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1.
Am J Trop Med Hyg ; 103(3): 1125-1128, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32602434

RESUMEN

Subarachnoid neurocysticercosis (SANCC) is a severe and progressive brain infection with Taenia solium. We performed a pilot study of noninvasive screening for SANCC in two endemic villages in northern Peru using a urine antigen screen followed by brain magnetic resonance imaging for participants with elevated levels of antigen. Among the 978 participants screened, we identified eight individuals with SANCC, many of whom were asymptomatic. This represents a minimum prevalence of 0.8% of SANCC, a level higher than expected based on prior studies, and a positive predictive value of 62% for our novel urine screening test. Future studies should confirm whether early detection and management improve clinical outcomes.


Asunto(s)
Antígenos Helmínticos/orina , Neurocisticercosis/diagnóstico por imagen , Espacio Subaracnoideo/inmunología , Taenia solium/inmunología , Teniasis/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Enfermedades Asintomáticas , Encéfalo/diagnóstico por imagen , Encéfalo/parasitología , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neurocisticercosis/epidemiología , Neurocisticercosis/parasitología , Perú/epidemiología , Proyectos Piloto , Teniasis/epidemiología , Teniasis/parasitología , Adulto Joven
2.
Parasit Vectors ; 12(1): 352, 2019 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-31311596

RESUMEN

BACKGROUND: Taenia solium (cysticercosis) is a parasitic cestode that is endemic in rural populations where open defecation is common and free-roaming pigs have access to human feces. The purpose of this study was to examine the roaming patterns of free-range pigs, and identify areas where T. solium transmission could occur via contact with human feces. We did this by using GPS trackers to log the movement of 108 pigs in three villages of northern Peru. Pigs were tracked for approximately six days each and tracking was repeated in the rainy and dry seasons. Maps of pig ranges were analyzed for size, distance from home, land type and contact with human defecation sites, which were assessed in a community-wide defecation survey. RESULTS: Consistent with prior GPS studies and spatial analyses, we found that the majority of pigs remained close to home during the tracking period and had contact with human feces in their home areas: pigs spent a median of 79% (IQR: 61-90%) of their active roaming time within 50 m of their homes and a median of 60% of their contact with open defecation within 100 m of home. Extended away-from-home roaming was predominately observed during the rainy season; overall, home range areas were 61% larger during the rainy season compared to the dry season (95% CI: 41-73%). Both home range size and contact with open defecation sites showed substantial variation between villages, and contact with open defecation sites was more frequent among pigs with larger home ranges and pigs living in higher density areas of their village. CONCLUSIONS: Our study builds upon prior work showing that pigs predominately roam and have contact with human feces within 50-100 m of the home, and that T. solium transmission is most likely to occur in these concentrated areas of contact. This finding, therefore, supports control strategies that target treatment resources to these areas of increased transmission. Our finding of a seasonal trend in roaming ranges may be useful for control programs relying on pig interventions, and in the field of transmission modeling, which require precise estimates of pig behavior and risk.


Asunto(s)
Cisticercosis/veterinaria , Defecación , Heces/parasitología , Estaciones del Año , Enfermedades de los Porcinos/transmisión , Animales , Conducta Animal , Cisticercosis/epidemiología , Cisticercosis/transmisión , Femenino , Sistemas de Información Geográfica , Humanos , Masculino , Movimiento , Perú/epidemiología , Factores de Riesgo , Población Rural , Análisis Espacial , Porcinos/parasitología , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/parasitología , Taenia solium/aislamiento & purificación
3.
Am J Trop Med Hyg ; 100(6): 1490-1493, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30938282

RESUMEN

Cysticercosis, caused by Taenia solium, is a neglected disease that causes preventable epilepsy. We conducted an experiential learning workshop in northern Peru to educate community members on T. solium transmission and motivate participation in community-led prevention and control. The workshop included presentation of local economic and epidemiologic data, followed by hands-on participation in pig dissection, group discussion of the T. solium life cycle, and viewing of eggs and nascent tapeworms with light microscopes. Among heads of household, we used community survey data to compare knowledge of the three-stage parasite life cycle at baseline and 2 months postworkshop. Knowledge of the life cycle increased significantly after the workshop, with greater gains for workshop attendees than non-attendees. Prior knowledge and workshop attendance were significant predictors of postworkshop knowledge. The use of local evidence and experiential learning positively affected knowledge of T. solium transmission, laying the foundation for subsequent community-engaged control efforts.


Asunto(s)
Cisticercosis/patología , Cisticercosis/parasitología , Educación en Salud , Enfermedades de los Porcinos/parasitología , Taenia solium , Animales , Niño , Femenino , Humanos , Masculino , Población Rural , Porcinos , Zoonosis
4.
Am J Trop Med Hyg ; 100(1): 140-142, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30457096

RESUMEN

Reintroduction of Taenia solium into a region in Peru where it had been eliminated prompted evaluation of the possibility of reintroduction from an urban reservoir of taeniasis. In a cross-sectional study of an adjacent urban area, we found low prevalence of taeniasis (4/1,621; 0.25%), suggesting minimal risk of parasite reintroduction into rural areas through this route.


Asunto(s)
Neurocisticercosis/epidemiología , Teniasis/epidemiología , Población Urbana , Adulto , Anciano , Animales , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Factores de Riesgo , Taenia solium/aislamiento & purificación , Teniasis/complicaciones , Teniasis/transmisión , Adulto Joven
5.
Am J Trop Med Hyg ; 98(6): 1748-1754, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29663901

RESUMEN

Infection of the brain with Taenia solium larvae (neurocysticercosis) is a leading cause of preventable epilepsy worldwide. Effective and sustainable strategies to control parasite transmission in rural endemic communities are needed to prevent the disease. Surveillance and targeted intervention around infected pigs (ring control strategy) have been shown to be effective when carried out by research teams. However, this strategy has not been implemented or tested as a community-based program. In this small trial in northern Peru, eight villages were randomly assigned to community-led surveillance and treatment (five villages, 997 residents) or control (three villages, 1,192 residents). In intervention villages, community-led surveillance and reporting were promoted by community health workers, radio advertisement, and school and household education. Each suspected pig infection was verified, with confirmed cases resulting in treatment with niclosamide for taeniasis and oxfendazole for pigs in clusters of homes nearby. No incentives beyond human and pig treatment were offered. Control villages received basic disease education but no treatment intervention in response to reports. Despite 14 case reports, community-based replication of ring control strategy did not replicate prior results. After 12 months, there was no change in seroincidence in intervention villages between the baseline and study end, and no difference compared with control villages. There was no difference in prevalence of taeniasis or porcine cysticercosis at study end. Community members described lack of knowledge as the main reason for not reporting infected pigs. Further exploration of methods to transfer ring strategy and other control interventions for cysticercosis to the community is needed.


Asunto(s)
Cisticercosis/epidemiología , Enfermedades Endémicas , Enfermedades de los Porcinos/epidemiología , Taenia solium/aislamiento & purificación , Animales , Agentes Comunitarios de Salud , Cisticercosis/parasitología , Cisticercosis/transmisión , Cysticercus/aislamiento & purificación , Notificación de Enfermedades , Femenino , Humanos , Masculino , Tamizaje Masivo , Perú/epidemiología , Proyectos Piloto , Prevalencia , Estudios Prospectivos , Población Rural , Porcinos , Enfermedades de los Porcinos/parasitología , Enfermedades de los Porcinos/transmisión , Zoonosis
6.
PLoS Negl Trop Dis ; 10(12): e0005130, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27992429

RESUMEN

BACKGROUND: Neurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level. METHODOLOGY: We conducted a population-based study of resident's ≥2 years old in a highly endemic village in Peru (pop. 454). We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB). We invited all residents ≥18 years old to have non-contrast computerized tomography (CT) of the head. PRINCIPAL FINDINGS: Of the 385 residents who provided serum samples, 142 (36.9%) were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8%) had brain calcifications consistent with NCC; 8/48 (17.0%) reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic. CONCLUSION: This study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future.


Asunto(s)
Infecciones Asintomáticas/epidemiología , Enfermedades Endémicas , Neurocisticercosis/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Anticuerpos Antihelmínticos/sangre , Encéfalo/parasitología , Encéfalo/patología , Niño , Preescolar , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Neurocisticercosis/sangre , Neurocisticercosis/diagnóstico por imagen , Neurocisticercosis/inmunología , Perú/epidemiología , Prevalencia , Salud Rural , Convulsiones/epidemiología , Convulsiones/etiología , Convulsiones/parasitología , Taenia solium/inmunología , Taenia solium/aislamiento & purificación , Tomografía Computarizada por Rayos X , Adulto Joven
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