title: Prevalence and risk factors associated with human Taenia solium infections in Mbozi District, Mbeya Region, Tanzania.
abstract: BACKGROUND
  Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania.
  
  
  RESULTS
  A cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0.05).
  
  
  CONCLUSIONS
  The present study indicates T. solium infection in humans is highly endemic in the southern highlands of Tanzania.
authors.affiliation: School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Gloria
authors.initials: G
authors.lastname: Mwanjali
authors.forename: Charles
authors.initials: C
authors.lastname: Kihamia
authors.forename: Deodatus Vitalis Conatus
authors.initials: DV
authors.lastname: Kakoko
authors.forename: Faustin
authors.initials: F
authors.lastname: Lekule
authors.forename: Helena
authors.initials: H
authors.lastname: Ngowi
authors.forename: Maria Vang
authors.initials: MV
authors.lastname: Johansen
authors.forename: Stig Milan
authors.initials: SM
authors.lastname: Thamsborg
authors.forename: Arve Lee
authors.initials: AL
authors.lastname: Willingham
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D000947:Antigens, Helminth / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D041201:Taenia solium / Q000302:isolation & purification*; D013622:Taeniasis / Q000453:epidemiology* / Q000469:parasitology; D013636:Tanzania / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014881:Water Supply; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth; D000947:Antigens, Helminth