title: Detection of Taenia solium taeniasis coproantigen is an early indicator of treatment failure for taeniasis.
abstract: Taenia solium causes taeniasis and cysticercosis, a zoonotic complex associated with a significant burden of epilepsy in most countries. Reliable diagnosis and efficacious treatment of taeniasis are needed for disease control. Currently, cure can be confirmed only after a period of at least 1 month, by negative stool microscopy. This study assessed the performance of detection by a coproantigen enzyme-linked immunosorbent assay (CoAg-ELISA) for the early evaluation of the efficacy of antiparasitic treatment of human T. solium taeniasis. We followed 69 tapeworm carriers who received niclosamide as standard treatment. Stool samples were collected on days 1, 3, 7, 15, 30, and 90 after treatment and were processed by microscopy and CoAg-ELISA. The efficacy of niclosamide was 77.9% (53/68). Thirteen patients received a second course of treatment and completed the follow-up. CoAg-ELISA was therefore evaluated for a total of 81 cases (68 treatments, 13 retreatments). In successful treatments (n = 64), the proportion of patients who became negative by CoAg-ELISA was 62.5% after 3 days, 89.1% after 7 days, 96.9% after 15 days, and 100% after 30 days. In treatment failures (n = 17), the CoAg-ELISA result was positive for 70.6% of patients after 3 days, 94.1% after 7 days, and 100% after 15 and 30 days. Only 2 of 17 samples in cases of treatment failure became positive by microscopy by day 30. The presence of one scolex, but not multiple scolices, in posttreatment stools was strongly associated with cure (odds ratio [OR], 52.5; P < 0.001). CoAg-ELISA is useful for the assessment of treatment failure in taeniasis. Early assessment at day 15 would detect treatment failure before patients become infective.
authors.affiliation: Department of Microbiology and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Javier A
authors.initials: JA
authors.lastname: Bustos
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodriguez
authors.forename: Juan A
authors.initials: JA
authors.lastname: Jimenez
authors.forename: Luz M
authors.initials: LM
authors.lastname: Moyano
authors.forename: Yesenia
authors.initials: Y
authors.lastname: Castillo
authors.forename: Viterbo
authors.initials: V
authors.lastname: Ayvar
authors.forename: James C
authors.initials: JC
authors.lastname: Allan
authors.forename: Philip S
authors.initials: PS
authors.lastname: Craig
authors.forename: Armando E
authors.initials: AE
authors.lastname: Gonzalez
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Victor C W
authors.initials: VC
authors.lastname: Tsang
authors.forename: Hector H
authors.initials: HH
authors.lastname: Garcia
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage; D000947:Antigens, Helminth / Q000032:analysis*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D016903:Drug Monitoring / Q000379:methods; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005243:Feces / Q000737:chemistry* / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009534:Niclosamide / Q000008:administration & dosage; D010274:Parasitology / Q000379:methods*; D011446:Prospective Studies; D041201:Taenia solium / Q000276:immunology*; D013622:Taeniasis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000947:Antigens, Helminth; D009534:Niclosamide