Year: 2014
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Taenia solium is a major cause of preventable epilepsy in developing nations. Screening and treatment of human intestinal stage infection (taeniasis) within high-risk foci may reduce transmission and prevent epilepsy by limiting human exposure to infective eggs. We piloted a ring-strategy that involves screening and treatment for taeniasis among households located nearby pigs heavily-infected with the larval stage (cysticercosis). These pigs mark areas of increased transmission and can be identified by tongue examination. METHODOLOGY: We selected two villages in northern Peru for a controlled prospective interventional cohort pilot study. In the intervention village (1,058 residents) we examined the tongues of all pigs every 4 months for nodules characteristic of cysticercosis. We then screened all residents living within 100-meters of any tongue-positive pig using enzyme-linked immunosorbent assay to detect Taenia antigens in stool. Residents with taeniasis were treated with niclosamide. In both the intervention and control (753 residents) we measured incidence of exposure by sampling the pig population every 4 months for serum antibodies against cysticercosis using enzyme-linked immunoelectrotransfer blot. PRINCIPAL FINDINGS: Baseline seroincidence among pigs born during the study was 22.6 cases per 100 pigs per-month (95% confidence interval [CI] 17.0-30.0) in the intervention and 18.1 (95% CI 12.7-25.9) in the control. After one year we observed a 41% reduction in seroincidence in the intervention village compared to baseline (incidence rate ratio 0.59, 95% CI 0.41-0.87) while the seroincidence in the control village remained unchanged. At study end, the prevalence of taeniasis was nearly 4 times lower in the intervention than in the control (prevalence ratio 0.28, 95% CI 0.08-0.91). CONCLUSIONS/SIGNIFICANCE: Ring-screening reduced transmission of T. solium in this pilot study and may provide an effective and practical approach for regions where resources are limited. However, this strategy requires validation in larger populations over a greater period of time.
Source: PLoS neglected tropical diseases
Authors: Seth E. O'Neal, Luz M. Moyano, Viterbo Ayvar, Silvia Rodriguez, Cesar Gavidia, Patricia P. Wilkins, Robert H. Gilman, Hector H. Garcia, Armando E. Gonzalez, for The Cysticercosis Working Group in Peru
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,670
Funders: Bill and Melinda Gates Foundation, Wellcome Trust, National Institutes of Health, Oregon Clinical and Translational Research Institute, Medical Research Council, Fogarty International Center, National Institute of Neurological Disorders and Stroke, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: Targeted screening for Taenia solium tapeworms, G1547128891, G1933198239, Definition and Characterization of the Contribution of Neurocysticercosis to Seizure Burden in Endemic Areas., Oregon Clinical and Translational Research Institute, G5744492008, Oregon Clinical and Translational Research Institute, G9000334989, Training in Infectious Diseases in Peru - Time for Implementation Research
OpenAlex ID: W2151294489