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Individuals diagnosed with neurocysticercosis often present with epilepsy and sometimes with progressively worsening severe chronic headaches (WSCH). While cross-sectional associations between seropositivity to cysticercal antigens and epilepsy have been reported, few large scale studies have been conducted in West Africa and none have measured the association between seropositivity to cysticercal antigens and headaches. This study aimed at filling these knowledge gaps by estimating the strength of the cross-sectional association between seropositivity to cysticercal antigens and the prevalence of epilepsy and WSCH in 60 villages of Burkina Faso, West Africa. Baseline data from a cluster randomized controlled trial collected from January 2011 to February 2012 in 60 villages across three provinces in Burkina Faso were used. Between 78 and 80 individuals were screened for epilepsy and WSCH in each village, and those screened positive were confirmed by a physician. Seventy-five percent of all participants were asked to provide a blood sample to test for Taenia solium cysticercus circulating antigens. Hierarchical multivariable logistic models were used to measure the association between seropositivity to cysticercal antigens and epilepsy (lifetime and active) as well as WSCH. Among 3696 individuals who provided a blood sample, 145 were found to have epilepsy only, 140 WSCH only and 19 both. There were positive associations between seropositivity to cysticercal antigens and active epilepsy (prevalence odds ratio (POR): 2.40 (95%CI: 1.15-5.00)) and WSCH (POR: 2.59 (1.34-4.99)). Our study is the first to demonstrate a cross-sectional association between seropositivity to cysticercal antigens and WSCH in a large community-based study conducted in West Africa. The measured cross-sectional association had a strength similar to the ones previously observed between seropositivity to cysticercal antigens and lifetime or active epilepsy. As a result, preventing new cysticercosis cases in communities may reduce the prevalence of these two important neurological disorders.

Porcine cysticercosis is caused by a zoonotic tapeworm, Taenia solium, which causes serious disease syndromes in human. Effective control of the parasite requires knowledge on the burden and pattern of the infections in order to properly direct limited resources. The objective of this study was to establish the spatial distribution of porcine cysticercosis in Mbulu district, northern Tanzania, to guide control strategies. This study is a secondary analysis of data collected during the baseline and follow-up periods of a randomized community trial aiming at reducing the incidence rate of porcine cysticercosis through an educational program. At baseline, 784 randomly selected pig-keeping households located in 42 villages in 14 wards were included. Lingual examination of indigenous pigs aged 2-12 (median 8) months, one randomly selected from each household, were conducted. Data from the control group of the randomized trial that included 21 of the 42 villages were used for the incidence study. A total of 295 pig-keeping households were provided with sentinel pigs (one each) and reassessed for cysticercosis incidence once or twice for 2-9 (median 4) months using lingual examination and antigen ELISA. Prevalence of porcine cysticercosis was computed in Epi Info 3.5. The prevalence and incidence of porcine cysticercosis were mapped at household level using ArcView 3.2. K functions were computed in R software to assess general clustering of porcine cysticercosis. Spatial scan statistics were computed in SatScan to identify local clusters of the infection. The overall prevalence of porcine cysticercosis was 7.3% (95% CI: 5.6, 9.4; n = 784). The K functions revealed a significant overall clustering of porcine cysticercosis incidence for all distances between 600 m and 5 km from a randomly chosen case household based on Ag-ELISA. Lingual examination revealed clustering from 650 m to 6 km and between 7.5 and 10 km. The prevalence study did not reveal any significant clustering by this method. Spatial scan statistics found one significant cluster of porcine cysticercosis prevalence (P = 0.0036; n = 370). In addition, the analysis found one large cluster of porcine cysticercosis incidence based on Ag-ELISA (P = 0.0010; n = 236) and two relatively small clusters of incidence based on lingual examination (P = 0.0012 and P = 0.0026; n = 241). These clusters had similar spatial location and included six wards, four of which were identified as high risk areas of porcine cysticercosis. This study has identified local clusters of porcine cysticercosis in Mbulu district, northern Tanzania, where limited resources for control of T. solium could be directed. Further studies are needed to establish causes of clustering to institute appropriate interventions.

The infection of the nervous system by the cystic larvae of Taenia solium (neurocysticercosis) is a frequent cause of seizure disorders. Neurocysticercosis is endemic or presumed to be endemic in many low-income countries. The lifecycle of the worm and the clinical manifestations of neurocysticercosis are well established, and CT and MRI have substantially improved knowledge of the disease course. Improvements in immunodiagnosis have further advanced comprehension of the pathophysiology of this disease. This knowledge has led to individualised treatment approaches that account for the involvement of parenchymal or extraparenchymal spaces, the number and form of parasites, and the extent of degeneration and associated inflammation. Clinical investigations are focused on development of effective treatments and reduction of side-effects induced by treatment, such as seizures, hydrocephalus, infarcts, and neuroinjury.

Zoonotic infections can be controlled by interceding in the animal host. This report describes elimination of T. solium infection from a region in Peru through intervention in the pig–human cycle; such intervention should diminish complications from cysticercosis in the future. Infection of the human brain by cystic larvae of the pork tapeworm species Taenia solium is the most frequent cause of late-onset seizures and epilepsy in the world. 1 , 2 Transmission is sustained in rural areas through a pig–human cycle in which humans harbor the adult intestinal tapeworm (taeniasis) and pigs carry the cystic larvae in their flesh (cysticercosis). In poor, rural villages, domestic pig husbandry and lack of sanitation allow pigs to become infected by consuming human feces containing tapeworm eggs. In turn, humans acquire taeniasis by consuming pork contaminated with larval cysts or acquire neurocysticercosis through incidental ingestion of . . .

We report a case of Taenia solium taeniasis in a 10-year-old child in Timor-Leste, confirmed by molecular analysis, suggesting T. solium transmission to humans is occurring in Timor-Leste. Proactive measures are needed to improve public understanding of prevalence, geographic spread, and health implications of human taeniasis and cysticercosis in Timor-Leste.

Autochthonous neurocysticercosis is exceptionally rare in Western Europe. We describe multiple brain lesions, initially mimicking metastases, in a 60-year-old man in Spain without travel history. We confirmed diagnosis by neuroimaging and positive serology. Our study highlights cryptic local Taenia solium nematode transmission risks and diagnostic challenges in nonendemic regions.

Taenia solium is responsible for a substantial global disease burden in pig-raising and pork-consuming regions of the developing world. The study assessed the reported spatial pattern of Taenia solium taeniosis and cysticercosis (TSTC) in Kenya, with the focus on risk mapping of TSTC in Busia County. The study employed a mixed approach, incorporating routinely collected data and open-source resources. A literature review and collection of pig population data were used to map the TSTC and pig population distribution at the national level. In Busia County, the retrospective study retrieved reports on porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) from hospitals and meat inspection records. The cross-sectional study assessed risk behaviors associated with TSTC in Busia County. The TSTC reports and proportions of porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) were aggregated at the county and sub-county levels and visualized using QGIS. In addition, the World Health Organization's (WHO's) T. solium mapping tool was employed for risk mapping T. solium in Busia County. The pig population data showed a linear growth trend, with a higher population reported in Central and Western Kenya. A systematic search of the literature yielded a total of fourteen research reports, with the reported cases ranging from 1.8% to 49.9% for porcine cysticercosis, 1.6% to 31.1% for human cysticercosis, and 0.18% to 19.9% for T. solium taeniosis, respectively. The retrospective data showed cases of porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) in all sub-counties of Busia. The WHO risk mapping tool categorized Bunyala, Teso South, Nambale, and Butula sub-counties as high-risk areas. The questionnaire survey highlighted semi-confinement as the predominant pig husbandry practice (61.1%), with 32% of pigs having access to sewage, and there was poor community awareness about TSTC in Busia County. The study indicated the presence of TSTC transmission in Western Kenya and identified Busia County as a high-risk area based on multiple layers of evidence. This mixed approach utilized readily available data to generate new evidence that could support sustainable One Health strategies for interrupting the T. solium transmission cycle.

Neurocysticercosis (NCC), a parasitic brain infection caused by Taenia solium larvae, remains a leading cause of preventable epilepsy globally. Although calcified brain lesions were formerly considered as the quiescent end stage of NCC, they may act as epileptogenic foci. It has been suggested that parasitic antigens within calcified lesions may act as potential triggers of inflammation and subsequent seizure activity. In this study, we developed and optimized immunohistochemistry (IHC) assays employing anti-Taenia solium monoclonal antibodies (mAbs) to detect residual cyst antigens in calcified lesions in a porcine NCC model and assessed antigen persistence for up to 12 months after successful antiparasitic treatment. Six mAbs raised against T. solium whole cyst (TsW5, TsW8, and TsW12), vesicular fluid (TsV3 and TsV4), and excretory/secretory products (TsE1) were used for IHC assay development and tested in brain sections containing viable brain cysts from NCC pigs and uninfected tissue from controls to optimize assay conditions, blocking, primary and secondary antibody dilutions. Optimized assays were subsequently performed in selected calcified granulomas (n = 20) obtained from NCC-infected pigs sacrificed at 4, 8, and 12 months after antiparasitic treatment to identify residual cyst antigens as well as their localization and area of reactivity. We observed residual cyst antigens in 65-80% of calcified granulomas, with TsW8 and TsV3 showing the highest percentages of immunoreactivity. Antigen localization followed two patterns, one with antigens entirely located within the calcified lesions (TsW5, TsW8, TsW12, and Tsv4) and another with antigens located outside the cyst in the perilesional brain tissue (TsV3 and TsE1). Antigen detection and the extent of reactivity declined progressively after antiparasitic treatment but persisted at detectable immunoreactive areas in calcified granulomas up to month 12 months after treatment. T. solium antigens remain detectable in calcified granulomas and in the perilesional tissue for up to 12 months after antiparasitic treatment in the pig model.

Neurocysticercosis (NCC) is a major public health concern in low-middle-income countries. Subarachnoid NCC (SANCC), a less frequent form of NCC, is characterized by severe clinical evolution, high mortality and impactful neurological sequelae in survivors. However, due to a long pre-clinical period, early diagnosis and treatment of SANCC would likely improve the clinical course and reduce the occurrence of complications. To date, data on the prevalence of SANCC in endemic settings are scant, and there are no commercially available tests for SANCC screening in at-risk populations. Between October 2023 and May 2024, we conducted a population-based cross-sectional study aimed at implementing a non-invasive screening for SANCC in a low-resource area of the Plurinational State of Bolivia, using a home-made Ag-ELISA urine assay based on the monoclonal antibody set TsW5-TsW8. Questionnaires were also administered to the study population to assess the presence of behaviors and risk factors for active transmission of Taenia solium in the area. The study involved 1,232 subjects aged ≥10 years, 1,130 of whom delivered a urine sample. Among them, a median age of 27.4 years was observed, with 38.1% of subjects being males. Overall, 7 subjects with positive urine antigen test, confirmed on two different samples, were identified and underwent magnetic resonance imaging. The diagnosis of SANCC was radiologically confirmed in 4/7 subjects, for a prevalence of SANCC in the enrolled population of 3.54/1,000. The antigen assay showed a positive predictive value for SANCC of 57.1%. Risk factors for active transmission of T. solium, such as lack of access to adequate sanitation and the widespread practice of domestic pig breeding and sacrifice, were frequent. While further studies are needed to better define the diagnostic performance of the employed urine assay, this study confirms the presence of SANCC in the study area, consistent with evidence from similar endemic settings.

Taenia solium (T. solium), is a zoonotic helminth causing three diseases namely; taeniasis (in humans), neurocysticercosis (NCC, in humans) and porcine cysticercosis (PCC, in pigs) and is one of the major foodborne diseases by burden. The success or failure of control options against this parasite in terms of reduced prevalence or incidence of the diseases may be attributed to the contextual factors which underpin the design, implementation, and evaluation of control programmes. The study used a mixed method approach combining systematic literature review (SLR) and key informant interviews (KII). The SLR focused on studies which implemented T. solium control programmes and was used to identify the contextual factors and enabling environment relevant to successful inception, planning and implementation of the interventions. The SLR used a protocol pre-registered at the International prospective register of systematic reviews (PROSPERO) number CRD42019138107 and followed PRISMA guidelines on reporting of SLR. To further highlight the importance and interlinkage of these contextual factors, KII were conducted with researchers/implementers of the studies included in the SLR. The SLR identified 41 publications that had considerations of the contextual factors. They were grouped into efficacy (10), effectiveness (28) and scale up or implementation (3) research studies. The identified contextual factors included epidemiological, socioeconomic, cultural, geographical and environmental, service and organizational, historical and financial factors. The enabling environment was mainly defined by policy and strategies supporting T. solium control. Failure to consider the contextual factors operating in target study sites was shown to later present challenges in project implementation and evaluation that negatively affected expected outcomes. This study highlights the importance of fully considering the various domains of the context and integrating these explicitly into the plan for implementation and evaluation of control programmes. Explicit reporting of these aspects in the resultant publication is also important to guide future work. The contextual factors highlighted in this study may be useful to guide future research and scale up of disease control programmes and demonstrates the importance of close multi-sectoral collaboration in a One Health approach.