Taenia solium metacestode preparation in rural areas of sub-Saharan Africa: a source for diagnosis and research on cysticercosis

Comparative global burden analysis of lymphoma subtypes: a statistical evaluation of severity across global regions

Introduction

Various subtypes of lymphoma, including Hodgkin lymphoma, non-Hodgkin lymphoma, and Burkitt lymphoma, impose a significant global health burden. This study aimed to analyze the severity of these lymphoma types across different global regions from 1990 to 2021, focusing on age-standardized incidence rates, disability-adjusted life years (DALYs), and the Quality of Care Index (QCI).

Methods

Data were collected from the Institute for Health Metrics and Evaluation (IHME). Global regions were categorized according to their socio-demographic index (SDI), and trends in death rates, DALYs, and case numbers of various lymphoma subtypes were examined over a 31-year period. The Analysis of Variance (ANOVA) test was employed to compare mortality and DALYs among regions.

Results

The analysis revealed significant global and regional trends in lymphoma burden. For Hodgkin lymphoma, DALYs decreased from 0.000513 to 0.000285, and the death rate declined from 0.000629 to 0.000313. In contrast, non-Hodgkin lymphoma exhibited an increase in DALYs from 0.002012 to 0.002430 and in deaths from 0.003182 to 0.003624. Notably, in low SDI regions, a marked increase in DALYs was observed for Hodgkin lymphoma (from 0.000396 to 0.000922) and non-Hodgkin lymphoma (from 0.001147 to 0.002779), with statistical analyses confirming higher mortality rates in these areas.

Discussion

These findings highlight significant regional disparities in the severity of lymphoma. While high-income regions demonstrated lower mortality rates due to better healthcare infrastructure, low-income areas experienced higher mortality, underlining the inequality in healthcare access. The results underscore the urgent need for targeted healthcare interventions and specialized treatment strategies to reduce the global lymphoma burden, particularly in under-resourced regions.

Taenia solium taeniosis and cysticercosis literature in Tanzania provides research evidence justification for control: A systematic scoping review

BACKGROUND

Despite Taenia solium taeniosis/cysticercosis (TSTC) having been put high on the global agenda of neglected tropical diseases (NTDs), which over the last years has received a lot of attention, there has been no control programmes in place in sub-Saharan Africa, a highly endemic region. This could be attributed to lack of awareness of many stakeholders on the burden and impact of T. solium. This information is essential in guiding TSTC policies, practices and research agendas as well as encouraging cross-sectoral collaboration in the control of this important zoonotic parasite using a One Health approach. National elimination of the parasite is the foundation for global eradication. This will require that substantial country-level information is provided to all key stakeholders. We have mapped out TSTC research evidence in Tanzania to inform on disease burden and potential for integrated control measures.

METHODOLOGY/PRINCIPAL FINDINGS

A scoping review of all TSTC studies undertaken in Tanzania and published up to December 2018 was conducted. The articles were searched from PUBMED, AJOL, Google Scholar and Google in general. Fifty-one (51) articles met the inclusion criteria and were reviewed. Prevalence of taeniosis of 2.3% - 5.2% was estimated based on copro-antigen ELISA while human cysticercosis of >16% was estimated based on serum antigen ELISA (Ag-ELISA) or IgG Western Blot. Neurocysticercosis (NCC) contributed significantly to epilepsy in adults. Farm prevalence of porcine cysticercosis were 6.0% - 17.4% (lingual examination) and 1.5% - 33.3% (Ag-ELISA). Slaughter-slab prevalence were 0% - 18.2% (routine meat inspection). Lacking latrines, watering pigs with river or pond water, and feeding pigs with potato peels were associated with porcine cysticercosis prevalence. Washing hands by dipping method increased the risk of human cysticercosis. In 2012, the number of DALYs/1000 person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6), around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Three rounds of annual treatment of school-age children with praziquantel significantly reduced prevalence of taeniosis and porcine cysticercosis. Health education was efficacious in improving knowledge and attitudes favourable for control of TSTC while a single dose of oxfendazole 30 mg/kg body weight was efficacious in eliminating T. solium cysticerci from pig musculature.

CONCLUSIONS/SIGNIFICANCE

The observed high burden of TSTC and the significant contribution of NCC to epilepsy in Tanzania warrant urgent interventions. Evaluation of best control options should make use of disease transmission dynamics models such as cystiSim, taking into account findings from the field based intervention studies. In addition, locally adapted management guidelines for people suffering from NCC are urgently needed.

A comparison of Taenia solium and Taenia hydatigena infection in pigs using serological diagnosis and post-mortem inspection methods in Benoué division, North Cameroon

The metacestodes of Taenia solium and Taenia hydatigena are the cause of cysticercosis in pigs. T. solium is also responsible of the taeniosis/neurocysticercosis complex in humans, constituting a main cause of epilepsy cases across endemic countries. T. hydatigena is non-zoonotic, but its occurrence in pigs contributes significantly to false positive reactions should genus-species serological methods be used for diagnosis of T. solium porcine cysticercosis. T. hydatigena is often considered not common in pigs in Africa compared to T. solium. On the basis of the evidence that these two cestodes coexist in Cameroon, we examined the viscera of 305 pigs for the identification of the metacestodes of T. hydatigena in Bénoué division, North Region of Cameroon. Tongue, masticatory muscles and heart were sliced for the identification of T. solium cysticerci (TMH dissection test). Twenty seven (8.85%) and 16 (5.24%) pigs were found infected with the metacestodes of T. solium and T. hydatigena, respectively. The difference between the two rates of infection was not statistically significant (P > 0.05). Serum samples were also collected for the evaluation of an inhibition ELISA (i-ELISA) specific to antibodies anti- T. solium or anti-T. hydatigena cysticerci. After incubation of these sera with cyst fluid of T. solium, T. hydatigena, T. multiceps multiceps, T. multiceps gaigeri and T. saginata to eliminate cross-reactions among cestodes parasites, the i-ELISA indicated that 26.56% and 28.52% slaughtered pigs had predominant specific antibodies to cyst fluid of T. solium and T. hydatigena, respectively. Combination of TMH dissection test, i-ELISA and a standard indirect ELISA in a Bayesian simulation approach revealed a true prevalence of 19.27% (0.7-49.27, CI 95%) and 24.85% (5.17-48.34, CI 95%) of porcine cysticercosis due to T. solium and T. hydatigena, respectively. These results indicated that T. hydatigena is as prevalent as T. solium in pigs in the North of Cameroon.