Cysticercosis in Indonesia: epidemiological aspects

Cysticercosis caused by the larval stage, cysticercus or cysticerci, of the pork tapeworm Taenia solium was recognized at first in Bali and in Paniai District, Irian Jaya (Papua), Indonesia in the 1970s. In the 1990s a rapid increase in the number of the cases of epileptic seizures and burns in Jayawijaya district, eastern Papua, was observed. There were a total of 1,120 new cases of burns (7.0%) and 293 new cases of epileptic seizures (1.8%) from 15,939 local people during 1991-1995. Both histopathological examination and mitochondrial DNA analysis of resected cysts from patients and pigs revealed cysticerci of T. solium. Antibody responses highly specific to cysticercosis were revealed in approximately 67% and 65% of persons respectively with epileptic seizures and with subcutaneous nodules. Therefore, most cases of epileptic seizures and burns were considered to be associated with cysticercosis in Papua. Additional serologically data from Bali showed that 13.5% of epileptic seizures (10/74) and 12.6% of asymptomatic individuals (94/746) were supposed having been exposed to T. solium. Histopathological evaluation of 80,000 tissue samples in East Java revealed that nine were cysticercosis. All cases were non-moslems and from two ethnic groups, Chinese and Balinese. Epidemiological data on cysticercosis are not available from other provinces of Indonesia, although cases of cysticercosis are occasionally reported. Therefore, other intensive epidemiological studies are strongly recommended, especially covering the eastern part of Indonesia.