Epidemiologic study and control of Taenia solium infections with praziquantel in a rural village of Mexico

This study reports the results of an epidemiologic survey for the detection of Taenia solium in a rural village of 559 inhabitants in Sinaloa, Mexico, as well as a large scale treatment of the population with praziquantel. The study was carried out in two stages. In stage 1, serial stool analysis of 392 persons detected a cluster of three T. solium tapeworms. A fourth T. solium tapeworm was detected through a household census, giving a 1.32% prevalence rate for this helminth. Over 70% of the population over five years of age was treated with a 10 mg/kg dose of praziquantel, and no additional tapeworms were found. Environmental studies for the detection of Taenia sp. eggs in soil, water, and and objects from the houses of tapeworm-infected individuals showed only one soil sample containing eggs compatible with Taenia sp. A total of 72 domestic pigs were examined for the presence of cysticerci under the tongue. One animal had cysts, and belonged to a household that had two T. solium tapeworm infections. Stage 2 of the study was carried out one year after large scale antihelminthic treatment (LSAT), and no infections with Taenia sp. eggs were found. No cysticercus-infected pigs were detected. Intestinal parasitosis decreased from 69.2% to 37.5%. It is concluded that LSAT with praziquantel is efficient in decreasing endemic foci of T. solium. Seropositivity to T. solium bladder fluid antigens was tested by enzyme-linked immunosorbent assay and found to be 11% before LSAT and 7% one year later. In family members living with T. solium tapeworm carriers, the number of seropositive individuals was 28%. The relative risk ratio of seropositivity for persons living in the same household with a T. solium tapeworm carrier was 2.95. Positive response was significantly higher in the 30-39-year-old age group, in which 30% were seropositive in stage 1, compared with 7% one year after LSAT. High seropositivity rates were significantly associated with tapeworm clusters as well as with individuals with a clinical history of seizures.