Cysticercosis, a Potential Public Health Concern in Kuwait: A New Diagnostic Method to Screen Taenia solium Taeniasis Carriers in the Expatriate Population

Abstract

Objective: Taenia solium infection is not endemic to Kuwait, butseveral casesof cysticercosis have been detected in Kuwaiti nationals with no history of travelling to endemic countries. Infected domestic helpers/food handlers from endemic countries who may have escaped detection of infection by microscopy at the time of their arrival in Kuwait have been suspected as the possible source of infection. This study determined the seroprevalence of T. solium among domestic helpers/food handlers by screening their blood using a sensitive taeniasis-specific anti-rES33 antibody assay. Subjects and Methods: Newly arrived domestic helpers (n = 500) and food handlers (n = 500) from endemic countries were enrolled in the period 2015-2017. T. solium-specific rES33 antigen was expressed and purified from human embryonic kidney (HEK)293-6E cells using the pTT5 mammalian expression vector. Stool samples were processed for microscopy, and blood samples were screened to detect anti-T. soliumtaeniasis-specific IgG antibodies by ELISA. Results: All stool samples were negative for T. soliumparasiteeggs by microscopy. However, 42 individuals (4.2%) tested positive for T. soliumtaeniasis-specific IgG antibodies. Though statistically not significant, the IgG seropositivity was higher in individuals with a lower education level, a low-income background, and a lower frequency of hand-washing. Conclusions: This is the first report from Kuwait and the Middle East on the detection of anti-T. soliumtaeniasis-specific serum IgG antibodies among the high-risk expatriate population. The results emphasize the importance of efficient and sensitive screening of T. solium carriers and thus the prevention of infection transmission and development of cysticercosis in the local population.