[Cysticercosis: a frequent and redoubtable parasitic disease].
Cysticercosis is due to development of the larval form of Taenia solium, Cysticercus cellulosae in human tissue. It is widespread in developing countries especially in rural areas where it is endemic. Larval invasion of the central nervous system constitutes a dreadful complication. The incidence of this worldwide disease is underestimated in French-speaking Black Africa; the Indian ocean region has one of the highest incidences with Madagascar reporting a seroprevalence of 18% in 1994. It is estimated that 50 million people are infected in the world with 50,000 deaths a year. "Taenia solium carriers" play a major role in transmitting the disease to their immediate entourage even if the initial contamination of the carrier was due to infestation of pork. A wide range of epileptic manifestations can and often do constitute the first signs of neurocysticercosis which has been estimated to be the cause of epilepsy in two thirds of cases. This fact explains the numerous neuro-epidemiologic studies have been undertaken. In industrialized countries computeur tomodensitometry and magnetic resonance imaging are widely used for diagnosis and follow-up but immunologic diagnosis is most common in developing countries since medical imaging techniques are generally unavailable. The immuno-enzymatic method provides a basis for suspicion of infection and immuno-electrotranfer-blot allows diagnosis of progression of the disease to a stage at which cestocide treatment is active. New agents against cysticercoids that can circulate in the central nervous system (praziquantel, albendazole) have greatly improved the prognosis of neurocysticercosis. Massive single-dose treatment with praziquantel is especially useful in developing countries since taeniasis is rarely diagnosed in Taenia solium carriers. Persistent efforts to prevent contamination of pork have eradicated the infection in industrialized countries and diminished seroprevalence in others (Reunion Island). Cysticercosis is a major public health problem in developing countries. Systematic detection of the hotbeds and application of adequate control measures are needed.
Aubry
P
P
l'Institut de Médecine Tropicale du Service de Santé des Armées, France.
Bequet
D
D
Queguiner
P
P
D000349:Africa / Q000453:epidemiology; D003551:Cysticercosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans
La cysticercose: une maladie parasitaire fréquente et redoutable.