Hyperendemicity of cysticercosis in Madagascar: Novel insights from school children population-based antigen prevalence study

Abstract

Objective Taenia solium (Ts) cysticercosis is a neglected zoonotic disease particularly prevalent in Madagascar. Few data are available for children, current data mainly rely on antibody prevalence. We sought to determine the Ts-antigen seroprevalence–determining active cysticercosis—amongst school children from various cities in Madagascar (excluding the capital) and evaluated associated risk factors. Methods In seven cities in Madagascar, the presence of cysticercosis in school children (n = 1751) was investigated in 2007 using the B158/B60 antigen (Ag)-ELISA. Results The overall prevalence based on Ag detection was 27.7% [95%CI: 10–37%]. Risk factors associated with Ag positivity were age, biotope, altitude and annual average rainfall. Conclusion These results highlight the high prevalence of active cysticercosis in Madagascar among school children in an urban setting. This high prevalence as well as the risk factors unraveled point to the emergency to implement appropriate Public Health measure son a national scale.

Seropositivity to Cysticercosis in School-Age Children Living in a Low-Income Municipality in the Midwest Region of Brazil

“…In Mali, 8% of the 805 serum samples from students aged 4–17 years were IgG-positive for the GST-rT24H T. solium antigen, as analyzed by the multiplex bead assay ( 24 ). In Madagascar, the prevalence of antigens detected by Ag-ELISA was 27.7% in the general population, with a high prevalence of active CC among schoolchildren in an urban setting ( 25 ).…”

Confirmation by necropsy of a high prevalence of porcine cysticercosis in a rural district of Madagascar

“…Taenia solium is endemic in Madagascar, where it has been reported since 1901 (Migliani et al ., 2000 ; Carod and Dorny, 2020 ). Neurocysticercosis is widespread in Madagascar (Andriantsimahavandy et al ., 2003 ), with infection levels in school-aged children a particular concern (Zafindraibe et al ., 2017 ; Carod et al ., 2021 ). It is the main cause of secondary childhood epilepsy (Carod and Dorny, 2020 ) and a major cause of late-onset epilepsy (Andriantsimahavandy et al ., 1997 ) in Madagascar.…”