Survey of Obstetrician-Gynecologists in the United States About Taeniasis and Cysticercosis

Abstract

An estimated 50 million persons worldwide are infected with cysticerci, the larval forms of the Taenia solium tapeworm. Neurocysticercosis can cause seizures, epilepsy, and hydrocephalus, and fatal cases have been reported in the United States in immigrants and in travelers returning from endemic countries. Pregnant women with symptomatic neurocysticercosis present treatment challenges, whereas those with the adult tapeworm infection (i.e., taeniasis) can put their infants and other family members, as well as obstetrician-gynecologists and their staff, at risk for cysticercosis. A questionnaire developed by the American College of Obstetricians and Gynecologists was sent to a representative sample of 1,000 physicians to assess their awareness of T. solium infection and the potential for it to be encountered in an obstetrics and gynecology setting. In total, 31.4% of respondents correctly answered that taeniasis is caused by eating undercooked pork containing T. solium cysts (95% confidence interval [CI] = 26.6-36.5). While only 14.5% (95% CI = 11.0-18.6) of respondents correctly answered that cysticercosis is acquired by ingesting tapeworm eggs shed in human stools, twice that number (30.3%; 95% CI = 25.5-35.3) correctly answered that a mother with taeniasis can cause cysticercosis in her infant. Practicing in a state in which cysticercosis was reportable at the time of the survey was not significantly associated with answering any of the 12 knowledge questions correctly. Overall, knowledge of T. solium infection among U.S. obstetricians-gynecologists is limited. This may result in missed opportunities to diagnose and treat pregnant women with taeniasis, which may put family members and obstetrics clinical staff at risk for cysticercosis.

Atenção à puérpera com neurocisticercose e seu recém-nascido: relato de experiência

“…Benefícios e riscos da terapia antiparasitária durante a gestação devem ser discutidos com a paciente, porém se a condição clínica for grave o suficiente tal que justifique seu uso, o tratamento de escolha é com praziquantel em detrimento ao albendazol, uma vez que este último apresenta um perfil teratogênico maior 2, 13 . Os corticosteroides podem ser usados na gravidez, se necessários, e devem ser associados à terapia antiparasitária para controle do edema secundário à resposta imune aos parasitas em degeneração, contudo devem ser evitados em pacientes com calcificações devido à piora dos sintomas após a diminuição gradual da medicação 13,14 .…”