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      The present situation and towards the prevention and control of neurocysticercosis on the tropical island, Bali, Indonesia

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          Abstract

          Neurocysticercosis (NCC), which is caused by accidental ingestion of eggs of the pork tapeworm, Taenia solium, was common in Bali, Indonesia until the early 1990s. However, improved education on hygiene and sanitation, a move to keeping pigs indoors, and improvement of economic and living conditions have substantially reduced the occurrence of NCC in Bali. Since 2011, T. solium tapeworm carriers ( T. solium taeniasis) and heavily infected pigs and dogs have exclusively been detected from villages in mountainous regions of northeastern Bali where NCC and ocular cysticercosis (OCC) cases have also been identified. In response to this continued area of high infection, a one-day workshop was convened to discuss how to prevent and control this potentially lethal zoonotic parasitic infection in Bali. This review presents an overview of the current status of T. solium taeniasis and cysticercosis in Indonesia and proposes a strategy for the prevention and control of this zoonosis in Bali.

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          Most cited references 135

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          Taenia solium cysticercosis.

           Marcio Garcia,  ,  E Gonzalez (2003)
          The larval stage of the pork tapeworm (Taenia solium) infects the human nervous system, causing neurocysticercosis. This disease is one of the main causes of epileptic seizures in many less developed countries and is also increasingly seen in more developed countries because of immigration from endemic areas. Little information is available on the natural evolution of taeniasis or cysticercosis. Available therapeutic measures include steroids, treatments for symptoms, surgery, and, more controversially, antiparasitic drugs to kill brain parasites. Efforts to control and eliminate this disease are underway through antiparasitic treatment of endemic populations, development of pig vaccines, and other measures.
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            Proposed diagnostic criteria for neurocysticercosis.

            Neurocysticercosis is the most common helminthic infection of the CNS but its diagnosis remains difficult. Clinical manifestations are nonspecific, most neuroimaging findings are not pathognomonic, and some serologic tests have low sensitivity and specificity. The authors provide diagnostic criteria for neurocysticercosis based on objective clinical, imaging, immunologic, and epidemiologic data. These include four categories of criteria stratified on the basis of their diagnostic strength, including the following: 1) absolute--histologic demonstration of the parasite from biopsy of a brain or spinal cord lesion, cystic lesions showing the scolex on CT or MRI, and direct visualization of subretinal parasites by funduscopic examination; 2) major--lesions highly suggestive of neurocysticercosis on neuroimaging studies, positive serum enzyme-linked immunoelectrotransfer blot for the detection of anticysticercal antibodies, resolution of intracranial cystic lesions after therapy with albendazole or praziquantel, and spontaneous resolution of small single enhancing lesions; 3) minor--lesions compatible with neurocysticercosis on neuroimaging studies, clinical manifestations suggestive of neurocysticercosis, positive CSF enzyme-linked immunosorbent assay for detection of anticysticercal antibodies or cysticercal antigens, and cysticercosis outside the CNS; and 4) epidemiologic--evidence of a household contact with Taenia solium infection, individuals coming from or living in an area where cysticercosis is endemic, and history of frequent travel to disease-endemic areas. Interpretation of these criteria permits two degrees of diagnostic certainty: 1) definitive diagnosis, in patients who have one absolute criterion or in those who have two major plus one minor and one epidemiologic criterion; and 2) probable diagnosis, in patients who have one major plus two minor criteria, in those who have one major plus one minor and one epidemiologic criterion, and in those who have three minor plus one epidemiologic criterion.
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              Neurocysticercosis: updated concepts about an old disease.

              Neurocysticercosis, the infection of the human brain by the larvae of Taenia solium, is a major cause of acquired epilepsy in most low-income countries. Cases of neurocysticercosis are becoming more common in high-income countries because of increased migration and travel. Diagnosis by neuroimaging and serological assessment has greatly improved over the past decade, and the natural progression of the disease and response to antiparasitic drugs is now much better understood. Neurocysticercosis is potentially eradicable, and control interventions are underway to eliminate this infection. Meanwhile, updated information on diagnosis and management of neurocysticercosis is required, especially for clinicians who are unfamiliar with its wide array of clinical presentations.
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                Author and article information

                Contributors
                tony_wdr2009@yahoo.com
                dekswas@yahoo.com
                nsdharmawan@yahoo.com
                ivan_poerba@yahoo.co.id
                kiosud@yahoo.com
                tyoshida@asahikawa-med.ac.jp
                yasusako@asahikawa-med.ac.jp
                okamoto.munehiro.6w@kyoto-u.ac.jp
                tu_eka07@yahoo.com
                srilaksmidps@yahoo.com
                yanagi-t@yamaguchi-u.ac.jp
                nakao@asahikawa-med.ac.jp
                akiraito@asahikawa-med.ac.jp
                Journal
                Parasit Vectors
                Parasit Vectors
                Parasites & Vectors
                BioMed Central (London )
                1756-3305
                7 March 2015
                7 March 2015
                2015
                : 8
                Affiliations
                [ ]Sari Mutiara Indonesia University, Medan, North Sumatra Indonesia
                [ ]Department of Parasitology, Faculty of Medicine, University of Udayana, Denpasar, Bali Indonesia
                [ ]Department of Veterinary Parasitology, Faculty of Veterinary Medicine, University of Udayana, Denpasar, Bali Indonesia
                [ ]Department of Health Science, Asahikawa Medical University, Asahikawa, Hokkaido Japan
                [ ]Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido Japan
                [ ]Section of Wildlife Diversity, Center for Human Evolution Modeling Research, Primate Research Institute, Kyoto University, Inuyama, Aichi Japan
                [ ]Laboratory of Veterinary Parasitology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yoshida, Yamaguchi Japan
                Article
                755
                10.1186/s13071-015-0755-z
                4356148
                8d107a39-6b87-4d17-a6d2-eff1068270b4
                © Wandra et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2015

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