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In countries where cysticercosis is endemic, the proportion of epilepsy due to cysticercosis is not well documented. To investigate the association between cysticercosis and epilepsy, we used the enzyme-linked immunoelectrotransfer blot (EITB) assay to detect serum antibodies to Taenia solium in 498 consecutive outpatients at a neurology clinic in Lima, Peru. Every patient was classified as epileptic (n = 189) or non-epileptic (n = 309) after neurological, and where possible electroencephalographic, examination. A substantially higher proportion of epileptic than nonepileptic patients was seropositive in the EITB (22 [12%] vs 8 [3%], p < 0·00l). 19% of epileptic patients born outside Lima, 20% of those with late-onset epilepsy, and 29% of patients with both these characteristics were seropositive. Thus, in Peru, cysticercosis is an important aetiological factor for epilepsy.

We used direct observer techniques to measure the frequency with which toddler-aged children were contaminated by poultry feces in homes in a peri-urban shanty town in Lima, Peru. The mean number of fowl was 5.4 (SD 3.1), with 10.0 (SD 10.7) poultry defecations per 12 hours. Toddlers' hand contact with poultry feces occurred a mean of 2.9 (SD 3.0) times/12 hours. A mean of 3.9 (SD 4.6) feces-to-mouth episodes per household/12 hours occurred both by direct hand-to-mouth contamination and indirectly by handling soiled objects which were then placed in the mouth. There was a strong correlation between feces-to-hand contamination and feces-to-mouth contamination (r = 0.94). There was also an IntroductionDiarrheal disease is an important factor in the infectionmalnutrition cycle of infants and young children in developing countries. In Peru, children under three years of age have a diarrheal incidence of 10 episodes per child-year, which can significantly affect their growth rates.' One important cause of diarrhea in Lima children less than one year of age is

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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...

Serum samples from sequential patients who underwent cerebral computed axial tomography (CT) scan in a Peruvian radiologic clinic were tested by the highly sensitive and specific enzyme-linked immunoelectrotransfer blot (EITB) test to detect antibodies to Taenia solium. The results of the EITB test were compared with those obtained by CT scan for the diagnosis of neurocysticercosis. Of the 383 patients sampled, 32 (8%) were seropositive. The results of CT and EITB were frequently discrepant. When compared with the EITB assay, the CT scan was 44% sensitive and 95% specific. The sensitivity of CT increased to 63% if less specific images (single calcifications, granulomas, or hydrocephalus) were included. The CT scan for diagnosis of cysticercosis can best be used in conjunction with a reliable serologic test such as the EITB.

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