The systemic reaction to severe trauma and/or infection, acute phase response (APR), are often associated with immunosuppression and reactivation of chronic latent infection. Our main purpose was to verify, in a group of 71 autopsied chronic chagasic with or without APR, the frequency of T. cruzi nests in the central vein of adrenal gland (CVAG). APR, defined by: 1) death secondary to sepsis and/or trauma plus, 2) bleeding stress gastric ulcerations or 3) spleen reactional state or 4) liver steatosis, was observed in 30 chronic chagasic (APR+). Weight, height and body mass index (BMI) were obtained. APR(+) chronic chagasic had worse nutritional status than APR(-) ones: weight = 49.0 vs 54.5 kg; BMI = 17.5 vs 20.6 kg/m2 (median p < 0.05). CVAG T. cruzi nests frequency were similar (43.3% and 43.9%, respectively) between both Groups. We conclude that APR(+) chronic chagasic had worse nutritional status than APR(-) ones, and that APR development did not change the CVAG T. cruzi nests frequency.

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

An epidemiological inquiry of humancysticercosis due to Taenia solium was carried out in Lagamar, Minas Gerais State, Brazil, in 1992. A survey of 1109 houses with 3344 inhabitants was made. The inquiry included 875 (86%) families and the questionnaire was answered by an informer, who was the father in 80% of the cases. One hundred pigsties, sheltering 406 swines in extremely precarious conditions, were found in 100 (11.4%) houses. A history on taeniasis in some member of the family was verified in 300 (34.2%) houses. A history of seizures was referred to by 125 (14.2%) of families. The outset of convulsion in adult age was characterized in 39 (37.8%) families. A history of mental disorder was reported in 53 (6.0%) of houses. Stool examinations were positive for Taenia spp in 24 (1.3%) of samples examined.

A clinic-epidemiological enquiry was conducted on in an endemic area for teniasis-cysticercosis. From the whole population 1080 (32.2%) individuals were examined. We found 198 (18.3%) individuals referring teniasis-bearing in the past, and 103 (9.5%) affirming to have had convulsions, either in the past or present. From the last group, 39 (37.8%) indicated that the crisis had begun in adulthood. From the group of patients presenting convulsions, 62 (62%) had laboratory tests performed. Computed tomography showed intracranial calcifications in 21 (33.8%) patients, variable in number and location, suggesting neurocysticercosis and no evidence of disease activity. Electroencephalograms showed abnormal waves in 21 (33.8%) patients and cerebrospinal fluid analyses were altered in 27 (43.5%) cases, having detected eosinophils only in 3 (4.8%) patients. Spinal fluid tests for cysticercosis through enzyme linked immunosorbent assay (ELISA) or indirect immunofluorescence were taken in only 26 (41.9%) patients, obtaining positive results in 6 (23%) samples. Varying upward shifts of protein levels were found in spinal fluid analysis. Assuming that all epidemiologic risk factors for teniasis-cysticercosis in the studied region and its correlation with the laboratory alterations described in convulsing crisis, a prevalence of 1.9% for neurocysticercosis was found.

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