Prevalência de Taenia saginata/ Cysticercus bovis na Região Autónoma da Madeira: estudo efectuado nos utentes dos Centros de Saúde do Faial, de Santo António da Serra e da Serra de Água, respectivamente, nos concelhos de Santana, de Machico e da Ribeira Brava e nos Centros de Abate da Região Autónoma da Madeira

Dissertação de Mestrado em Saúde Pública VeterináriaCom este estudo pretende-se melhorar o conhecimento existente, na Região Autónoma da Madeira (RAM), sobre a epidemio-infecciologia de Taenia saginata. Os objectivos específicos foram: estimar a prevalência de T. saginata na população madeirense, recorrendo à pesquisa de ovos por microscopia e à pesquisa de antigénio nas fezes; identificar possíveis focos de infecção para o ser humano e para os bovinos relacionando os resultados parasitológicos humanos com os achados em matadouro, por área geográfica; relacionar a presença de Cysticercus bovis nas carcaças com as movimentações efectuadas pelos animais. Para a prossecução do primeiro objectivo, projectámos um conjunto de acções junto dos utentes do Centro de Saúde do Faial, do C. S. de Santo António da Serra e do C. S. da Serra de Água, as quais, releva-se, mereceram uma adesão de 76,22%. Foram efectuadas análises coprológicas pela Técnica de Ritchie a 509 utentes não tendo sido encontrados ovos de Taenia spp. Por razões de carácter logístico, não foi possível realizar a pesquisa de coproantigénio. Num levantamento retrospectivo de casos de Taenia spp. detectados pelo laboratório do Serviço Regional de Saúde, E.P.E. (2000-2006) temos a assinalar 48 casos na RAM, das quais 20,83% ocorreram em habitantes do concelho de São Vicente, 18,75% em habitantes do concelho do Funchal, 16,67% em habitantes do concelho de Santana e distribuindo-se os restantes 43,75% pelos outros concelhos. A par, desenvolveu-se um levantamento dos arquivos da inspecção sanitária em bovinos abatidos na RAM, abrangendo os anos de 2005 e 2006. Neste período foram abatidos 16 316 bovinos e detectados 825 casos de C. bovis (prevalência=5,06%), que deram origem a 93 rejeições totais e 732 parciais (órgãos e/ou massas musculares). A análise destes casos em relação ao local de nascimento e o momento presumível em que ocorreu a infecção dos animais corrobora a existência de C. bovis na RAM bem como na população bovina oriunda da Região Autónoma dos Açores (RAA). A contaminação dos bovinos na RAM aparenta estar relacionada com a inexistência de instalações sanitárias disponíveis aquando do desenvolvimento de actividades ao ar livre, a não disponibilização de rede de saneamento básico a toda a população, à existência de tratadores parasitados, e ao acesso dos bovinos a comida e água contaminadas com ovos de T. saginata. Assim sendo, conclui-se que urge serem tomadas medidas coordenadas pelas entidades responsáveis de Saúde Pública, de ambas as Regiões Autónomas, de forma a combater e eliminar esta zoonose, envolvendo os meios e as populações neste desiderato.ABSTRACT: With this study we intended to improve the existing knowledge on the epidemio - infecciology of Taenia saginata in the Autonomous Region of Madeira (ARM). The specific objectives were: to estimate the prevalence of T. saginata in population from Madeira, using the search of eggs per microscopy and the search of antigen in faeces; reconnecting parasitological results in humans with the findings in slaughterhouse, by geographic area; linking the presence of Cysticercus bovis in carcasses with the movements made by the animals. In furtherance of the first goal, we outlined a series of actions among users of the Health Centre of Faial, the H. C. of Santo António da Serra and H. C. of Serra de Água, which, pertinently, deserved an accession of 76.22%. Coprology analyses were made by the Ritchie’s Technique on 509 persons were examined and no eggs of Taenia spp. were found. For reasons of logistical nature, it was not possible to search for copro-antigens. In a retrospective review of cases of Taenia spp. detected by the Laboratory of the Regional Health Service (2000-2006) there were referenced 48 events in ARM of which 20.83% occurred in people of São Vicente county, 18.75% in inhabitants of Funchal county and 16.67% in inhabitants of Santana county and distributing up the remaining 43.75% by other counties. Moreover, it has been developed an inventory of the archives of health inspection in cattle slaughtered in ARM, which covers the years 2005 and 2006. In this period 16 316 cattle were slaughtered and detected 825 cases of C. Bovis (prevalence = 5.06%), giving rise to 93 condemnations of the carcass and 732 partial disapprovals (organs and / or muscle mass). The analysis of these cases in relation to the place of birth and the presumed moment where the infection of animals occurred confirms the existence of C. bovis in ARM as well as in the cattle population that come from the Autonomous Region of the Azores (ARA). The contamination of cattle in ARM appear to be related to the lack of sanitary facilities available during the development of outdoor activities, the non availability of wastewater network to the whole population, the existence of infected workers in farms and the access of cattle to the food and water contaminated with eggs of T. saginata. Therefore, it is concluded that urgent measures have to be taken and coordinated by the entities responsible of Public Health, in both Autonomous Regions, in order to combat and eliminate this zoonosis, involving the means and the populations in this desideratum.Dissertação realizada com o apoio do Centro de Ciências e Tecnologia da Madeira pelo Programa Operacional Plurifundos da Região Autónoma da Madeira II através de financiamento do Fundo Social Europe

Epidemiology of taeniosis/cysticercosis in Europe, a systematic review : Western Europe

Background: Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. Methods: We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. Results: Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata, although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002-7.82%. Conclusions: Detection and reporting of taeniosis in western Europe should be improved. The existence of T. solium tapeworm carriers, of suspected autochthonous cases of human cysticercosis and the lack of confirmation of porcine cysticercosis cases deserve further attention. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniosis and human cysticercosis should be notifiable and surveillance in animals should be improved.Peer reviewe