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Review
. 2015 Jul 6;9(7):e0003919.
doi: 10.1371/journal.pntd.0003919. eCollection 2015.

Taenia Solium Human Cysticercosis: A Systematic Review of Sero-epidemiological Data From Endemic Zones Around the World

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Free PMC article
Review

Taenia Solium Human Cysticercosis: A Systematic Review of Sero-epidemiological Data From Endemic Zones Around the World

Marco Coral-Almeida et al. PLoS Negl Trop Dis. .
Free PMC article

Abstract

Background: Taenia solium cysticercosis is a zoonotic neglected disease responsible for severe health disorders such as seizures and death. Understanding the epidemiology of human cysticercosis (HCC) in endemic regions will help to expose critical information about the transmission of the disease, which could be used to design efficient control programs. This review gathered serological data on apparent prevalence of T. solium circulating antigens and/or seroprevalence of T. solium antibodies, apparent prevalence of human taeniasis and risk factors for HCC from endemic communities in order to understand the differences in exposure to the parasite and active infections with T. solium metacestodes in endemic areas around the world.

Methods: Three databases were used to search sero-epidemiological data from community-based studies conducted between 1989 and 2014 in cysticercosis endemic communities worldwide. The search focused on data obtained from T. solium circulating antigen detection by monoclonal antibody-based sandwich ELISA and/or T. solium antibody seroprevalence determined by Enzyme-linked Immunoelectrotransfer Blot (EITB). A meta-analysis was performed per continent.

Principal findings: A total of 39,271 participants from 19 countries, described in 37 articles were studied. The estimates for the prevalence of circulating T. solium antigens for Africa, Latin America and Asia were: 7.30% (95% CI [4.23-12.31]), 4.08% (95% CI [2.77-5.95]) and 3.98% (95% CI [2.81-5.61]), respectively. Seroprevalence estimates of T. solium antibodies were 17.37% (95% CI [3.33-56.20]), 13.03% (95% CI [9.95-16.88]) and 15.68% (95% CI [10.25-23.24]) respectively. Taeniasis reported prevalences ranged from 0 (95% CI [0.00-1.62]) to 17.25% (95% CI [14.55-20.23]).

Significance: A significant variation in the sero-epidemiological data was observed within each continent, with African countries reporting the highest apparent prevalences of active infections. Intrinsic factors in the human host such as age and immunity were main determinants for the occurrence of infections, while exposure was mostly related to environmental factors which varied from community to community.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram describing literature search and selection of studies (PRISMA 2009 flow chart).
Fig 2
Fig 2. Global distribution of the endemic countries where Ag-ELISA and/or EITB based epidemiological studies were held.
Light yellow represents the countries confirmed as endemic by the World Health Organization (WHO) until 2012 [66]. Circles represent the countries where Ag-ELISA based studies took place. Each color represents the average prevalence per country found from the selected articles in this review classified in 0 to 5 percent; 5 to 10 percent and more than 10 percent. Triangles represent the countries where EITB based studies took place. Each color represents the average prevalence per country found from the selected articles in this review classified in 0 to 5 percent; 5 to 10 percent and more than 10 percent.

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Grant support

This work was financially supported by the Belgian Cooperation in the framework of the Institutional Collaboration between the Institute of Tropical Medicine in Antwerp, Belgium and the Centro Internacional de Zoonosis, Quito-Ecuador. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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