Weka Rebecca Paul, Kamani Joshua, Cogan Tristan, Eisler Mark, Morgan Eric R
Parasitology Division, National Veterinary Research Institute, PMB 01 Vom, Plateau State, Nigeria; Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, United Kingdom.
Parasitology Division, National Veterinary Research Institute, PMB 01 Vom, Plateau State, Nigeria.
Acta Trop. 2019 Feb;190:329-338. doi: 10.1016/j.actatropica.2018.12.012. Epub 2018 Dec 7.
Human and porcine cysticercosis is endemic in West Africa, where epilepsy is relatively common, but rarely reported due to fear of stigmatization. Neurocysticercosis, caused by Taenia solium, tends to affect the poor in developing countries and control is hampered by inadequate infrastructure and financial resources coupled with lack of adequate information about its significance and distribution. The risk factors for human cysticercosis are closely associated with the characteristics of smallholder or backyard pig farming systems prevalent in this region. Poverty, ignorance and lack of political will militate against successful eradication, while tools for effective diagnosis, prevention and treatment, including vaccines for pigs, are not yet available in many countries. Cysticercosis was targeted for control by The World Health Organization global plan for 2008-2015; however, measures for control are yet to be undertaken in a coordinated manner in West Africa. Diagnostic tools, including neuroimaging facilities, should be strategically situated and made accessible to rural populations in West Africa. Community education in combination with a multipronged approach consisting of vaccination of pigs using TSOL18 vaccine and treatment with oxfendazole along with mass chemotherapy of humans with praziquantel could eliminate taeniasis and should be considered. In-depth and extensive epidemiological studies are required in West Africa in order to fully elucidate the prevalence of T. solium and to support more coordinated and effective control of human and porcine cysticercosis.
人和猪囊尾蚴病在西非呈地方性流行,那里癫痫相对常见,但由于担心受到污名化而很少报告。由猪带绦虫引起的神经囊尾蚴病往往影响发展中国家的贫困人口,基础设施和财政资源不足,加上缺乏关于其重要性和分布的充分信息,阻碍了该病的控制。人类囊尾蚴病的危险因素与该地区普遍存在的小农或家庭养猪系统的特点密切相关。贫困、无知和缺乏政治意愿不利于成功根除该病,而许多国家尚未具备有效的诊断、预防和治疗工具,包括猪用疫苗。囊尾蚴病是世界卫生组织2008 - 2015年全球计划的控制目标;然而,西非尚未以协调的方式采取控制措施。包括神经影像设施在内的诊断工具应合理布局,以便西非农村人口能够使用。结合多管齐下的方法开展社区教育,包括使用TSOL18疫苗给猪接种疫苗、用奥芬达唑进行治疗以及用吡喹酮对人群进行大规模化疗,可消除绦虫病,应予以考虑。西非需要开展深入广泛的流行病学研究,以充分阐明猪带绦虫的流行情况,并支持对人和猪囊尾蚴病进行更协调有效的控制。