents of Daegu and Gyeongbuk provinces and had a history of raw beef consumption. Most of them had no overseas travel experience. The gravid proglottids obtained from the 10 cases had 15-20 lateral uterine branches. A part of internal transcribed spacer 1 (ITS1) DNA of the 10 cases, amplified by polymerase chain reaction (PCR) and digested with AleI restriction enzyme, produced the same band pattern of Taenia saginata, which differentiated from T. asiatica and T. solium. Sequences of ITS1 and cytochrome c oxidase subunit 1 (cox1) showed higher homology to T. saginata than to T. asiatica and T. solium. Collectively, these 10 cases were identified as T. saginata human infections. As taeniasis is one of the important parasitic diseases in humans, it is necessary to maintain hygienic conditions during livestock farming to avoid public health concerns.

Four Taeniasis saginata Cases Diagnosed at a University Hospital in Korea.

In recent years, the taeniasis has been rarely reported in the Republic of Korea (Korea). But in this study, we intend to report 4 taeniasis cases caused by Taenia saginata during a 5-month period (February to June 2018) at a unversity hospital in Gwangju, Korea. Worm samples (proglottids) discharged from all cases were identified by phenotypic and molecular diagnostics. Mitochondrial cytochrome c oxidase subunit I sequences showed 99.4-99.9% identity with T. saginata but, differed by 4% from T. asiatica and by 7% from T. multiceps, respectively. We found that tapeworms in 2 cases (Cases 2 and 3) yielded exactly the same sequences between them, which differed from those in Cases 1 and 4, suggesting intra-species variation in tapeworms. These taeniasis cases by T. saginata infection in this study, which occurred within a limited time period and region, suggest the possibility of a mini-outbreak. This study highlights the need for further epidemiological investigation of potentially overlooked cases of T. saginata infection in Korea.

Short communication: Four cases of Taenia saginata taeniasis in urban Venezuelan communities.

We report four cases of Taenia saginata taeniasis in different urban communities of Aragua state, Venezuela. After subsequent treatment with praziquantel and a saline purge, adult tapeworms were collected from all four patients and demonstrated to be T. saginata by morphological and molecular characterization. The finding of T. saginata in four distinct and separate urban municipalities of the Aragua state indicates the pertinence of rigorous meat inspection, and the importance of establishing parasite prevalence in human and bovine Venezuelan populations.

A co-infection case report of Taenia saginata in a patient with subclinical clonorchiasis confirmed by the combination of diagnostic tools.

BACKGROUND: Clonorchiasis is the common parasitic infection in the general population of the Republic of Korea, however, taeniasis is scarcely reported recently. Here, we describe a case of co-infection with the cestode T. saginata in a patient with subclinical clonorchiasis diagnosed by a combination of diagnostic tools in Korea. CASE PRESENTATION: A 56-year-old man visited the hospital having passed proglottids in his stool for the past two months and brought a stool sample with segments to our hospital. He had no abdominal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, or constipation. He used to consume raw beef and fish frequently. We could not find evidence of gravid proglottids which contain fully developed uteri filled with ova or branched uterine structures, within the submitted sample. To identify the tapeworm species, we carried out molecular analyses on the proglottids. The cox1 and ef1a sequences had a 100% match with those of T. saginata and differed from the sequences of the other Taenia species. Upon examination of stool samples fixed by formalin-ether concentration method, no Taenia species ova were observed in 10 slides. Instead, C. sinensis ova were observed, despite the level of IgG specific to C. sinensis being within the normal range. The patient was treated with praziquantel (25 mg/kg, three times a day) for 3 days, and subsequently C. sinensis ova were not found in his stool. CONCLUSION: Our case indicates that a combination of morphological, serological, and molecular diagnostic tools should be used for the accurate diagnosis of subclinical parasitic infections.

Molecular characterization of the Taenia solium Tso31 antigen and homologous of other Taenia species from Peru.

Several studies have been performed to determine specific antigens for the diagnosis of tapeworms. One of these antigens is Tso31, which is used to differentiate Taenia solium and Taenia saginata in human feces. The aim of the present work was the molecular characterization of this protein in different tapeworm specimens collected in Peru: T. omisa (n = 6), T. hydatigena (n = 7), T. taeniaeformis (n = 4), T. pisiformes (n = 1), T. multiceps (n = 7), and T. solium (n = 10). Total DNA was extracted from each proglottid using a commercial DNA kit for tissue. A nested PCR was used to amplify a fragment of the previously described oncosphere-specific protein Tso31 gene. The nested PCR products were analyzed by 1.5% agarose gel electrophoresis and visualized after ethidium bromide staining. All nested PCR-positive products were sequenced and their sequences were compared. Of all the tapeworms analyzed, only T. solium and T. multiceps amplified the Tso31 gene. All sequences were identical for each species. Our T. solium Tso31 showed 100% similarity when compared with published GenBank sequences. The difference between T. solium and T. multiceps Tso31 samples was 8.1%. In conclusion, our results show that the tsol31 gene is not exclusive to T. solium.

Genetic Characterization of Taenia saginata Cyst Isolates from Germany.

The beef tapeworm Taenia saginata, which causes taeniosis in humans and cysticercosis in cattle, is of medical and economic importance. Understanding the parasite's genetic population structure may help to analyze transmission patterns and aid in the development of control measures. As information on sequence variability is scarce for European isolates, this study aimed to elucidate the intraspecific genetic variability of T. saginata cysts from German cattle by sequence comparison of the mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 5 (nad5) genes, in relationship to sequences from other geographical origins. Cysts were collected from northern German, Swiss, and Belgian cattle. Moreover, proglottids from an adult T. saginata specimen from Palestine were included. Amplification and Sanger sequencing of the cox1 gene was successful for 57 samples (45 German, 9 Swiss, 2 Belgian, 1 Palestinian), whereas 32 sequences were obtained for the nad5 gene (21 German, 10 Swiss, 1 Palestinian). For German isolates, sequence comparison revealed minor genetic variability with two polymorphic sites and mutations in both genes. Three haplotypes with haplotype diversity of 0.088 for cox1 and 0.186 for nad5, as well as nucleotide diversities of 0.00028 and 0.00095, respectively, were observed. Comparison of the cox1 gene sequence of German isolates with other European, African, American, and Asian isolates obtained from National Center for Biotechnology Information (total of 71 sequences) raised 11 polymorphic sites and mutations as well as 10 haplotypes (haplotype diversity: 0.239; nucleotide diversity: 0.00097). Although nad5 sequence comparison comprised less sequences (N = 33), analyses revealed 11 polymorphic sites, 12 mutation sites, and 7 haplotypes (haplotype diversity: 0.335, nucleotide diversity: 0.00391), indicating a better resolution of genetic variability compared to cox1. Thus, nad5 may be particularly useful for in-depth studies on genetic divergence of T. saginata.

Molecular Diagnosis of Taenia saginata Tapeworm Infection in 2 Schoolchildren, Myanmar.

Taenia saginata is the most common human tapeworm worldwide but has been unknown in Myanmar. In 2017, fecal examination in Yangon, Myanmar, revealed eggs of Taenia species in 2 children from a monastic school. Several proglottids expelled after medication with praziquantel were morphologically and molecularly confirmed to be T. saginata tapeworms.

Development of the multi-epitope chimeric antigen rqTSA-25 from Taenia saginata for serological diagnosis of bovine cysticercosis.

Bovine cysticercosis is a worldwide distributed zoonosis caused by the larval form of Taenia saginata present in bovine muscles. The diagnosis is based on the postmortem inspection at slaughterhouses and consists of the macroscopic visualization of lesions caused by cysticercosis in muscle sites. However, parasitized animals can pass unnoticed during sanitary inspection. Thus, the objective of this study was to characterize and evaluate the performance of different peptides from different regions of T. saginata for the cysticercosis diagnosis using enzyme-linked immunosorbent assay. We generated and evaluated a new recombinant protein chimera derived from the fusion of different peptides. We selected three distinct regions of T. saginata and predicted six peptides with antigenic potential (EP2-EP7). These peptides were analyzed individually and selected for generating a new chimeric recombinant protein. The new protein was termed rqTSA-25, and its performance rates were: 93.3% sensitivity (confidence interval (CI) = 76-98%), 95.3% specificity (CI = 82-99%), 93% positive predictive value (CI = 76-98%), 95% negative predictive value (CI = 82-99%), and 95% accuracy. In the immunoblot, this protein showed no false positive or false negative reaction. Thus, the use of rqTSA-25 is recommended for the diagnosis of bovine cysticercosis.

HDP2: a ribosomal DNA (NTS-ETS) sequence as a target for species-specific molecular diagnosis of intestinal taeniasis in humans.

BACKGROUND: Taenia solium, T. asiatica and T. saginata tapeworms cause human taeniasis and are the origin of porcine and bovine cysticercosis. Furthermore, T. solium eggs can cause human cysticercosis, with neurocysticercosis being the most serious form of the disease. These helminth infections are neglected tropical diseases and are endemic in several countries in the Americas, Asia and Africa. As a result of globalization, migration in particular, the infections have been extending to non-endemic territories. Species-specific diagnosis of taeniasis is subject to drawbacks that could be resolved using molecular approaches. In the present study, conventional and real-time amplification protocols (cPCR and qPCR) based on the T. saginata HDP2 sequence were applied in the differential diagnosis of taeniasis (T. saginata, T. solium) in both fecal samples and proglottids expelled by patients. The HDP2 homolog in T. solium was cloned and characterized. RESULTS: Semi-nested cPCR and qPCR (Sn-HDP2 cPCR and Sn-HDP2 qPCR) amplified T. saginata and T. solium DNA, with an analytical sensitivity of 40 and 400 fg, respectively, and identically in both protocols. Eighteen taeniasis patients were diagnosed directly with T. saginata or T. solium, either from proglottids or fecal samples with/without eggs (detected using microscopy), based on the optimized Sn-HDP2 qPCR. After cloning, the T. solium HDP2 homolog sequence was confirmed to be a ribosomal sequence. The HDP2 fragment corresponded to a non-transcribed sequence/external transcribed repeat (NTS/ETS) of ribosomal DNA. Compared with the T. saginata HDP2 homolog, the T solium HDP2 sequence lacked the first 900 nt at the 5' end and showed nucleotide substitutions and small deletions. CONCLUSIONS: Sn-HDP2 cPCR and Sn-HDP2 qPCR were set up for the diagnosis of human taeniasis, using proglottids and fecal samples from affected patients. The new Sn-HDP2 qPCR protocol was the best option, as it directly differentiated T. saginata from T. solium. The diagnosis of an imported T. solium-taeniasis case and nine European T. saginata cases was relevant. Finally, the cloning and sequencing of the T. solium HDP2 fragment confirmed that HDP2 was part of a ribosomal unit.

Taenia solium, Taenia saginata, Taenia asiatica, their hybrids and other helminthic infections occurring in a neglected tropical diseases' highly endemic area in Lao PDR.

Most part of Southeast Asia is considered endemic for human-infecting Taenia tapeworms; Taenia solium, T. saginata, and T. asiatica. However, until now there was no report of the occurrence of human cases of T. asiatica in Lao PDR. This study, conducted in Savannakhet Province, Lao PDR, microscopically examined a total of 470 fecal samples by Kato Katz method and found 86% of people harboring at least one helminth. Hookworms were detected in 56% of the samples besides Opisthorchis like eggs (42%), Trichuris trichiura (27%), Ascaris spp. (14%), and Taenia spp. (4%) eggs. Serology for cysticercosis showed 6.8% positives with results varying from 3% to 14.3% in Ethnic School students and Kalouk Kao village respectively. Species-specific PCR targeting mitochondrial DNA (mtDNA) of 28 tapeworms, recovered from 16 patients, revealed T. solium (n = 2), T. saginata (n = 21), and T. asiatica (n = 5). Two patients were confirmed to be coinfected with T. saginata and T. asiatica, indicating the endemicity of the 3 human Taenia in Lao PDR. However, nucleotide sequencing of a nuclear DNA gene, DNA polymerase delta (pold) revealed that all the tapeworms identified as T. asiatica using mtDNA had T. saginata type allele at pold locus, demonstrating that they are not "pure T. asiatica" but the hybrid descendants between the two species, confirming the wide distribution of hybrids of T. saginata/ T. asiatica in Southeast Asia. The high prevalence of several helminthic NTDs in east Savannakhet area even with conventional control measures indicates the importance to establish wide and multifaceted health programs to sustainably improve the quality of life of the populations living in these communities.