REVIEW ON BOVINE CYSTICERCOSIS AND ITS PUBLIC HEALTH IMPORTANCE IN ETHIOPIA

By

KASSAHUN SEMIE

May, 2014

INTRODUCTION

Tapeworm infestation has been recorded in history 1500 years ago

as human parasitic disease.

T. saginata is a worldwide zoonotic cestode affecting 55-77 million

individuals annually.

T. saginata adult worms cause taeniasis in human.

Bovine cysticercosis is a disease that affects the musculature of

cattle.

It is caused by metacestode stage of T. saginata.

Con’t……..

It is most prevalent in developing countries like Ethiopia.

Deep rooted tradition and custom of eating raw and under cooked

meat, habit of open field defecation and free grazing made

taeniasis/bovine cysticercosis most prevalent in Ethiopia.

Ethiopia is ideally placed to export live animals to Middle East

markets.

But export earning is low due to presence of unimproved animal

health problems like bovine cysticercosis.

Objectives :

To highlight the status bovine cysticercosis in Ethiopia. To review control and prevention strategies, and public health and

economic importance of the disease.

BOVINE CYSTICERCOSIS

ETIOLOGY

Metacestode stage of human intestinal cestode, T. saginata.

T. saginata is classified under:

Kingdom – Animalia

Phylum – Platyhelminthes

Class – Cestoda

Order – Cyclophyllidea

Family – Taeniidae

Genus – Taenia

Species – T. saginata

Morphology

Adult T. saginata – commonly known as beef tapeworm:

large ribbon-shaped (usually 4-15 m long)

white flat worm

multisegmented

hermaphrodite

its body is divided into three distinct parts as:

head (scolex) – attachment organ provided with suckers

neck – short unsegmented organ

strobilla – chain of segments (proglottids)

Eggs - sub spherical to spherical in shape

- measures about 30 – 45µm

Morphology…………..

Eggs - contain- shell

- hexacanth embryo (oncosphere)

- thick and brown in color

- resistant to external environment

Metacestode stage (larval stage) – commonly known as beef

measles or bladder worm

- small pea-sized

- oval in shape ss

- translucent scolex

- contain single white scolex

EPIDEMIOLOGY

Host range

♠ Adult – in intestinal tract of man (definitive host)♠ Larval stage – musculature of cattle (intermediatehosts)♠ Cattle of all ages are susceptible, but youngs are more

susceptible.

Geographic Distribution

♦ Worldwide ♦ Highly endemic in developing countries like Ethiopia.

Con’t………….

☞ In Ethiopia, taeniasis/bovine cysticercosis is common due to:§ customs of eating raw or under cooked beef dishes such

as kurt, lebleb and kitffo,§ Open field (under bush) defecation, and § Free grazing.

☞ Estimates made by different investigators on prevalence of taeniasis/bovine cysticercosis in Ethiopia vary widely

- from 2% - 16% to over 70%.

Distribution Of Metacestodes In Organs:

♠ Metacestode are found throughout edible parts which includes: Masseter muscles Cardiac muscles Triceps Thigh muscles Shoulder muscles Diaphragm Intercostal muscles Tongue Liver

The tongue, masseter muscles, heart muscles, triceps muscles and thigh muscles are the main predilection sites of the cyst.

Source of infection and Mode of transmission

Man is the source of the parasite·human habits are responsible for spread of BC

non-hygienic disposal of stoolusage of human sewage as fertilizer on pasture

☞these acts are responsible for cattle infection. Human infection perpetuates as a result of man’s custom

§eating raw/under cooked beef§poor sanitation

♠In Ethiopia incidence of T.saginata taeniasis is high due to♦ extensive cattle rearing system♦ poor sanitation ♦ tradition of raw meat aeting

LIFE CYCLE

CLINICAL MANIFESTATION

In human generally asymptomatic manifested as non specific GIT illness

abdominal pain digestive disturbance nausea

utilizes nutrition of man – leads to weight loss in large number – causes enteritis

In cattle no clinical illness in heavy infection – causes myocarditis

- muscle stiffness

DIAGNOSIS

☞ In man♠ no clear clinical picture ♠ diagnosis is based on

• laboratory findings• stool examination for gravid proglottids

for identification of T. saginata focus on proglottids – more than 13 uterine branches scolex – lacks hooks/rostellum

☞ In cattle √ meat inspection – incise at the predilection muscles√ immunological dx – using ELISA to detect a

antibodies like IgG

Differential dx

Sarcocyst species – forms white soft nodules (protozoa)

-found mainly in esophagus

Onchocerca dukei – nematode parasite

- nodules are firm to touch and reveal worms

upon sectioning

Cysticercus dromedarius (C. cameli)

· metacestode of T. hyenae

· twice larger than C. bovis

· possesses double raw of hooks

TREATMENT

© Most widely used anticestodal drugs for Rx of human taeniasis in Ethiopia are:

niclosamide (@ dose rate of 2000mg) praziquantel (@ dose rate of 5 – 10)

☞ Many traditional herbal drugs are used by rural inhabitants in Ethiopia. Some of them are:

♠ Enkoko – Embelia schimperi♠ Kosso – Hygenia abyssinica♠ Bisana – Corton macrustachy♠ Duba firie – Cucurbita pepo: the pump kin

© In cattle – albendazole (50 mg per kg)-Praziquantel (50 mg per kg)- mebendazole (50 mg per kg)

but they are not fully effective.

PUBLIC HEALTH IMPORTANCE

� Bovine cysticercosis is important zoonotic disease � Pose variety of problems in man like:

non specific intestinal disturbance – colic, discomfort non specific appetite change – increase or loss

loss – due to abdominal pain and discomfort increase – in heavy infestation because they compete with

parasites for nutrients, they need to eat a lot body weakness, headaches, dizziness and delirium (mind disturbance) malnutrition – large no. of worms cause malabsorption poor hair quality – due to severe malnutrition (in children) intestinal blockage – due to massive infestation perinial or anal irritation – due to migrating proglottids

☞ Infected workers may absent from work or reduce their working uneasiness lowers productivity.

Economic Importance

Economic loss is determined by

disease prevalence

grade of animals infected – not fit for market

potential market policy of cattle – export market

treatment cost for live animals and detained carcass

carcass condemination.

CONTROL AND PREVENTION

In cattle improve livestock farming techniques – intensive reinforcement of veterinary inspection vaccination – under trial not marketed

In human· diagnose carriers and treat with taenicides · improve personal hygiene · installation of good sanitary accommodations· enhance environmental hygiene · public health education, stressing danger of raw meat consumption

· mass education to use latrine

CONCLUSION AND RECOMMENDATIONS

♠ Cysticercosis is important zoonotic disease that affects both human and animal health

♠ Prevalence of the disease in Ethiopia is high and economically significant

♠ customs of eating raw/under cooked meat, backyard slaughtering especially in holydays, and lack of sanitation give a great favor for continual existence of parasite/disease within human and animal population.

☞ Based on the above conclusion the following recommendations are forwarded:

there should be public awareness about health and economic importance of the disease through social and public media

Con’t

avoid raw/undercooked meat

infected meat and meat products should under go the

processes of boiling and freezing

strong collaboration between medical and veterinary

professionals should exist to reduce impact of the disease

the community should use latrines/toilets

untreated human feces shouldn’t used as fertilizer on

pasture

there should be strict meat inspection

“Eat healthily, sleep well, breathe deeply, move

harmoniously.” 

Barral J.P

THANK YOU !