Kadek Swastika

An ocular cysticercosis in Bali, Indonesia caused by Taenia solium Asian genotype

An ocular cysticercosis case of a nine-year-old Balinese girl in Indonesia is reported. She presented with redness and pain in the left eye and showed a cysticercus in the anterior chamber in December 2010. Morphological feature of the cysticercus removed from the anterior chamber indicated that it was an immature cysticercus of Taenia species with no hooklets. However, mitochondrial DNA analysis using a piece of histopathological specimen revealed it a cysticercus of Taenia solium Asian genotype. Serology by immunoblot and ELISA highly specific to cysticercosis was negative.

The first workshop towards the control of cestode zoonoses in Asia and Africa.

The first workshop towards the control of cestode zoonoses in Asia and Africa was held in Asahikawa Medical University, Japan on 15 and 16 Feb 2011. This meeting was fully supported by the Asian Science and Technology Strategic Cooperation Promotion Programs sponsored by the Special Coordination Funds for Promoting Science and Technology, the Ministry of Education Japan (MEXT) for 3 years from 2010 to Akira Ito. A total of 24 researchers from 9 countries joined together and discussed the present situation and problems towards the control of cestode zoonoses. As the meeting was simultaneously for the establishment of joint international, either bilateral or multilateral collaboration projects, the main purposes were directed to 1) how to detect taeniasis/cysticercosis infected patients, 2) how to differentiate Taenia solium from two other human Taenia species, T. saginata and T. asiatica, 3) how to evaluate T. asiatica based on the evidence of hybrid and hybrid-derived adult tapeworms from Thailand and China, 4) how to evaluate T. solium and T. hyaenae and other Taenia species from the wild animals in Ethiopia, and 5) how to detect echinococcosis patients and 6) how to differentiate Echinococcus species worldwide. Such important topics are summarized in this meeting report.

Neurocysticercosis Diagnosed in a Patient with Taenia saginata Taeniasisafter Administration of Praziquantel: A Case Study and Review of theLiterature

Taeniasis, caused by infection with Taenia saginata or Taenia solium, occurs on Bali due to the consumption of undercooked beef and pork, respectively. Fieldwork conducted on Bali from 2002-2007, identified 69 taeniasis cases due to T. saginata. In August 2007, three T. saginata tapeworm carriers in the Gianyar district of Bali were treated with a single dose of praziquantel. Within a few hours of treatment, a 47 year old man had a seizure and was admitted to a hospital in the city of Denpasar. A computed tomography (CT) scan revealed two cystic lesions in the man’s brain. Serology showed specific antibody responses to T. solium metacestode antigens. The patient was, therefore, diagnosed with a dual infection of T. solium neurocysticercosis (NCC) and T. saginata taeniasis. This case report is illustrative of the risk of veiled NCC in areas where T. saginata and T. solium are co-endemic. As globalization increases, the possibility of co-infections will continue to rise and researchers and physicians participating in mass drug administration programs will need to be vigilant in their monitoring for adverse effects.

Swine cysticercosis in the Karangasem district of Bali, Indonesia: An evaluation of serological screening methods

A serological assessment was undertaken on pigs from the Kubu and Abang sub-districts of Karangasem on the island of Bali, Indonesia, where earlier studies had detected patients with cysticercosis. Antigens purified from Taenia solium cyst fluid by cation-exchange chromatography were used to evaluate antibody responses in the pigs and the serological tests were also evaluated using sera from pigs experimentally infected with T. solium eggs. A total of 392 serum samples from naturally exposed pigs were tested using an ELISA that could be read based on both a colour change perceptible by the naked eye and an ELISA based on absorbance values. Twenty six (6.6%) pigs were found seropositive by the naked-eye ELISA and were categorized into three groups: strongly positive (absorbance values >0.8, n=6), moderately positive (absorbance values between 0.2 and 0.8, n=7), and weakly positive (absorbance values <0.2, n=13). Necropsies performed on 11 strongly and moderately positive pigs revealed that six strongly positive pigs were infected either solely with T. solium cysticerci (n=3), or co-infected with both T. solium and Taenia hydatigena (n=3). Four moderately positive pigs were infected solely with T. hydatigena. No cysticerci were found in one pig that was moderately positive by the naked-eye ELISA. Two experimentally infected pigs became antibody positive by 6 weeks post-infection, whereas eight control pigs remained negative. An additional 60 pigs slaughtered at authorized abattoirs on Bali were tested using the same ELISA. All 60 pigs were seronegative with no evidence of Taenia infection at necropsy. The results confirm the presence of porcine cysticercosis on Bali and, while the serological responses seen in T. solium infected animals were much stronger than those infected with T. hydatigena, the diagnostic antigens are clearly not species specific. Further studies are necessary to confirm if it is possible to draw a cut off line for differentiation of pig infected with T. solium from those infected with T. hydatigena.

Taeniasis caused by Taenia saginata in Gianyar town and Taenia solium in Karangasem villages of Bali, Indonesia, 2011–2016: How to detect tapeworm carriers, anamnesis or microscopy?

From January 2011 until September 2016, screening of taeniasis carriers was carried out in a town in Gianyar District (Taenia saginata) and in villages which consisted of several Banjars (the smallest community units) on the eastern slope of Mt. Agung, Karangasem District (Taenia solium) in Bali, Indonesia. Fecal samples from all community members who chose to participate were examined microscopically for detection of taeniid eggs each person completedwith a questionnaire to determine if they had seen whitish, noodle-like proglottids (anamnesis) in their feces. Members with egg positive feces, and those with anamnesis, were treated with niclosamide (Yomesan®, Bayer). A total of 39T. saginata tapeworm carriers were confirmed in Gianyar after deworming based on anamnesis (100%, 39/39). Only three of them (3/39, 7.7%) and 3/173 participants (1.7%) were identified by fecal microscopy. In contrast, 20T. solium carriers including one migrated to Gianyar were confirmed from 12 patients with eggs in their feces and from another 8 persons of 12 persons suspected to be infected due anamnesis only (8/12,66.7%) in Karangasem. The majority of carriers (12/20, 60.0%) identified by microscopy included 4 (33.3%) and 8 (66.7%) carriers confirmed microscopically with and without anamnesis, respectively. The prevalence rate was 12/1090 (1.10%) of participants. The results indicate that anamnesis is reliable for detection of T. saginata carriers, whereas it is not so reliable for detection of T. solium taeniasis (8/12, 66.7%) and that microscopy is more informative than anamnesis for T. solium. Eggs were detected more frequently in T. solium carriers (4/12, 33.3%) than in patients infected with T. saginata (3/39, 7.7%). T. solium carriers have so far been confirmed from nine of 13 Banjars examined in Karangasem. This study reveals that anamnesis is highly useful for screening of T. saginata carriers, whereas microscopy is a more valuable tool for detection of T. solium carriers.

Identification of a previously unidentified endemic region for taeniasis in North Sumatra, Indonesia

In North Sumatra, Indonesia, taeniasis has previously been reported solely from Samosir Island located in Lake Toba. In 2014, however, three individuals were identified with taeniasis after voluntarily reporting for treatment, stimulating a subsequent investigation conducted in 2017. This investigation indicated that a previously unidentified endemic area exists in Simalungun District. Molecular analysis showed the worms to be hybrid-derived descendants of Taenia asiatica and Taenia saginata, which is consistent with specimens identified previously from Samosir Island.