RESUMEN

Neurocysticercosis is a leading cause of seizures in adults, but in paediatric patients, the diagnosis is controversial. The aim of this study was to search for antibodies to Taenia solium cysticerci in paediatric patients with seizures. We retrospectively studied a cohort of 41 serum samples from paediatric patients and 40 serum samples from healthy children. Antibodies were analysed by ELISA (vesicular fluid) and by Western blot (glycoproteins). Clinical, image and socio-demographic data were obtained from the medical records. The frequency of positive by ELISA was of 12% (n=5) in patients with seizures, while no positive samples were found in the healthy group. Results of Western blot were negatives. The analysis of the medical records showed a cyst of unknown origin in 2/5 ELISA positive samples. According to the diagnostic criteria for neurocysticercosis, three minor criteria (positive serology, active seizures and compatible image) were associated to an epidemiological condition (Mexico is endemic for neurocysticercosis); thus, the probable frequency of neurocysticercosis in the studied sample of patients with seizures was 4.9% (2/41 patients). The three remaining positive samples were associated with problems of noninfectious origin. The positivity was associated with the identification of cysts by magnetic resonance imaging (p = 0.047; chi-square), but found no association with the socio-economic characteristics of the patients, family history or to clinical symptoms. In conclusion, scarce frequency of antibodies to T. solium cysticerci was determined in paediatric patients with seizures. The low prevalence of antibodies detected in children is an indirect indicator of the interruption of T. solium transmission. Further studies are needed to design an algorithm for the conclusive diagnosis of seizures.

RESUMEN

Blastocystis hominis is a common human parasite with infection rates up to 50% in developing countries, and giardiasis is the commonest intestinal one in Mexico. No doubt, various parasites as Giardia lamblia and Entamoeba histolytica can cause rheumatic diseases. This study coproparasitoscopic analysis evaluated the cysts by B. hominis, G. lamblia, E. hartmani, E. coli and E. histolytica in Mexican rheumatic disease patients. Also, ELISA was used to detect E. histolytica, Ascaris lumbricoides, Toxocara canis, and Trichinella spiralis in Mexican patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Thirty-six patients (24 with AS and 12 with RA) and 77 healthy control individuals were enrolled in this study. The frequencies of protozoan cysts were comparable in rheumatic disease patients (AS and RA) and healthy control donors (33 and 25 vs. 26%, respectively; p > 0.05). The frequency of antibodies to T. canis was significantly higher in AS patients than in healthy control donors (16 vs. 2.6%, respectively; p = 0.027), whereas no differences were observed for the prevalence of antibodies for the other parasites (E. histolytica, A. lumbricoides and T. spiralis) (p > 0.05). This information indicates the need to intensify educational efforts for the prevention of parasite infections associated with AS disease that cannot be controlled only by drugs.

Asunto(s)

RESUMEN

Human neurocysticercosis is an important parasitic disease in developing countries. Most epidemiological studies on the disease have used antibody-based assays that allow the detection of transmission 'hot spots' and the identification of the main risk factors for transmission. However, such assays have low predictive value in the detection of active cases of neurocysticercosis. The screening potential of the most commonly used antibody-detection technique, the electroimmunotransfer blot assay (EITB), has now been compared with an antigen-capture assay, in an endemic region of Mexico. The subjects were 68 patients with late-onset epilepsy, 35 cases of taeniasis and a randomly selected, control group of 133 individuals from the same region. Parasite-specific antibodies and antigens were more common among the epileptics and taeniasis cases than among the controls. The antigens appeared to be associated with late-onset epilepsy and the antibodies with the presence of subcutaneous nodules. The sensitivities of both tests, to detect epilepsy or taeniasis, were low, but the specificity and the positive predictive value of the antigen-capture assay was high when used with the epileptics. As late-onset epilepsy and neurocysticercosis seem to be associated in endemic regions, antigen-capture assays are probably the most reliable method of detecting active cases of neurocysticercosis in epidemiological studies.

Asunto(s)

Asunto(s)