RESUMO
A two-phase study was conducted in a rural community in Honduras, to evaluate the association between neurocysticercosis (NCC) diagnosed by computed tomography (CT), epilepsy, seropositivity for antibodies to the cysticerci of Taenia solium [determined by enzyme-linked-immunoelectrotransfer-blot (EITB) assays], intestinal infection with this parasite, and various epidemiological factors. Of the 480 individuals studied in the first phase, 17% were seropositive and 2.5% supplied faecal samples which contained T. solium eggs. In the second phase, 148 individuals (74 of the seropositive subjects from the first phase and 74 matched controls from the seronegatives) underwent CT and neurological examinations. The CT results appeared normal in 110 (74%) of the 148, showed anatomical abnormality in seven (5%), and active or calcified lesions compatible with NCC in 31 (23% of the seropositives and 19% of the seronegatives). Only five of the latter had neurological symptoms (two being epileptics) and only five lived in households in which intestinal taeniasis had been detected. Subject age was significantly associated with NCC-compatible lesions but all the other factors investigated, including seropositivity, showed no significant association with the CT findings. The overall sensitivity of the EITB assays was found to be 55%. Taken together, the present results indicate that, even though it is a valuable tool in determining transmission levels in sero-epidemiological studies, the EITB assay should not be used to predict the existence of NCC or to estimate the prevalence of NCC. The results do provide further evidence that taeniasis and cysticercosis are widely prevalent in Honduras, and indicate that much larger studies of hyper-endemic communities may be necessary if the factors associated with the transmission of T. solium are to be elucidated.
Assuntos
Intestinos/parasitologia , Taenia , Teníase/diagnóstico , Teníase/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anticorpos Anti-Helmínticos/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Cisticercose/diagnóstico , Cisticercose/epidemiologia , Ensaio de Imunoadsorção Enzimática/métodos , Fezes/parasitologia , Feminino , Honduras/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurocisticercose/diagnóstico , Neurocisticercose/epidemiologia , Contagem de Ovos de Parasitas , Prevalência , Estudos Soroepidemiológicos , Tomografia Computadorizada por Raios XRESUMO
Several retrospective studies have shown that human Taenia solium cysticercosis is endemic in Honduras, but very few reports of porcine cysticercosis in rural communities have been published. To determine the local prevalence of this disease in pigs, a serological survey has been undertaken in a rural community, Salamá, in the Department of Olancho in central Honduras. Eighty-five families raising pigs in the community were randomly selected and sera were obtained from pigs older than one month of age. The sera were examined by the enzyme-linked immunoelectrotransfer blot assay (EITB). Of 192 porcine sera, 27.1% (52) were positive by the EITB. Seropositivity did not correlate with age and sex by statistical analysis. With respect to the number and the frequency of recognition of the seven diagnostic glycoprotein bands in the EITB, 67.3% of the positive serum specimens recognized only one band and 80.8% of them recognized GP42-39. Since recognition of GP42-39 has been reported as a characteristic of late infection, these results suggest that most of the seropositive pigs were in the late stage of infection (more than 5-8 weeks postinfection). It seems that pigs in this community may be infected with this parasite soon after the birth and be in a hyperendemic steady state. In view of a high prevalence of antibodies to T. solium in pigs or characteristics of the antigen detected by the EITB, the infection pressure of T. solium appears to be very high in this community. This is probably the case in most of the communities in Honduras.