Taenia solium cysticercosis hotspots surrounding tapeworm carriers: clustering on human seroprevalence but not on seizures.
BACKGROUND
Neurocysticercosis accounts for 30%-50% of all late-onset epilepsy in endemic countries. We assessed the clustering patterns of Taenia solium human cysticercosis seropositivity and seizures around tapeworm carriers in seven rural communities in Peru.


METHODS
The presence of T. solium-specific antibodies was defined as one or more positive bands in the enzyme-linked immunoelectrotransfer blot (EITB). Neurocysticercosis-related seizures cases were diagnosed clinically and had positive neuroimaging or EITB.


RESULTS
Eleven tapeworm carriers were identified by stool microscopy. The seroprevalence of human cysticercosis was 24% (196/803). Seroprevalence was 21% >50 m from a carrier and increased to 32% at 1-50 m (p = 0.047), and from that distance seroprevalence had another significant increase to 64% at the homes of carriers (p = 0.004). Seizure prevalence was 3.0% (25/837) but there were no differences between any pair of distance ranges (p = 0.629, Wald test 2 degrees of freedom).


CONCLUSIONS
We observed a significant human cysticercosis seroprevalence gradient surrounding current tapeworm carriers, although cysticercosis-related seizures did not cluster around carriers. Due to differences in the timing of the two outcomes, seroprevalence may reflect recent T. solium exposure more accurately than seizure frequency.
Lescano
Andres G
AG
United States Naval Medical Research Center Detachment, Public Health Training Program (AGL) and Virology Program (SMM), Lima, Perú.
Garcia
Hector H
HH
Gilman
Robert H
RH
Gavidia
Cesar M
CM
Tsang
Victor C W
VC
Rodriguez
Silvia
S
Moulton
Lawrence H
LH
Villaran
Manuel V
MV
Montano
Silvia M
SM
Gonzalez
Armando E
AE
D000293:Adolescent; D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D002353:Carrier State / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003551:Cysticercosis / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D012640:Seizures / Q000453:epidemiology* / Q000469:parasitology; D016036:Seroepidemiologic Studies; D041201:Taenia solium / Q000276:immunology*
D000909:Antibodies, Helminth