Institut Pasteur de Madagascar, Immunology of Infectious Diseases Unit, Antananarivo, Madagascar.
Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America.
PLoS Negl Trop Dis. 2022 Apr 11;16(4):e0010265. doi: 10.1371/journal.pntd.0010265. eCollection 2022 Apr.
Infections with the tapeworm Taenia solium (taeniosis and cysticercosis) are Neglected Tropical Diseases (NTD) highly endemic in Madagascar. These infections are however underdiagnosed, underreported and their burden at the community level remains unknown especially in rural remote settings. This study aims at assessing the prevalence of T. solium infections and associated risk factors in twelve remote villages surrounding Ranomafana National Park (RNP), Ifanadiana District, Madagascar.
A community based cross-sectional survey was conducted in June 2016. Stool and serum samples were collected from participants. Tapeworm carriers were identified by stool examination. Taenia species and T. solium genotypes were characterised by PCR and sequencing of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Detection of specific anti-cysticercal antibodies (IgG) or circulating cysticercal antigens was performed by ELISA or EITB/Western blot assays.
Of the 459 participants with paired stool and blood samples included ten participants from seven distinct villages harbored Taenia spp. eggs in their stools samples DNA sequencing of the cox1 gene revealed a majority of T. solium Asian genotype (9/10) carriage. The overall seroprevalences of anti-cysticercal IgGs detected by ELISA and EITB were quite similar (27.5% and 29.8% respectively). A prevalence rate of 12.4% of circulating cysticercal antigens was observed reflecting cysticercosis with viable cysts. Open defecation (Odds Ratio, OR = 1.5, 95% CI: 1.0-2.3) and promiscuity with households of more than 4 people (OR = 1.9, 95% CI: 1.1-3.1) seem to be the main risk factors associated with anticysticercal antibodies detection. Being over 15 years of age would be a risk factor associated with an active cysticercosis (OR = 1.6, 95% CI: 1.0-2.7). Females (OR = 0.5, 95% CI: 0.3-0.9) and use of river as house water source (OR = 0.3, 95% CI: 0.1-1.5) were less likely to have cysticercosis with viable cysts.
CONCLUSIONS/SIGNIFICANCE: This study indicates a high exposure of the investigated population to T. solium infections with a high prevalence of cysticercosis with viable cysts. These data can be useful to strengthen public health interventions in these remote settings.
在马达加斯加，带绦虫（囊虫病和囊尾蚴病）感染是被忽视的热带病（NTD）的高度地方性疾病。然而，这些感染的诊断率低，报告率低，其在社区层面的负担仍然未知，尤其是在农村偏远地区。本研究旨在评估在马达加斯加拉努马法纳国家公园（RNP）周边的十二个偏远村庄中，猪带绦虫感染及其相关危险因素的流行情况。
2016 年 6 月进行了一项基于社区的横断面调查。从参与者中采集粪便和血清样本。通过粪便检查确定带绦虫携带者。通过聚合酶链反应（PCR）和线粒体细胞色素 c 氧化酶亚单位 1（cox1）基因的测序来鉴定绦虫种类和猪带绦虫基因型。通过酶联免疫吸附试验（ELISA）或 EITB/Western blot 检测特定的抗囊尾蚴抗体（IgG）或循环囊尾蚴抗原。
在 459 名有配对粪便和血液样本的参与者中，有 10 名来自七个不同村庄的参与者粪便样本中存在带绦虫属虫卵。cox1 基因的 DNA 测序显示，大多数为猪带绦虫亚洲基因型（9/10）携带。通过 ELISA 和 EITB 检测到的抗囊尾蚴 IgG 的血清阳性率非常相似（分别为 27.5%和 29.8%）。检测到循环囊尾蚴抗原的流行率为 12.4%，反映出有活囊尾蚴的囊尾蚴病。露天排便（优势比，OR = 1.5，95%可信区间：1.0-2.3）和与超过 4 人家庭的混居（OR = 1.9，95%可信区间：1.1-3.1）似乎是与抗囊尾蚴抗体检测相关的主要危险因素。年龄超过 15 岁可能是与活囊尾蚴有关的感染风险因素（OR = 1.6，95%可信区间：1.0-2.7）。女性（OR = 0.5，95%可信区间：0.3-0.9）和使用河水作为家庭用水来源（OR = 0.3，95%可信区间：0.1-1.5）不太可能患有有活囊尾蚴的囊尾蚴病。
结论/意义：本研究表明，该人群接触猪带绦虫感染的风险很高，囊尾蚴病的流行率很高，且有活囊尾蚴。这些数据可用于加强这些偏远地区的公共卫生干预措施。
