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Taeniasis in Asia - an overview
Symposium (C) / Parasitology International 47 (Suppl.) (1998) 71-95
n
C-4. Emerging Zoonoses as Exemplified by Echinococcosis and Cysticercocis s-u-2
EVALUATION OF TWO INTERVENTION STRATEGIES FOR THE PREVENTION AND CONTROL OF TAENIA SOLJUM CY STICERCOSIS IN RURAL AREAS OF MEXICO
Elsa S&i*: Peter M. Schant.z**and Ana Flisser*** * Direction General de Epidemiolom&to National de Salud Publica, Sccretaria de Salud Mexico DF 11340 **Division of Parasitic Diseases. National Center for Infectious Diseases, Centers for Disease Control and Prevention. Atlanta, Georgia. ***Fact&ad de Medicina. Universidad National Autonoma de Mexico and Instituto National de Diagnostic0 y Referencia Epidemiologicos. Secretaria de Salud, Mexico DF I1340 An intervention study for evaluating control strategies against Taenia sodium was carried out in three rural communities in Mexico. Atotonilco received mass treatment with praziquantel (5 mg/kg, single dose). Chalcatzingo received health education and Tetelilla both intervention strategies. Demographic, epidemiologic& clinical, sanitary and sociological data from 98% of the inhabitants were obtained. Prevalence and incidence rates of taeniosis were measured by the frequency of Tuenia coproantigens and Taenia eggs in feces and for swine cysticercosis by palpating the surface of pig’s tongues and by the presence of serum antibodies. Changes in knowledge, attitudes and practices (KAP) in the communities were obtained from a questionnaire repared exprofesso and by direct observation of the interviewers be Pore, Immediately after, six months and 3 years after intervention strategies were implemented. In both communities that received praziquantel treatment, 68% instead of the 95% expected reduction of taeniosis was detected. Without education, swine cysticercosis had no significant changes. Where health education was provided, between SO and 100% reduction of swine cysticercosis and significant KAP changes were obtained. Without taenicidal treatment but with education, 56% reduction of taeniosis was seen. These results suggest that adequate educational programs are effective for Taenia solium control, while other alternatives for treatment, such as directed instead of massive should be evaluated.
s-c4-3
SCt&l.NlNGSANWU K&IS1tKS W tCIUNOCOCCoSIS MANAGEMFIU‘T A..2ND PLACEIN1-m SU!4M!WLLANCE OF TIlr. I)ISI:ASf.S
ci-CJ-6
TAENlASIS 1s ASIA - AN OVERVIEM’
Fan PC*, Ooi HK** *Institute of Parasitology, Taipei and **Department Chung Hsing University,
National Yangming University. of L’eterinary Medicine, National Taichung. Taiwan
Taenlasis in Asia is complicated by the existence of 7’aenia sodium, Taenia saginata and the so-called “Taiwan taenia”. The “Taiwan taenia “, which is transmitted to humans through the eating of pig liver, has been found in Taiwan, Korea, Thailand, The Philippines, Myanmar and Indonesia. It has been designated as T. saginata asiatica and the classical T. saginata as T. saginata saginata. Migrant workers in recent years may also contribure to reemerging taeniasis in their host countries. This is illustrated by a Myanmar migrant worker who had taeniasis saginata in Malaysia, a country where human taeniasis had not been reported for the past 2 decades. In 25 provinces of mainland China, the prevalence of taeniasis solium ranged from 0.06% to 2.01% and in some of these regions, over 30% of the pigs were found to have cysticercosis cellulosae. It was estimated that there were 3 million cases of human cysticercosis in mainland China. Rim & Rom reported finding cysticerci in liver of 256 (1.01%) pigs out of 25,358 stdughtered in Cheongju City, South Korea. Dharmawan also reported that out of 706 pigs slaughtered in Bali, Indonesia, 158 (22.37%) had cysticerci in their livers. On Bali Island, 0.8-23.0 96 of the population were reportedly infected with taeniasis and most of the expelled proglottids were similar to those of T. saginara. In north India, cysticerrosis ranged from OS-20% in humans and S-10% in pigs. Eggs of T. s. asiatica from Asia and T. s. saginata from Poland and Madagascar could develop to cysticerci in the liver of SEM pigs. However, human cysticercosis is never a problem in Asian Muslim communities and 7. s. asiatica and T. s. saginata do not cause human cysticercosis. In conclusion, taeniasis is not on11 detrimental to human health but also cause enormous economic loss in Asia through lost work days. S-(.-I-7 CYSTIC ECHINOCOCCOSIS IN URUGUAY
*Vunmn DA *Graudoux P. *Harraga S. *Bresson-Hadni S. **Slu DZ “Craig PS. ‘Banholomot B *WHO Collahoraung Center for Prexennon and Treatnlent of Human Echmocxcosis. and **assoclaled teams - F. 25n30 Besan$on.France.
Screemng programmes are essenual 10 evaluale the aclual malence of &seases and to allo\\ earl! therapeutic mtenenlion ahen the!_ are rare. severe. and a%mptomauc for a long tune as it is rhe case for alveolar cchu~o~occos~s (AE) Fxst mass screenmg programmes III AE ha\ e been developed III Hokkaido smce the sixnes and are still gomg on. nhh major results h terms of disclosed .AE cases and ~mpro\ed prognosn as 14 as tnfomxkm on ep&m!olog~cal trends In Europe. screening prognmmes. using serolo~. ha\e been performed m endennc areas of S~\nzerland. Germany and France. la Eastern France. \\e screened 12.(Io(l subjects from 1987 10 1993 : I2 cases of AE (8 e\olunve cases. 5 aborWe cases) nere hagnosed and treated Costeffkac! anal!s!s mdxated a reducuon of hospltalhnten’ennon costs in panents &agnosed at screening. compared to patrents \rith symptomatic cases. A rcglsler of human AE cases and data on ckfinitke and mtermed!ak hosts 1s currenll! developed 111Europe (EurEchunoReg) A second screening in the same populauon (19Y3-1998) disclosed 2 addnmnal cases. S!sremanc of all rropositi\e subjects !\nhout lesions at first ultrasonograph) exzmunauon.5 !ears after the I” screening. could find a ne\\ e~olutne case. a combmed I’)‘).# to 1997. \\e performed In Chma. from serolog\/ultmsaoograph~ screemng m 2732 subjects of a rural communn! m South Gansu A npxal lesmn of AE nas disclosed in 83 subjects and a high frequent! of h\er calcificatmns associated \\rth posinre serolog! u&cared thal abortne cases could also he frequent. Potential ‘“earl! cases” nere obsened in 40 SubJeCls. In bxh countries. these resulls xxre combmed nub ecologxal studxs and led 1o the hlpothesrs that AE n1 humans \xas related to mcxhfications of Ihe pamsrtic cycle 111~wture. hnked to human-related changes in environment. This anal?s,s and estabhshment of registers should help epidemiologtsls to pre&ct emergenceof lhe dsease in fulure !ears m areas sImilarI! mtified in thex environmental slrucnue
Carmona. C’, Cabrera, P”. Correa. o”, Haran, P”, Morana, A”, Patietti. S” Valledor S”, Perdomo, R’, CarM. A”‘. Aivarez. C’. Monti’. Grauert, R’,‘Stern, D’. Perera. G.““Lloyd, S”“‘, Gemmell. M’“” ‘Unidsd de Biologfa Parasitaria, Fecuitad de Ciencies, lnstituto de Higiene, Montevideo, Uruguay.“; Departamento de Parssitologla, Faculted de Veterinaria, Montevideo, Uruguay; “‘Clinica Radiomica, Fact&ad de Medicina, Montevideo, Uruguay; **** Depsrtamenteo de Matetiticss, Facultad de Ciencies, Montevideo, Uruguay and”‘*Deparhnent of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK Uruguay, an agricultural based country, belongs to a group of countries that are highly endemic for Echirwcoaxs granulosus. A research programme established to determine transmission dynamics and stability of E.grenufosus in Uruguay has shown that: a) E. gmnufosus is in the unstable endemic steady state contrasting the situation of Taenia hydafigena and T.ovi> both in the stable hyperendemic state. b) E. gram~losus and T. hydafipna were present in 13-14% of dogs, E. granulosus being absent from the dogs tested 2 months after treatment. c) Sonographic evidence of cystic echinococcosis wss found in 1.84 % of neariy 10.000 people studied and risk factors associated with the infection were determined. d) Simulated phases of a control programme had demonstrated that E. ~anulosus in Uruguay is amenable to control by means of &weekiy treatments of dogs with praziquantel and that transmission from dogs to sheep ceased within 1 year of the start of treatment. In this context, s control programme was started nationwide in IQ91 and the attack phase of the programme, based on a 4-weekty treatment of dogs, reached by 1997 a coverage of 97% of the territory and 75% of registered dogs.Latest official records on prevalence will be presented and discussed
n
C-4. Emerging Zoonoses as Exemplified by Echinococcosis and Cysticercocis s-u-2
EVALUATION OF TWO INTERVENTION STRATEGIES FOR THE PREVENTION AND CONTROL OF TAENIA SOLJUM CY STICERCOSIS IN RURAL AREAS OF MEXICO
Elsa S&i*: Peter M. Schant.z**and Ana Flisser*** * Direction General de Epidemiolom&to National de Salud Publica, Sccretaria de Salud Mexico DF 11340 **Division of Parasitic Diseases. National Center for Infectious Diseases, Centers for Disease Control and Prevention. Atlanta, Georgia. ***Fact&ad de Medicina. Universidad National Autonoma de Mexico and Instituto National de Diagnostic0 y Referencia Epidemiologicos. Secretaria de Salud, Mexico DF I1340 An intervention study for evaluating control strategies against Taenia sodium was carried out in three rural communities in Mexico. Atotonilco received mass treatment with praziquantel (5 mg/kg, single dose). Chalcatzingo received health education and Tetelilla both intervention strategies. Demographic, epidemiologic& clinical, sanitary and sociological data from 98% of the inhabitants were obtained. Prevalence and incidence rates of taeniosis were measured by the frequency of Tuenia coproantigens and Taenia eggs in feces and for swine cysticercosis by palpating the surface of pig’s tongues and by the presence of serum antibodies. Changes in knowledge, attitudes and practices (KAP) in the communities were obtained from a questionnaire repared exprofesso and by direct observation of the interviewers be Pore, Immediately after, six months and 3 years after intervention strategies were implemented. In both communities that received praziquantel treatment, 68% instead of the 95% expected reduction of taeniosis was detected. Without education, swine cysticercosis had no significant changes. Where health education was provided, between SO and 100% reduction of swine cysticercosis and significant KAP changes were obtained. Without taenicidal treatment but with education, 56% reduction of taeniosis was seen. These results suggest that adequate educational programs are effective for Taenia solium control, while other alternatives for treatment, such as directed instead of massive should be evaluated.
s-c4-3
SCt&l.NlNGSANWU K&IS1tKS W tCIUNOCOCCoSIS MANAGEMFIU‘T A..2ND PLACEIN1-m SU!4M!WLLANCE OF TIlr. I)ISI:ASf.S
ci-CJ-6
TAENlASIS 1s ASIA - AN OVERVIEM’
Fan PC*, Ooi HK** *Institute of Parasitology, Taipei and **Department Chung Hsing University,
National Yangming University. of L’eterinary Medicine, National Taichung. Taiwan
Taenlasis in Asia is complicated by the existence of 7’aenia sodium, Taenia saginata and the so-called “Taiwan taenia”. The “Taiwan taenia “, which is transmitted to humans through the eating of pig liver, has been found in Taiwan, Korea, Thailand, The Philippines, Myanmar and Indonesia. It has been designated as T. saginata asiatica and the classical T. saginata as T. saginata saginata. Migrant workers in recent years may also contribure to reemerging taeniasis in their host countries. This is illustrated by a Myanmar migrant worker who had taeniasis saginata in Malaysia, a country where human taeniasis had not been reported for the past 2 decades. In 25 provinces of mainland China, the prevalence of taeniasis solium ranged from 0.06% to 2.01% and in some of these regions, over 30% of the pigs were found to have cysticercosis cellulosae. It was estimated that there were 3 million cases of human cysticercosis in mainland China. Rim & Rom reported finding cysticerci in liver of 256 (1.01%) pigs out of 25,358 stdughtered in Cheongju City, South Korea. Dharmawan also reported that out of 706 pigs slaughtered in Bali, Indonesia, 158 (22.37%) had cysticerci in their livers. On Bali Island, 0.8-23.0 96 of the population were reportedly infected with taeniasis and most of the expelled proglottids were similar to those of T. saginara. In north India, cysticerrosis ranged from OS-20% in humans and S-10% in pigs. Eggs of T. s. asiatica from Asia and T. s. saginata from Poland and Madagascar could develop to cysticerci in the liver of SEM pigs. However, human cysticercosis is never a problem in Asian Muslim communities and 7. s. asiatica and T. s. saginata do not cause human cysticercosis. In conclusion, taeniasis is not on11 detrimental to human health but also cause enormous economic loss in Asia through lost work days. S-(.-I-7 CYSTIC ECHINOCOCCOSIS IN URUGUAY
*Vunmn DA *Graudoux P. *Harraga S. *Bresson-Hadni S. **Slu DZ “Craig PS. ‘Banholomot B *WHO Collahoraung Center for Prexennon and Treatnlent of Human Echmocxcosis. and **assoclaled teams - F. 25n30 Besan$on.France.
Screemng programmes are essenual 10 evaluale the aclual malence of &seases and to allo\\ earl! therapeutic mtenenlion ahen the!_ are rare. severe. and a%mptomauc for a long tune as it is rhe case for alveolar cchu~o~occos~s (AE) Fxst mass screenmg programmes III AE ha\ e been developed III Hokkaido smce the sixnes and are still gomg on. nhh major results h terms of disclosed .AE cases and ~mpro\ed prognosn as 14 as tnfomxkm on ep&m!olog~cal trends In Europe. screening prognmmes. using serolo~. ha\e been performed m endennc areas of S~\nzerland. Germany and France. la Eastern France. \\e screened 12.(Io(l subjects from 1987 10 1993 : I2 cases of AE (8 e\olunve cases. 5 aborWe cases) nere hagnosed and treated Costeffkac! anal!s!s mdxated a reducuon of hospltalhnten’ennon costs in panents &agnosed at screening. compared to patrents \rith symptomatic cases. A rcglsler of human AE cases and data on ckfinitke and mtermed!ak hosts 1s currenll! developed 111Europe (EurEchunoReg) A second screening in the same populauon (19Y3-1998) disclosed 2 addnmnal cases. S!sremanc of all rropositi\e subjects !\nhout lesions at first ultrasonograph) exzmunauon.5 !ears after the I” screening. could find a ne\\ e~olutne case. a combmed I’)‘).# to 1997. \\e performed In Chma. from serolog\/ultmsaoograph~ screemng m 2732 subjects of a rural communn! m South Gansu A npxal lesmn of AE nas disclosed in 83 subjects and a high frequent! of h\er calcificatmns associated \\rth posinre serolog! u&cared thal abortne cases could also he frequent. Potential ‘“earl! cases” nere obsened in 40 SubJeCls. In bxh countries. these resulls xxre combmed nub ecologxal studxs and led 1o the hlpothesrs that AE n1 humans \xas related to mcxhfications of Ihe pamsrtic cycle 111~wture. hnked to human-related changes in environment. This anal?s,s and estabhshment of registers should help epidemiologtsls to pre&ct emergenceof lhe dsease in fulure !ears m areas sImilarI! mtified in thex environmental slrucnue
Carmona. C’, Cabrera, P”. Correa. o”, Haran, P”, Morana, A”, Patietti. S” Valledor S”, Perdomo, R’, CarM. A”‘. Aivarez. C’. Monti’. Grauert, R’,‘Stern, D’. Perera. G.““Lloyd, S”“‘, Gemmell. M’“” ‘Unidsd de Biologfa Parasitaria, Fecuitad de Ciencies, lnstituto de Higiene, Montevideo, Uruguay.“; Departamento de Parssitologla, Faculted de Veterinaria, Montevideo, Uruguay; “‘Clinica Radiomica, Fact&ad de Medicina, Montevideo, Uruguay; **** Depsrtamenteo de Matetiticss, Facultad de Ciencies, Montevideo, Uruguay and”‘*Deparhnent of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK Uruguay, an agricultural based country, belongs to a group of countries that are highly endemic for Echirwcoaxs granulosus. A research programme established to determine transmission dynamics and stability of E.grenufosus in Uruguay has shown that: a) E. gmnufosus is in the unstable endemic steady state contrasting the situation of Taenia hydafigena and T.ovi> both in the stable hyperendemic state. b) E. gram~losus and T. hydafipna were present in 13-14% of dogs, E. granulosus being absent from the dogs tested 2 months after treatment. c) Sonographic evidence of cystic echinococcosis wss found in 1.84 % of neariy 10.000 people studied and risk factors associated with the infection were determined. d) Simulated phases of a control programme had demonstrated that E. ~anulosus in Uruguay is amenable to control by means of &weekiy treatments of dogs with praziquantel and that transmission from dogs to sheep ceased within 1 year of the start of treatment. In this context, s control programme was started nationwide in IQ91 and the attack phase of the programme, based on a 4-weekty treatment of dogs, reached by 1997 a coverage of 97% of the territory and 75% of registered dogs.Latest official records on prevalence will be presented and discussed