AID  Vol.4 No.4 , December 2014
A Review of Human Cysticercosis and Diagnostic Challenges in Endemic Resource Poor Countries
Abstract: Human cysticercosis is a neglected tropical parasitic zoonotic disease with high public health concerns. Infection of Taenia solium cysticerci in the brain commonly known as neurocysticercosis is a cause to over 29% of all epileptic cases in endemic countries. Unfortunately, this infection can go unnoticed for over 10 years. The objective of this review was to characterize the diagnostic approaches accessible in endemic poor resource countries. The review sought literature from library catalogues and public databases for studies on epidemiology and diagnosis challenges of human cysticercosis. The search key words included “Taenia solium, T. solium cysticercosis, human cysticercosis, neurocysticercosis and diagnosis”. Most of the diagnostic procedures rely on serology. Neuroimaging tools which would confirm and thus enable the assessment of the burden of the disease in endemic countries are rarely used. Therefore assessing the estimate on prevalence and burden of the disease fallacious is owing to the low sensitivity of serological tools and the inhibition of humoral, cellular immune responses, inflammatory reaction and cytokines by the living cysticerci.
Cite this paper: Gamba Nkwengulila, G. (2014) A Review of Human Cysticercosis and Diagnostic Challenges in Endemic Resource Poor Countries. Advances in Infectious Diseases, 4, 207-213. doi: 10.4236/aid.2014.44029.

[1]   Michelet, L., Carod, J.F., Rakontondrazaka, M., Mac, L., Gayd, F. and Daugae, C. (2010) The Pig tapeworm Taenia solium, the Cause of Cysticercosis: Biogeographic (Temporal and Spacial) Origins in Madagascar. Molecular Phylogenetics and Evolution, 55, 744-750.

[2]   Michelet, L. and Dauga, C. (2012) Molecular Evidence of Host Influences on the Evolution and Spread of Human Tapeworms. Biological Reviews of the Cambridge Philosophical Society, 87, 731-741.

[3]   Markell, E.K., John, D.T. and Krotoski, W.A. (1999) Modern Pathology Markell and Voge’s Medical Parasitology. 8th Edition, W.B. Saunders, Philadelphia, 501.

[4]   Mwanjali, G., Kihamia, C., Kakoko, D., Lekule, F. and Ngowi, H. (2013) Prevalence and Risk Factors Associated with Human Taenia Solium Infections in Mbozi District, Mbeya Region, Tanzania. PLOS Neglected Tropical Diseases, 7, Article ID: E2102.

[5]   Mwang’onde, B.J. (2014) Epidemiology and Burden of Human Cysticercosis in Mbulu District, Tanzania. Ph.D. Thesis, University of Dar es Salaam, Tanzania.

[6]   Carabin, H., Bhattarai, R. and Budke, C. (2014) The Burden of Cysticercosis.

[7]   Yanagida, T., Sako, Y., Nakao, M., Nakaya, K. and Ito, A. (2012) Taeniasis and Cysticercosis Due to Taenia solium in Japan. Parasites & Vectors, 5.

[8]   Garcia, H.H., Gonzalez, A.E., Evans, C.A. and Gilman, R.H. (2003) Cysticercosis Working Group in Peru. Taenia solium Cystericercosis. Lancet, 362, 547-556.

[9]   Canas, N.M., Calado, S.L. and Vale, J. (2005) Treatment of Racemose Neurocysticercosis of the Spine. Revista de Neurología, 40, 544-547.

[10]   Schantz, P.M., Moore, A.C., Munoz, J.L., Hartman, B.J., Schaefer, J.A., Aron, A.M., Persaud, D., Sarti, E., Wilson, M. and Flisser, A. (1992) Neurocysticercosis in an Orthodox Jewish Community in New York City. New England Journal of Medicine, 327, 692-695.

[11]   Shandera, W.X. and Kassy, J.S. (2006) Neurocysticercosis: Current Knowledge and Advances. Current Neurology and Neuroscience Reports, 6, 453-459.

[12]   Moore, A.C., Larry, I.L., Schantz, P., Joy, B., Pilcher, M.W., Allen, W.H., Edward, K.C., Elfatih, I.M.A., Joyce, R.G., et al. (1995) Seroprevalence of Cysticercosis in an Orthodox Jewish Community. American Journal of Tropical Medicine and Hygiene, 53, 439-442.

[13]   Swastika, K., Dewiyani, C.I., Yanagida, T., Sako, Y., Sudarmaja, M., Sutisna, P., Wandra, T., Dharmawan, N.S., Nakaya, K., Okamoto, M., et al. (2012) An Ocular Cysticercosis in Bali, Indonesia Caused by Taenia solium Asian Genotype. Parasitology International, 61, 378-380.

[14]   Sorvillo, F., Wilkins, P., Shafir, S. and Eberhard, M. (2011) Public Health Implications of Cysticercosis Acquired in the United States. Emerging Infectious Diseases, 17, 1-6.

[15]   Anantaphruti, T.M., Yamasaki, H., Nakao, M., Waikagul, J., Wattanakulpanich, D., Nuamtanong, S., et al. (2007) Sympatric Occurrence of Taenia solium, T. saginaga, and T. asiatica, Thailand. Emerging Infectious Diseases, 13, 1413-1416.

[16]   Schantz, P.M., Wilkins, P.P. and Tsang, V.C.W. (1998) Immigrants, Imaging, and Immunoblots: The Emergence of Neurocysticercosis as a Significant Public Health Problem. In: Emerging Infections 2, ASM Press, Washington DC, 213-242.

[17]   Francis, H.P.R., Abdella, N.A., Gupta, R., Ai-Ali, F.M., Grover, S., Khalid, N., Abdeen, S., Iqbal, J., Wilson, M. and Tsang, V.C. (2004) Cysticercosis: Imported and Autochthonous Infections in Kuwait. Transactions of the Royal Society of Tropical Medicine and Hygiene, 98, 233-239.

[18]   WHO (2003) Control of Neurocysticercosis. Fifty-Sixth World Health Assembly.

[19]   Fregni, F. (2008) Taenia solium (Taeniasis/Cysticercosis). Collaborative Course on Infectious Diseases. Harvard School of Public Health, Boston.

[20]   Tolan, R.W. (2011) Taenia Infection. http://wwwtheinfectiousdiseasesdailycom/

[21]   Carabin, H., Cowan, L., Nash, T. and Willingham, A.L. (2014) Estimating the Global Burden of Taenia solium Cysticercosis/Taeniosis.

[22]   Zoli, A., Shey-Njila, O., Assana, E., Nguekam, J.P., Dorny, P., Brandt, J. and Geerts, S. (2003) Regional Status, Epidemiology and Impact of Taenia solium Cysticercosis in Western and Central Africa. Acta Tropica, 87, 35-42.

[23]   Cao, W.C., Van der, P.C.P., Gao, C.L., Xu, J.F., Cao, X.C., Cui, Z.H., Ren, Z.X. and Habbema, J.D. (1996) Seroprevalence and Risk Factors of Human Cysticercosis in a Community of Shandong, China. Southeast Asian Journal of Tropical Medicine and Public Health, 27, 279-285.

[24]   Raccurt, C.P., Agnamey, P., Boncy, J., Henrys, J.H. and Totet, A. (2009) Seroprevalence of Human Taenia solium Cysticercosis in Haiti. Journal of Helminthology, 83, 113-116.

[25]   IEN: Iternational Epilepsy News (2014) Taenia solium Tapeworms and Epilepsy in Uganda.

[26]   Winkler, A.S., Blocher, J., Auerd, H., Gotwalde, T., Matuja, W. and Schmutzhard, E. (2008) Anticysticercal and Antitoxocaral Antibodies in People with Epilepsy in Rural Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene, 102, 1032-1038.

[27]   Willingham III, A.L., Harrison, L.J., Fèvre, E.M. and Parkhouse, M.E. (2008) Inaugural Meeting of the Cysticercosis Working Group in Europe. Emerging Infectious Diseases, 14.

[28]   Allan, J.C., Wilkins, P.P., Tsang, V.C.W. and Craig, P.S. (2003) Immunodiagnostic Tools for Taeniasis. Acta Tropica, 87, 87-93.

[29]   Gonzalez, L.M., Montero, E., Puente, S., Lopez-Velez, R., Hernandez, M., Sciutto, E., Harrison, L.J., Parkhouse, R.M. and Garate, T. (2002) PCR Tools for the Differential Diagnosis of Taenia saginata and Taenia solium Taeniasis/Cysticercosis from Different Geographical Locations. Diagnostic Microbiology and Infectious Disease, 42, 243-249.

[30]   Feldman, M., Plancarte, A., Sandoval, M., Wilson, M. and Flisser, A. (1990) Comparison of Two Assays (EIA and EITB) and Two Samples (Saliva and Serum) for the Diagnosis of Neurocysticercosis. Transactions of the Royal Society of Tropical Medicine and Hygiene, 84, 559-562.

[31]   Gottstein, B., Zini, D. and Schantz, P.M. (1987) Species-Specific Immunodiagnosis of Taenia solium Cysticercosis by ELISA and Immunoblotting. Tropical Medicine and Parasitology, 38, 299-303.

[32]   Joshi, D.D., Bista, P.R., Ito, A. and Yamasaki, H. (2007) Present Situation of Porcine Taeniasis and Human Cysticercosis in Nepal. Southeast Asian Journal of Tropical Medicine and Public Health, 38, 144-150.

[33]   Panta, B. (2006) Neurocysticercosis: A Major Cause of Seizure in Nepal. In: Joshi, D.D., Sharma, M. and Rana, S., Eds., Present Situation Challenges in Treatment and Elimination of Taeniasis/-Cysticercosis in Nepal, National Zoonoses and Food Hygiene Research Center, Kathmandu, 55-68.

[34]   Mamkin, I., Sood, M.D.N. and Ramanan, S.V. (2011) Taenia solium Neurocysticercosis. New England Journal of Medicine, 357, 1666-1667.

[35]   Tran, D.S., Odermatt, P., Oanh, L.T., Huc, P., Poumindr, N., Ito, A., Druet-Cabanac, M., Preux, P.M. and Strobel, M. (2007) Risk Factors for Epilepsy in Rural Laos: A Case-Control Study. Southeast Asian Journal of Tropical Medicine and Public Health, 38.

[36]   Winkler, A.S., Mosser, P. and Schmutzhard, E. (2009) Neurological Disorders in Rural Africa: A Systematic Approach. Tropical Doctor, 39, 102-104.

[37]   Avode, D.G., Bouteille, B., Houngbe, F., Adjien, C., Adjide, C. and Houinato, D. (1998) Epilepsy, Cysticercosis and Neurocysticercosis in Benin. In: Winkler, A.S., Willingham III, A.L., Sikasunge, C.S. and Schmutzhard, E., Eds., Epilepsy and Neurocysticercosis in Sub-10 Saharan Africa, Springer-Verlag, Berlin, 19-20.

[38]   Nguekam, J.P., Zoli, A.P., Zogo, P.O., Kamga, A.C.T., Speybroeck, N., Dorny, P., et al. (2003) A Seroepidemiological Study of Human Cysticercosis in West Cameroon. Tropical Medicine & International Health, 8, 144-149.

[39]   Newell, E., Vyungimana, F., Geerts, S., Van Kerckhoven, I., Tsang, V.C. and Engels, D. (1997) Prevalence of Cysticercosis in Epileptics and Members of Their Families in Burundi. Transactions of the Royal Society of Tropical Medicine and Hygiene, 91, 389-391.

[40]   Houinato, D., Ramanankandrasana, B., Adjidé, C., Melaku, Z., Josse, R., Avodé, G., et al. (1998) Seroprevalence of Cysticercosis in Benin. Transactions of the Royal Society of Tropical Medicine and Hygiene, 92, 621-624.

[41]   Nsengiyumva, G., Druet-Cabanac, M., Ramanankandrasana, B., Bouteille, B., Nsizabira, L. and Preux, P.M. (2003) Cysticercosis as a Major Risk Factor for Epilepsy in Burundi, East Africa. Epilepsia, 44, 950-955.

[42]   Elsdon-Dew, R. (1964) Taeniasis in the Bantu. South African Medical Journal, 38, 974-976.

[43]   Heinz, H. and Macnab, G. (1965) Cysticercosis in the Bantu of Southern Africa. South African Journal of Medical Sciences, 30, 19-31.

[44]   Thomson, A., De Villiers J.C., Moosa, A. and Van Dellen, J. (1984) Cerebral Cysticercosis in Children in South Africa. Annals of Tropical Paediatrics, 4, 67-77.

[45]   Pammenter, M. and Rossouw, E. (1987) The Value of an Antigenic Fraction of Cysticercus Cellulosae in the Serodiagnosis of Cysticercosis. Annals of Tropical Medicine and Parasitology, 81, 117-123.

[46]   Mafojane, N.A., Appleton, C.C., Krecek, R.C., Michael, L.M. and Willingham, A.L. (2003) The Current Status of Neurocysticercosis in Eastern and Southern Africa. Acta Tropica, 87, 25-33.

[47]   Rachman, I. (1970) Epilepsy in African Hospital Practice. Central African Journal of Medicine, 16, 201-204.

[48]   Mason, P., Houston, S. and Gwanzura, L. (1992) Neurocysticercosis: Experience with Diagnosis by ELISA Serology and Computerised Tomography in Zimbabwe. Central African Journal of Medicine, 38, 149-154.

[49]   Vilhena, M., Santos, M. and Torgal, J. (1999) Seroprevalence of Human Cysticercosis in Maputo, Mozambique. American Journal of Tropical Medicine and Hygiene, 61, 59-62.

[50]   Afonso, S., Neves, L., Afonso, C., Nota, A., Vilhena, M. and Ito, A. (2001) Cysticercosus Cellulosae in Tete Province, Mozambique. Proceedings of the Workshop on Human Helminth Infections “Future Research Foci”, Lusaka, 5-9 March 2001, 32.

[51]   Michel, P., Callies, P., Raharison, H., Guyon, P., Holvoet, L. and Genin, C. (1993) Epidemiology of Cysticercosis in Madagascar. Bulletin de la Société de Pathologie Exotique, 86, 62-67.

[52]   Andriantsimahavandy, A., Lesbordes, J., Rasoaharimalala, B., Peghini, M., Rabarijaona, L., Roux, J. and Boisier, P. (1997) Neurocysticercosis: A Major Aetiological Factor of Late-Onset Epilepsy in Madagascar. Tropical Medicine & International Health, 2, 741-746.

[53]   Macharia, W., Ramanankandrasana, B., Druet-Cabanac, M., Nsengiyumva, G., Bouteille, B. and Preux, P.M. (2002) Kenya: A New Human Cysticercosis Focus. Letters. African Journal of Neuroscience.

[54]   García, H.H., Gilman, R.H., Gonzalez, A.E., Verastegui, M., Rodriguez, S., Gavidia, C., Tsang, V.C., Falcon, N., Lescano, A.G., Moulton, L.H., et al. (2003) Cysticercosis Working Group in Perú. Hyperendemic Human and Porcine Taenia solium Infection in Perú. American Journal of Tropical Medicine and Hygiene, 68, 268-275.

[55]   Del Brutto, O.H. (2012) Neurocysticercosis in a 2-Year-End b in Fected at Home. Pathogens and Global Health, 106.

[56]   Davis, L.E. (2005) “Neurocysticercosis” Emerging Neurological Infections. Taylor & Francis Group, Boca Raton, 261-287.

[57]   Flisser, A., Correa, D. and Evans, C.A.W. (2002) Taenia solium Cysticercosis: New and Revisited Immunological Aspects. In: Singh, G. and Prabhakar, S., Eds., Taenia solium Cysticercosis: From Basic to Clinical Science, CAB International, Wallingford, 15-24.

[58]   Molinari, J. and Tato, P. (2002) Molecular Determinants of Host-Parasite Interactions: Focus on Parasite. In: Singh, G. and Prabhakar, S., Eds., Taenia solium Cysticercosis: From Basic to Clinical Science, CAB International, Wallingford, 25-33.