Taenia Infection Guidelines

Updated: Jul 24, 2018
  • Author: Supatida Tengsupakul, MD; Chief Editor: Russell W Steele, MD  more...
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Guidelines

Guidelines Summary

COHEMI (COordinating resources to assess and improve HEalth status of MIgrants from LatinAmerica) project published guidelines for screening, diagnosis and management of T. solium taeniasis and cysticercosis in 2017. [24]

1. Who should be screened for cysticercosis?

Subjects at high risk for cysticercosis including:

  • Confirmed T. solium taeniasis 
  • Household and daily contacts of confirmed T. solium taeniasis cases
  • Family members of a cysticercosis patient
  • Subjects with possible exposure in an endemic country before undergoing treatment with antiparasitic drugs such as praziquantel or albendazole 

High-risk subjects should be screened for symptoms (headache, seizure) and signs (subcutaneous nodules) suggestive of neurocysticercosis and have brain imaging studies such as CT scan or MRI if indicated. 

2. Who should be screened for T. solium taeniasis?

  • Patients with cysticercosis and live parenchymal cyst or enhancing lesions
  • Household and daily contacts of patients with cysticercosis, especially if a recent/local transmission is suspected such as cysticercosis in children, cysticercosis in patients who never travel to endemic countries, patients with viable cysticerci
  • Patients with history of proglottids expulsion within the last year 

3. How to diagnose T. solium taeniasis?

  • History of proglottids expulsion within the past year, with visualization of proglottids in stool sample
  • Microscopic and macroscopic examination of stool samples collected on three different days showing proglottids or eggs
  • Taenia species identification should always be performed, especially in subjects exposed to T. solium in highly endemic countries (Latin America, Asia and Africa) by examining scolex, proglottids and uterine branches

4. Treatment of T. solium taeniasis 

  • Single dose of praziquantel or niclosamide
  • Confirm the efficacy of treatment with history of proglottids expulsion after 1 week of treatment, microscopic and macroscopic examination of stool samples 1 month and 3 months later and if available, obtain CoAg-ELISA at 1 month and 3 months later. If any of these tests become positive, the treatment should be repeated

Diagnosis and treatment of cysticercosis, see Neurocysticercosis.