Improved diagnosis as an aid to better surveillance of Taenia solium cysticercosis, a potential public health threat to Papua New Guinea

Abstract

Taenia solium cysticercosis has been recognized as a public health problem in Indonesian Irian Jaya since its unfortunate introduction in a number of infected pigs imported from Bali. From its original point of introduction in 1971, the infection has spread from the Wissel Lakes area to other places within Irian Jaya. The present situation at the border between Irian Jaya and Papua New Guinea (PNG) is difficult to assess accurately but, in light of the flow of refugees and the traditional rights of movement of people with their pigs in the border area, PNG populations are now at risk. Government health officers and veterinarians in PNG are well aware of this threat and have been watching closely for transmission of Taenia solium into PNG. A rigorous survey of Irianese refugees at the border and surrounding areas in PNG using recently developed immunodiagnostic procedures such as the EITB (enzyme immunoelectrotransfer blot) for detecting human and pig cysticercosis and the dipstick ELISA (enzyme-linked immunosorbent assay) for identifying T. solium carriers, coupled with careful assessment of medical history and clinical and stool examination, is, however, required. Such a study would allow evaluation of the prevalence of cysticercosis and taeniasis in Irian Jayan refugees residing in camps in PNG. The study would also determine the extent to which the parasite has spread easterly and, importantly, whether cysticercosis/taeniasis has crossed the border and is endemic in PNG, thereby constituting a potentially serious public health problem.

PIP: Taenia solium cysticercosis, a common public health problem in developing countries where free-ranging pigs are raised, has been present in Indonesian Irian Jaya since 1971. Populations in Papua New Guinea are also at risk given the movement of people with their pigs at the border with Irian Jaya. The most common serious manifestations of T. solium cysticercosis are neurologic, caused when the parasites invade the central nervous system. Diagnosis is usually based on clinical symptoms, confirmed by tests such as ultrasound. The recent development of the enzyme immunoelectrotransfer blot (EITB) for detecting human and pig cysticercosis offers a precise method of diagnosing T. solium infection in neurologic patients; the test has been shown to be 100% sensitive and 100% specific. In addition, tests based on capture-type micro enzyme-linked immunosorbent assays (ELISA) have been used to detect Taenia antigens in the feces of human carriers. DNA hybridization techniques also have been used in the detection of Taenia eggs in human feces. Needed are rigorous surveys conducted at the border and adjacent areas in Papua New Guinea that combine new diagnostic technology with careful assessment of medical history and clinical and stool examination. Such research would determine whether cysticercosis and taeniasis represent a serious public health problem in the area.