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. 2023 Mar 31;17(3):e0011042.
doi: 10.1371/journal.pntd.0011042. eCollection 2023 Mar.

The epidemiology of human Taenia solium infections: A systematic review of the distribution in Eastern and Southern Africa

Gideon Zulu  1   2 , Dominik Stelzle  3 , Kabemba E Mwape  1 , Tamara M Welte  3   4 , Hilde Strømme  5 , Chishimba Mubanga  1 , Wilbroad Mutale  6 , Annette Abraham  3 , Alex Hachangu  1 , Veronika Schmidt  3 , Chummy S Sikasunge  7 , Isaac K Phiri  1 , Andrea S Winkler  3   8
Affiliations

The epidemiology of human Taenia solium infections: A systematic review of the distribution in Eastern and Southern Africa

Gideon Zulu et al. PLoS Negl Trop Dis. .

Abstract

Background: Taenia solium is a tapeworm that causes taeniosis in humans and cysticercosis in humans and pigs. Within Eastern and Southern Africa (ESA), information on the presence of human taeniosis and cysticercosis seems scarce. This systematic review aimed to describe the current information available and gaps in the epidemiology of human T. solium infections in ESA.

Methods/principle findings: Scientific literature published between 1st January 2000 and 20th June 2022 in international databases [MEDLINE (Ovid), Embase (Ovid), Global Health (Ovid), Scopus (Elsevier), African Index Medicus (via WHO Global Index Medicus), and Open Grey] was systematically reviewed for ESA. The study area included 27 countries that make up the ESA region. Information on either taeniosis, cysticercosis or NCC was available for 16 of 27 countries within the region and a total of 113 reports were retained for the review. Most case reports for cysticercosis and NCC were from South Africa, while Tanzania had the most aggregated cysticercosis reports. Eleven countries reported on NCC with seven countries reporting data on NCC and epilepsy. Unconfirmed human T. solium taeniosis cases were reported in nine countries while two countries (Madagascar and Zambia) reported confirmed T. solium cases. The cysticercosis seroprevalence ranged between 0.7-40.8% on antigen (Ag) ELISA and between 13.1-45.3% on antibody (Ab) ELISA. Based on immunoblot tests the Ab seroprevalence was between 1.7-39.3%, while the proportion of NCC-suggestive lesions on brain CT scans was between 1.0-76% depending on the study population. The human taeniosis prevalence based on microscopy ranged between 0.1-14.7%. Based on Copro Ag-ELISA studies conducted in Kenya, Rwanda, Tanzania, and Zambia, the highest prevalence of 19.7% was reported in Kenya.

Conclusions: Despite the public health and economic impact of T. solium in ESA, there are still large gaps in knowledge about the occurrence of the parasite, and the resulting One Health disease complex, and monitoring of T. solium taeniosis and cysticercosis is mostly not in place.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Fig 2
Fig 2. Aggregated human cysticercosis cases reported in community-based cross-sectional studies in Eastern and Southern Africa between the years 2000 and 2022.
Fig 3
Fig 3. Diagnostic methods used for aggregated human cysticercosis cases in the included studies for Eastern and Southern Africa.
Fig 4
Fig 4. The distribution of human cysticercosis seroprevalence in the included studies for Eastern and Southern Africa (*Ag-ELISA, #Ab-ELISA, ¥Immunoblot).
The maps were obtained from an openly available source, Mapchart.net for free. Link: https://www.mapchart.net/terms.html#licensing-maps. Permission has been obtained from the owner.)
Fig 5
Fig 5. Prevalence of human cysticercosis in Eastern and Southern Africa based on serology data in reviewed studies with high variation observed in Madagascar, Rwanda, Tanzania and Zambia.
Fig 6
Fig 6. The distribution of human neurocysticercosis based on imaging data in reviewed studies in Eastern and Southern Africa.
*Proportion based on MRI. (The maps were obtained from an openly available source, Mapchart.net for free. Link: https://www.mapchart.net/terms.html#licensing-maps. Permission has been obtained from the owner).
Fig 7
Fig 7. The distribution of human taeniosis in Eastern and Southern Africa showing prevalence data based on microscopy and *prevalence based on serology (rES33-immunoblot), and copro-Ag ELISA.
(The maps were obtained from an openly available source, Mapchart.net for free. Link: https://www.mapchart.net/terms.html#licensing-maps. Permission has been obtained from the owner).
Fig 8
Fig 8. Taeniosis cases reported in Eastern and Southern Africa between 2000–2020.
Fig 9
Fig 9. Prevalence of taeniosis in Eastern and Southern Africa based on microscopy data in reviewed studies.
Fig 10
Fig 10. Prevalence of taeniosis based on copro-Ag ELISA in reviewed studies in Eastern and Southern Africa.
See this image and copyright information in PMC

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