Comparative assessment of immunochromatographic test kits using low-molecular-weight antigens from cyst fluids of two different genotypes of Taenia solium for serodiagnosis of human cysticercosis

Human cysticercosis is a serious zoonosis caused by infection with larvae (cysticerci) of the pork tapeworm, Taenia solium. Infection can involve the nervous system, causing chronic headache and intracranial hypertension, focal neurological deficits, epileptic seizures, and paralysis. The disease is found in developing countries, where porcine cysticercosis is prevalent and undercooked pork is habitually consumed. This study aimed to develop immunochromatography-based test (ICT) kits, using low-molecular-weight antigens purified from cyst fluids of Latin American and Asian genotypes of T. solium. To evaluate the kits, we used 164 serum samples, including 24 from proven/confirmed cysticercosis cases, 110 from cases with other parasitoses, and 30 from healthy individuals. Diagnostic performances were calculated. The sensitivity, specificity, and accuracy were 83.3% (95% CI [62.6-95.3]), 93.6% (95% CI [88.1-97.0]), and 92.1% (95% CI [86.8-95.7]), respectively for the American genotype-based ICT kit, while for the Asian genotype-based ICT kit, they were 87.5% (95% CI [67.6-97.3]), 98.6% (95% CI [94.9-99.8]), and 97.0% (95% CI [93.0-99.0]), respectively. The sensitivity and specificity did not significantly differ between the two ICT kits (exact McNemar's test; p > 0.05), with a concordance of 93.9%, represented by a Cohen's kappa of 0.77 (p < 0.001), indicating substantial agreement. These results indicate that affinity-purified antigens from different geographical isolates can be used for the diagnosis of human cysticercosis. The diagnostic specificities were better than for a previously reported ICT kit that used crude antigen.