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TAENIASIS AND CYSTICERCOSIS IN HOUSEMAIDS WORKING IN AFFLUENT NEIGHBORHOODS IN LIMA, PERU

Taenia solium taeniasis/cysticercosis is endemic in most developing countries, where it is an important cause of epileptic seizures and other neurologic symptoms. In industrialized countries, cysticercosis results from travel or immigration of tapeworm carriers from endemic areas. In both endemic and nonendemic countries, housemaids commonly immigrate from cysticercosis-endemic areas and can transmit the infection if they carry the adult tapeworm. Between July 2001 and July 2002, 1,178 housemaids (961 of them work in the top five most affluent districts of Lima, a metropolis of 8 million inhabitants considered nonendemic for cysticercosis) were evaluated for serum antibodies to Taenia solium and stool microscopy for taeniasis and cysticercosis. The serosurvey revealed a prevalence of cysticercosis-specific antibodies of 14.6% (95% CI 12.6–16.6%), and stool microscopy detected 12 T. solium tapeworm carriers, for a prevalence of taeniasis of 1.2% (95% CI: 0.6–1.8%). A nonrandom sample of 26 seropositive housemaids was examined by brain CT and 50% of them had brain lesions compatible with neurocysticercosis, mainly calcifications. From the families who used a tapeworm-carrier housemaid, cysticercosis antibodies were detected in 6 (23%) of 26 persons who agreed to participate. One seropositive member of the employer families was symptomatic for seizures and had brain calcifications. The prevalence of tapeworm infections in this housemaid group is similar to levels in endemic areas, constituting a source of neurocysticercosis infection.

Received November 5, 2004. Accepted for publication February 25, 2005.

Acknowledgments: We are grateful to Carmen Taquiri for her hard work on sample processing.

Financial support: This work was mainly funded by grant number 892 from the VIGIA project (USAID/Instituto Nacional de Salud - Peruvian Ministry of Health). Research grants from the National Institutes of Health (R.G., H.G.), The Wellcome Trust (R.G., A.G., H.G.), the Food and Drug Administration (H.G.), and the Bill and Melinda Gates Foundation (R.G., V.T., A.G., H.G.) fund ongoing cysticercosis research from the authors. The sponsors had no role in the design or writing of this work.

^* Address correspondence to Hector H. García, Cysticercosis Unit, Instituto de Ciencias Neurológicas, Jr. Ancash 1271, Barrios Altos, Lima 1, Perú. E-mail: hgarcia{at}jhsph.edu

Authors’ addresses: Branko N. Huisa, Luis A. Menacho, and Hector H. García, Department of Microbiology, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado 430, San Martin de Porras, Lima 31, Peru, E-mail: hgarcia{at}jhsph.edu. Silvia Rodriquez and Javier A. Bustos, Cysticercosis Unit, Instituto de Ciencias Neurológicas, Jr., Ancash 1271, Barrios Altos, Lima 1, Peru. Robert H. Gilman, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, 615 North Wolfe Street, Baltimore, MD 21205. Victor C. W. Tsang, Immunology Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-13, Atlanta, GA 30341-3724. Armando E. Gonzalez, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Cuadra 29 Avenida Circunvalacion s/n, San Borja, Lima, Peru.

Reprint requests: Hector H. García, Cysticercosis Unit, Instituto de Ciencias Neurológicas, Jr. Ancash 1271, Barrios Altos, Lima 1, Perú, Telephone: (51-1) 328-7360, Fax: (51-1) 328-7382, E-mail: hgarcia{at}jhsph.edu.