Craig Philip, Ito Akira
Cestode Zoonoses Research Group, Biomedical Sciences Research Institute and School of Environment and Life Sciences, University of Salford, Greater Manchester, UK.
Curr Opin Infect Dis. 2007 Oct;20(5):524-32. doi: 10.1097/QCO.0b013e3282ef579e.
This review summarizes the biology, clinical aspects, diagnosis, treatment and epidemiology for the common and rarer (zoonotic) intestinal cestodes of humans.
Mass drug application to eliminate Taenia solium carriers may have only temporary effects on cysticercosis transmission. At least two major world genotypes of T. solium have been identified and greater genetic heterogeneity may occur at the regional level. A new human taeniid T. asiatica has been confirmed which occurs sympatrically with T. saginata and T. solium in Southeast Asia. Coproantigen and PCR tests for Taenia spp. have greatly improved diagnostic efficacy and epidemiological studies. There appears to be an increase in human diphyllobothriasis in Europe, Japan and the Americas.
Human intestinal cestode infections are globally primarily caused by species in three genera: Taenia, Hymenolepis or Diphyllobothrium. Sporadic zoonotic infections caused by nontaeniids are usually food-borne or due to accidental ingestion of invertebrate hosts. Intestinal cestode infections generally result in only mild symptoms characterized chiefly by abdominal discomfort and diarrhoea. Most human intestinal cestode infections can be treated with a single oral dose of praziquantel or niclosamide.
本综述总结了人类常见及罕见(人畜共患)肠道绦虫的生物学、临床特征、诊断、治疗及流行病学情况。
大规模药物应用以清除猪带绦虫携带者可能仅对囊尾蚴病传播产生暂时影响。已鉴定出至少两种主要的世界猪带绦虫基因型,且在区域层面可能存在更大的遗传异质性。一种新的人体带绦虫——亚洲带绦虫已得到确认,它在东南亚与牛带绦虫和猪带绦虫同域分布。针对带绦虫属的粪便抗原和聚合酶链反应检测极大地提高了诊断效率和流行病学研究水平。在欧洲、日本和美洲,人体阔节裂头绦虫病似乎有增加趋势。
全球范围内,人类肠道绦虫感染主要由三个属的物种引起:带绦虫属、膜壳绦虫属或裂头绦虫属。由非带绦虫属引起的散发性人畜共患感染通常是食源性的,或因意外摄入无脊椎动物宿主所致。肠道绦虫感染一般仅导致以腹部不适和腹泻为主的轻微症状。大多数人类肠道绦虫感染可用单剂量口服吡喹酮或氯硝柳胺进行治疗。