Cysticercosis or Taeniasis is an intestinal infection caused primarily due to tapeworms. The largest frequency of infections is caused by the Taenia solium variety of tapeworms which are found in pork. T. solium mediated cysticercosis affects the livelihoods of millions of people over the world, yet remains a largely neglected disease. Cysticerci develop in a number of tissues during the larval tapeworm stage. Besides pork, other sources of obtaining the disease are uncooked vegetables and in rare occasions contaminated water. The cysticeri can develop in any voluntary muscle in humans which causes fever, myositis and muscular pseudohypertrophy. Dramatic weight loss can be observed in many cases due to diarrhea and in severe cases, the pathogen can cause neurocysticercosis, wherein cysts form in the parenchyma of the brain which can lead to paralysis, seizures and painful headaches. Stringent regulations in pig farming and disposal of waste will help control and potentially eradicate this disease. Vaccines such as S3PVAC can help immunize animals against this pathogen preventing its spreading to other species including humans.
The worm is common throughout the world with prevalence between 3.1 and 3.9 percent. A very high prevalence is seen in Africa and certain South East Asian countries. Latin America, has an estimated 75 million people living in endemic areas with 400,000 people exhibiting symptomatic disease. Diagnosis of Cysticercosis/Taeniasis can be done with the help of biopsy, computed tomography or magnetic resonance imaging and serologic testing through enzyme linked immunoelectrotransfer blot (EITB) or western blot. Taeniasis is diagnosed by finding taenia eggs when examining the stool under the microscope.
Praziquantel (isoquinolone) and albendazole (imidazole) are current therapeutics that are currently being used for the treatment of neurocysticercosis and cysticercosis/taeniasis. Albendazole is considerably cheaper and has found a larger market in developing regions such as Africa and South-East Asia. The most significant drawback of the treatment is the high frequency of adverse reactions, primarily due to the body’s inflammatory reaction to the dying parasites. Symptomatic therapy is the mainstay of treatment for Cysticercosis or Taeniasis and several other drug classes may be required for prescription, which include anti-convulsants and corticosteroids. In some cases CSF diversion may also be required. It is advised to give patients with multiple cysticerci, particularly in the basilar cisterns, or with giant cysticerci of the sylvian fissures, to receive both corticosteroids and antiparasitic therapy.
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Due to the major prevalence of the disease, the market for treatment lies in endemic developing regions and very low cases occur in developed countries, although they occur very frequently among lower economic groups in almost all countries. Africa, Asia and Latin America remain the largest markets for treatment of Cysticercosis or Taeniasis. Low hygiene and awareness, socially and economically challenged communities face the major brunt of this disease since food is in short supply. This compels the preservation and storage of food in hot or humid areas beyond an advised period of time. The market for Cysticercosis or Taeniasis treatment is growing at a very low rate due to an overall decrease in incidence. Short controllable epidemics have been extremely rare over the world, due to which it is stated by International Task Force for Disease Eradication as an eradicable disease.
The market for treatment is highly generic in nature and thus very fragmented. Notable players operating over the world include Cipla, GlaxoSmithKline, Bonaide, Amedra Pharmaceuticals, Klarsehen India, Salius, Ranbaxy and Bayer among several others. These drugs are mostly available in tablet formulation, although other liquid forms are also available for both humans and veterinary medical care.
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