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Objective To develop a better understanding on mechanisms of seizures and long-term epileptogenesis caused by neurocysticercosis. Methods A workshop was held bringing together experts in epilepsy and epileptogenesis and neurocysticercosis Results Human neurocysticercosis and parallel animal models offer a unique opportunity to understand basic mechanisms of seizures. Inflammatory responses to degenerating forms and in later stage calcified parasite granulomas are associated with seizures and epilepsy. Other mechanisms may also be involved in epileptogenesis as well. Conclusions Naturally occurring brain infections with neurocysticercosis offer a unique opportunity to develop treatments for one of the world’s most common causes of epilepsy and for the development of more general anti-epileptogenic treatments. Key advantages stem from the time course where an acute seizure heralds a start of the epileptogenic process and radiographic changes of calcification and perilesional edema provide biomarkers of a chronic epileptic state.

Taeniasis diagnosis is an important step in the control and elimination of both cysticercosis and taeniasis. We report the development of 2 serological taeniasis diagnostic tests using recombinant antigens rES33 and rES38 expressed by baculovirus in insect cells in an EITB format. In laboratory testing with defined sera from nonendemic areas, rES33 has a sensitivity of 98% (n = 167) and a specificity of 99% (n = 310) (J index: 0.97); rES38 has a sensitivity of 99% (n = 146) and a specificity of 97% (n = 275) (J index: 0.96). Independent field testing in Peru showed 97% (n = 203) of the taeniasis sera were positive with rES33, and 100% of the nontaeniasis sera (n = 272) were negative with rES33; 98% (n = 198) of taeniasis sera were positive with rES38, and 91% (n = 274) of the nontaeniasis sera were negative with rES38. Among the Peruvian sera tested, 17 of 26 Peruvian Taenia saginata sera were false positive with rES38 test. Both tests were also examined with cysticercosis sera, with a positive rate ranging from 21% to 46%. rES33 and rES38 tests offer sensitive and specific diagnosis of taeniasis and easy sample collection through finger sticks that can be used in large-scale studies. They are currently being used in cysticercosis elimination programs in Peru.

To determine the prevalence of cysticercosis in a rural area where the disease is endemic, the authors studied the seroepidemiology of human and porcine cysticercosis in a Peruvian jungle community (Maceda, Peru) in 1988 using an enzyme-linked immunoelectrotransfer blot (EITB) assay. Of the 371 sampled inhabitants, 30 (8%) were seropositive, most of whom were asymptomatic. After niclosamide therapy, four Taenia species worms were identified in the seropositive group, compared with one in the control group (p = 0.06). Pigs were frequently infected: 44 of 133 (33%) were found positive for Taenia by tongue examination and 57 of 133 (43%) were positive by EITB. In 69% of the sampled households that had pigs, there was at least one seropositive pig. The number of pigs diagnosed positive by the tongue examination was significantly greater in households that had latrines than in those that did not. Cysticercosis is a common but usually asymptomatic infection that affects both humans and pigs in the high jungle areas of Peru. Keywords cysticercosis; environmental monitoring; immunoblotting; swine; Taenia; toilet facilities; transfer blot Cysticercosis is a disease endemic in most developing countries where pigs are raised (1). In both Mexico and Peru, more than 10 percent of neurologic patients receiving acute care have serologic evidence of Taenia solium infection (2, 3). Humans acquire cysticercosis by ingesting T. solium eggs from human feces either directly or indirectly, through contaminated food or water. The eggs mature into larvae, which invade the intestinal wall, Copyright © 1992 Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts muscle, brain, and other tissues. Pigs also acquire cysticercosis in the same manner. Humans develop taeniasis after ingesting raw or poorly cooked pork or beef that contains the larval form of T. solium or Taenia saginata. Larvae invaginate the small intestine of humans and develop into adult tapeworms. The tapeworm produces eggs after 3 months and may survive for years, thus spreading cysticercosis in both humans and pigs (4, pages 609-25).Rational programs to control cysticercosis cannot be developed until the epidemiology of the disease is better understood. The true incidence of cysticercosis in both human and pig populations is unknown. The prevalence of porcine infection, based on meat inspections in Mexican slaughterhouses, has been estimated at 0.005-10 percent (5). However, many infected pigs are raised by small farmers, who often sell their pigs in informal markets where meat inspection is not performed. Since governmental and international agencies base their statistics for porcine cysticercosis on slaughterhouse statistics (6, 7), clandestine sale of meat results in a considerable underestimation of the true prevalence rates of porcine cysticercosis. For example, in Huancayo, a city of 500,000 inhabitants in the highlands of Peru, no pigs were registered as infected with cysticercosis (8), yet field surveys revealed that more than 30 per...

Cystic echinococcosis (CE) caused by the larval form of Echinococcus granulosus is a major public health problem in sheep-raising regions of the World. This study compared portable ultrasound with the enzyme-linked immunoelectrotransfer blot (EITB) assay as screening methods to estimate the prevalence of human CE in a remote village in the Peruvian Andes. Three hundred eighty-nine villagers were examined by portable ultrasound and blood samples were drawn by venipuncture. Sera were collected and tested for antibodies against CE using an EITB assay. Cystic lesions were classified based on their ultrasound morphologic characteristics. The prevalence of human CE using portable ultrasound and the EITB assay were 4.9% and 2.6%, respectively. Fifty-three percent of subjects with CE were EITB positive. Portable ultrasound was well received by the community, augmented CE detection and allowed a faster estimate of human infection than the EITB assay.

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Neurocysticercosis, an endemic parasitic disease in most developing countries, is caused by Taenia solium and compromises the human central nervous system. Cathepsin L-like proteases are secreted by several parasites including T. solium and constitute important antigens for immunodiagnostics. A protein fraction with cathepsin L-like activity was purified from the cysticercus fluid by size exclusion and ion exchange chromatography. Cathepsin L-like activity was measured fluorometrically by detecting the hydrolysis of the fluorogenic substrate Z-Phe-Arg-AMC. The purified protein fraction included antigens of 53 and 25 kD that were tested in a Western immunoblot and in an enzyme-linked immunosorbent assay (ELISA) for detection of human cysticercosis. The sensitivity of the Western immunoblot was 96% for patients infected with multiple cysts and 78% for patients with a single cyst. Specificity was 98%. The sensitivity of the ELISA was 98% in patients with multiple cysts and 84% in patients with a single cyst. Specificity was 92.7%.

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