Taenia solium Cysticercosis in the Democratic Republic of Congo: How Does Pork Trade Affect the Transmission of the Parasite?

Taenia solium is a parasite that can affect both humans and pigs, causing important economic losses in pig production and being the main cause of acquired epilepsy in endemic areas. However, the parasite has been neglected in many African countries and particularly in the Democratic Republic of Congo (DRC), where recent data are non-existent. The present study is part of a first initiative to assess whether cysticercosis is actually present in DRC and to estimate its potential economic and public health importance. Focusing our work on porcine cysticercosis, we demonstrated high prevalence figures of active infections in villages in a rural area of DRC and in markets in the city of Kinshasa. Moreover, the intensity of infection was higher in pigs sampled in villages as compared to pigs sampled on urban markets. Preliminary surveys conducted in parallel in both study sites suggest an effect of pork trade on the transmission of the parasite selecting highly infected pigs at village level

High prevalence of Taenia solium cysticerosis in a village community of Bas-Congo, Democratic Republic of Congo.

Cysticercosis results from tissue infection with the larval stage of the pig tapeworm Taenia solium. Infection of the brain may cause neurocysticercosis, the most frequent cause of acquired epilepsy in developing countries. Information on human cysticercosis in the Democratic Republic of Congo (DRC) is scarce and outdated. We believe this is the first reported study on human cysticercosis and epilepsy in a village community of DRC. The proportion of villagers seropositive by ELISA for T. solium circulating antigen was 21.6%, the highest figure reported to date. The adjusted prevalence of active epilepsy in the community was 12.7 in 1,000

Cysticercosis in the Democratic Republic Of Congo

Cysticercosis, caused by Taenia solium eggs, is a zoonotic disease whose consequences can be severe especially in the cerebral localisation (neuorcysticercosis). Indeed, neurocysticercosis is the first cause of epilepsy amongst the infectious etiology group. Following the increase of epilepsy cases in Kinshasa and Bas-Congo, it was important to assess the fraction attributable to neurocysticercosis especially as data on cysticercosis in Democratic Republic Of Congo (DRC) dating from 1970. A joint study between veterinary and human doctors was conducted in the provinces of Bas-Congo and Kinshasa between 2008 and 2010. Blood samples were collected from the general population, patients with epilepsy and pigs. These samples were analysed using ELISA antigen in the laboratory of the Institute of Tropical Medicine in Antwerp. Patients positive to ELISA antigen took the CT scan exam for the confirmation of neurocysticercosis. In the province of Kinshasa, of 530 epileptic patients, 6.3% were identified as neurocysticercosis cases. Out of a total of 498 pigs, 38.9% were positive for cysticercosis. In the province of Bas- Congo, of 943 inhabitants from Malanga village, 21.6% were positive with predominance in males (26.4% versus 17.5%). A total of 145 pigs from 5 villages were examined and 41.2% found positive. We can conclude that cysticercosis in the DRC has been neglected for a long time and cysticercosis could be a real major public health problem. Prospective studies addressing the consequences of cysticercosis in communities are needed in order to prevent epilepsy due to neurocysticercosis

Effect of a control project on clinical profiles and outcomes in buruli ulcer: a before/after study in Bas-Congo, Democratic Republic of Congo

BACKGROUND: Buruli ulcer (BU) is a necrotizing bacterial infection of skin, subcutaneous tissue and bone caused by Mycobacterium ulcerans. Although the functional impairment caused by BU results in severe suffering and in socio-economic problems, the disease remains largely neglected in Africa. The province of Bas-Congo in Democratic Republic of Congo contains one of the most important BU foci of the country, i.e. the Songololo Territory in the District of Cataractes. This study aims to assess the impact of a BU control project launched in 2004 in the Songololo Territory. METHODS: We used a comparative non-randomized study design, comparing clinical profiles and outcomes of the group of patients admitted at the General Reference Hospital (GRH) of the "Institut Medical Evangelique" (IME) of Kimpese 3 years before the start of the project (2002-2004) with those admitted during the 3 years after the start of the project (2005-2007). RESULTS: The BU control project was associated with a strong increase in the number of admitted BU cases at the GRH of IME/Kimpese and a fundamental change in the profile of those patients; more female patients presented with BU, the proportion of relapse cases amongst all admissions reduced, the proportion of early lesions and simple ulcerative forms increased, more patients healed without complications and the case fatality rate decreased substantially. The median duration since the onset of first symptoms however remained high, as well as the proportion of patients with osteomyelitis or limitations of joint movement, suggesting that the diagnostic delay remains substantial. CONCLUSION: Implementing a specialized program for BU may be effective in improving clinical profiles and outcomes in BU. Despite these encouraging results, our study highlights the need of considering new strategies to better improve BU control in a low resources setting