Taeniasis and Cysticercosis in Honduras : epidemiological, serological, and clinical aspects

Detta är en avhandling från Stockholm : Karolinska Institutet, Microbiology and Tumor Biology Center (MTC)

Sammanfattning: Taenia solium taeniasis and cysticercosis are recognised as important and increasing public health problems in Latin America. These infections not only have a significant socio-economical impact due to chronic morbidity, decreased productivity of affected persons, high cost of medical diagnosis and treatment, but also cause economical losses due to the condemnation of infected pork meat. In order to obtain baseline data to determine the actual prevalence of T. solium infections in Honduras, a number of epidemiological and clinical studies were undertaken. The methodology used included collection of epidemiological data, enzyme-linked immunoelectrotransfer blot (EITB) assay to detect specific antibodies, Ritchie's technique for taeniasis diagnosis, neurological evaluation, computed tomography (CT), and electro-encephalograms. In two rural villages (Agua Caliente, n=562; and Salama, n=480), antibody prevalences of 34%, and 17%, and taeniasis prevalences of 2% and 2.5%, were recorded, respectively. Both communities could be considered hyperendemic for T. solium. In Salama, a case control study revealed that 21% of the inhabitants had lesions compatible with NCC, and that the presence of a tapeworm carrier in the household could be a risk factor for acquiring NCC. The CT was proven to be a better diagnostic procedure to assess the number of cases of NCC than EITB. Also in Salama, 27% of 192 pigs examined were seropositive, suggesting that environmental contamination with T. solium eggs was very high. An urban study conducted in Tegucigalpa, Honduras, demonstrated that 16% of 404 individuals investigated were seropositive. Two (0.6%) cases of taeniasis were identified, both in individuals who had recently migrated from rural areas. In a clinical study in Tegucigalpa, NCC was established as definitive diagnosis in 23% and as probable diagnosis in 53%, of 60 neurological patients. Also, NCC was established as the cause of epilepsy in at least 19% of epileptic patients. These studies demonstrated that Taenia solium taeniasis and cysticercosis are highly prevalent in rural as well as in urban areas of Honduras; that NCC is an important aetiology for epilepsy, and that porcine cysticercosis is affecting an important proportion of the pig population.

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