High frequency of Taenia solium antigen positivity in patients admitted for neurological disorders in the Rural Hospital of Mosango, Democratic Republic of Congo

BMC Infectious Diseases

Andrea S. Winkler¹  Pierre Dorny²  Barbara Barbé³  Emmanuel Bottieau³  Jan Jacobs⁴  Marleen Boelaert⁵  Kristien Verdonck⁵  Sarah Gabriël⁶  François Chappuis⁷  Jean-Roger Lilo Kalo⁸  Pascal Lutumba⁹  Deby Mukendi⁹  Cedric P. Yansouni^1,10 

[1] Center for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany;Center for Global Health, University of Oslo, Oslo, Norway;Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium;Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;Department of Veterinary Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium;Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland;Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo;Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo;Départment de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;JD MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada;

关键词: Neurocysticercosis;    Taenia solium;    Neurology;    Serological test;    Democratic Republic of Congo;    Cross-sectional study;   

DOI  :  10.1186/s12879-021-06032-8

来源: Springer

【 摘 要 】

BackgroundThe epidemiology of human cysticercosis and neurocysticercosis, caused by the larval stage of the pork tapeworm Taenia solium, is not well known in the Democratic Republic of Congo (DRC). Within a multicenter etiological and diagnostic study conducted by the NIDIAG consortium (“Better Diagnosis for Neglected Infections”) and investigating several challenging syndromes, we consecutively evaluated from 2012 to 2015 all patients older than 5 years presenting with neurological disorders (neurology cohort) and with fever > 7 days (persistent fever cohort) at the rural hospital of Mosango, province of Kwilu, DRC. In both cohorts, etiological diagnosis relied on a systematic set of reference laboratory assays and on pre-established clinical case definitions. No neuroimaging was available in the study hospital. In this study, we determined the frequency of T. solium infection in both cohorts and explored in the neurology cohort its association with specific neurological presentations and final etiological diagnoses.MethodsWe conducted a post-hoc descriptive and analytic study on cysticercosis in the neurology and persistent fever cohorts, based on the presence in serum samples of circulating T. solium antigen using the B158/B60 enzyme-linked immunosorbent assay (ELISA) and of cysticercosis IgG using the LDBIO Cysticercosis Western Blot IgG assay.ResultsFor the neurology cohort, 340 samples (of 351 enrolled patients) were available for analysis (males: 46.8%; mean age: 38.9 years). T. solium antigen positivity was found in 43 participants (12.6%; 95% confidence interval [CI] 9.3–16.7%), including 9 of 60 (15%) patients with epilepsy. Among the 148 samples available from the persistent fever cohort (males: 39.9%; mean age: 19.9 years), 7 were positive in the T. solium antigen ELISA (4.7%; 95% CI 1.9–9.5%; P = 0.009 when compared to the neurology cohort). No significant association was found within the neurology cohort between positivity and clinical presentation or final diagnoses. Of note, the IgG antibody-detecting assay was found positive in only four (1.3%) of the participants of the neurology cohort and in none of the persistent fever cohort.ConclusionsT. solium antigen positivity was found in at least 10% of patients admitted with neurological disorders in the Kwilu province, DRC, with no specific pattern of presentation. Further neuroimaging studies should be used to confirm whether neurocysticercosis is prevalent in this region.

【 授权许可】

CC BY