Sarti E, Schantz P M, Plancarte A, Wilson M, Gutierrez I O, Lopez A S, Roberts J, Flisser A
Division of Parasitic Diseases, Centers For Disease Control, Atlanta, Georgia.
Am J Trop Med Hyg. 1992 Jun;46(6):677-85. doi: 10.4269/ajtmh.1992.46.677.
In a Mexican village in which Taenia solium infection was known to be endemic, we selected a cluster sample of 368 households (21% of the total) for demographic, environmental, and diagnostic surveys, and medical histories for taeniasis and cysticercosis. Coproparasitologic studies of 1,531 participants revealed infection by Taenia sp. in four (0.3%) individuals; however, 5.8% of the respondents reported a history of having passed tapeworm proglottids in feces. Of 1,552 human serum specimens, 10.8% tested positive in the cysticercosis immunoblot assay. Seropositivity increased with age and reached a maximum in subjects ages 46-55 years. Risk factors associated with seropositivity included a history of passing tapeworm proglottids, frequent consumption of pork, and poor personal and household hygiene (P less than 0.05). A history of seizures was also significantly associated with seropositivity (P less than 0.05); approximately one-third of persons with such histories were seropositive. Of 571 pigs examined by tongue inspection, 23 (4.0%) had cysticerci; infection rates increased with the age of pigs, and were higher in pigs that habitually ran loose or were fed human feces (P less than 0.05). Goodness of fit analysis confirmed that seropositive persons (but not infected pigs) were significantly clustered within households, particularly, in households in which a member reported a history of having passed tapeworm proglottids. The results of this study have identified community behavioral and environmental practices that must be modified to prevent continued transmission of cysticercosis and taeniasis.
在一个已知有猪带绦虫感染流行的墨西哥村庄,我们选取了368户家庭的整群样本(占总数的21%)进行人口统计学、环境及诊断调查,以及关于绦虫病和囊尾蚴病的病史调查。对1531名参与者进行的粪便寄生虫学研究显示,有4人(0.3%)感染了带绦虫属;然而,5.8%的受访者报告有粪便中排出绦虫节片的病史。在1552份人体血清标本中,10.8%在囊尾蚴病免疫印迹试验中呈阳性。血清阳性率随年龄增长而升高,在46 - 55岁的人群中达到最高。与血清阳性相关的危险因素包括排出绦虫节片的病史、经常食用猪肉以及个人和家庭卫生状况差(P < 0.05)。癫痫病史也与血清阳性显著相关(P < 0.05);有此类病史的人中约三分之一血清呈阳性。在通过舌检检查的571头猪中,有23头(4.0%)有囊尾蚴;感染率随猪的年龄增长而升高,在习惯放养或用人类粪便喂养的猪中更高(P < 0.05)。拟合优度分析证实,血清阳性者(而非感染猪)在家庭中显著聚集,特别是在有成员报告有排出绦虫节片病史的家庭中。本研究结果确定了必须改变的社区行为和环境习惯,以防止囊尾蚴病和绦虫病的持续传播。