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Am. J. Trop. Med. Hyg., 68(3), 2003, pp. 268-275
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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HYPERENDEMIC HUMAN AND PORCINE TAENIA SOLIUM INFECTION IN PERÚ

HÉCTOR H. GARCÍA, ROBERT H. GILMAN, ARMANDO E. GONZALEZ, MANUELA VERASTEGUI, SILVIA RODRIGUEZ, CESAR GAVIDIA, VICTOR C. W. TSANG, NESTOR FALCON, ANDRES G. LESCANO, LAWRENCE H. MOULTON, TERESA BERNAL, AND MARCO TOVAR and The Cysticercosis Working Group in Perú*
Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Perú; Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Perú; Departments of International Health and Biostatistics, Johns Hopkins University School of Hygiene and Public Health, Baltimore; Asociacion Benefica PRISMA, Lima, Perú; School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta.

The prevalence and characteristics of human taeniasis/cysticercosis and porcine cysticercosis were assessed in an endemic area of the Peruvian highlands. Individuals from 10 communities had stool examinations (N = 2,951) and serologic testing for Taenia solium antibodies (N = 2,583). The total porcine population present (N = 703) was also examined by serology. Cysticercosis is hyperendemic in this area and is associated with an important number of seizure cases. Human seroprevalence by village ranged from 7.1–26.9% (mean, 13.9%). Seroprevalence was higher among individuals with a history of seizures but not in those reporting a history of headache or intestinal taeniasis. Prevalence of taeniasis ranged from 0–6.7% (median, 2.5%). Coproantigen detection found 2.4 times more taeniasis cases than did microscopy (direct and after concentration). Age distribution for taeniasis showed a peak at younger ages than for seroprevalence. Porcine seroprevalence ranged from 42–75%. Random effects logistic regression models for human seropositivity demonstrated both in-house clustering of cases and a large increase in risk associated with a tapeworm carrier in the house. Besides confirming the close relationship between taeniasis and cysticercosis cases, this large-scale field study demonstrated early age of tapeworm and cysticercosis infections in humans, and short duration of taeniasis infections.


Received November 15, 2001. Accepted for publication June 27, 2002.

Acknowledgments: We thank the residents of Quilcas who made it possible to perform this study. Help from the personnel of the Laboratory of Cysticercosis of the Instituto Nacional de Ciencias Neurologicas, Laboratory of Pathology of the Universidad Peruana Cayetano Heredia, and the Facultad de Medicina Veterinaria of the Universidad Nacional Mayor de San Marcos, J. B. Phu and D. Sara in sample management and data collection is also acknowledged.

Financial support: This study was funded by grants number 1-U-19-A145431-01, ABC and ITREID from the National Institutes of Health and the Fogarty Foundation.

Authors’ addresses: H. H. Garcia and M. Verastegui, Department of Microbiology, Universidad Peruana Cayetano Heredia, Av. H. Delgado 430, S.M.P., Lima 31, Peru, E-mail: hgarcia{at}terra.com.pe. R. H. Gilman, L. M. Moulton and A. G. Lescano, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Room 3501, Baltimore, MD 21205. A. E. Gonzalez, C. Gavidia, N. Falcon and T. Bernal, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Av. Circunvalacion s/n, Salamanca de Monterrico, Lima, Peru. S. Rodriguez, Cysticercosis Unit, Instituto de Ciencias Neurologicas, Jiron Ancash 1271, Barrios Altos, Lima 1, Peru. M. Tovar, A. B. PRISMA, C. Gonzalez 251, Maranga, San Miguel, Lima, Peru. V. C. W. Tsang, Immunology Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail Stop F-13, Atlanta, GA 30333.

Reprint requests: Robert H. Gilman, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, 615 N. Wolfe Street, Room 3501, Baltimore, MD 21205. Phone: 410-614-3639, Fax: 410-614-6060, E-mail: rgilman{at}jhsph.edu

* Other members of the Cysticercosis Working Group in Perú are H. Mayta, J. Jimenez, P. Castillo (Universidad Peruana Cayetano Heredia, Lima, Perú); M. Martinez (Instituto Nacional de Ciencias Neurologicas, Lima, Perú); C. A. W. Evans (Cambridge University, England).




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