1
|
Uwibambe E, Shyaka A, Niyotwagira E, Mutoniwase J, Fèvre EM, Quinnell RJ, Trevisan C. The Vicious Worm education tool improves the knowledge of community health workers on Taenia solium cysticercosis in Rwanda. PLoS Negl Trop Dis 2024; 18:e0012140. [PMID: 38630842 PMCID: PMC11057718 DOI: 10.1371/journal.pntd.0012140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/29/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
The pork tapeworm Taenia solium causes human taeniasis and cysticercosis when ingested as viable cysts and eggs, respectively. Despite its high health burden in low-income countries, knowledge of the parasite in endemic areas such as Rwanda is often limited. Here, we assess whether The Vicious Worm education software can increase knowledge in endemic areas of Rwanda. A cross-sectional mixed-methods study was conducted to evaluate knowledge about T. solium among community health workers trained using the Vicious Worm education software. Knowledge was assessed before, immediately after, and four weeks after the training. The health workers perceptions of the software were analysed thematically. A total of 207 community health workers were recruited from Nyamagabe district in Southern Province, Rwanda. Participants were composed of males (33.5%) and females (66.5%), aged between 22 and 68 years, and most (71%) had only completed primary education. Knowledge of cysticercosis at baseline was low, particularly knowledge of human cysticercosis and neurocysticercosis. The overall knowledge score increased significantly after training and was maintained four weeks after the training. Overall, insufficient knowledge was associated with neurocysticercosis-related questions, which after the training, remained relatively lower compared to questions of other categories. Participants reported the software to be user-friendly and educational. Digital illiteracy and the lack of smartphones were among the critical challenges highlighted in responses. This study has shown gaps in knowledge regarding T. solium infections within rural Rwanda, particularly neurocysticercosis. Health education using the Vicious Worm education software should be considered in integrated control programs.
Collapse
Affiliation(s)
- Esther Uwibambe
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
| | - Anselme Shyaka
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
| | - Egide Niyotwagira
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
| | | | - Eric M. Fèvre
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Rupert J. Quinnell
- Faculty of Biological Sciences, School of Biology, University of Leeds, Leeds, United Kingdom
| | - Chiara Trevisan
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
2
|
Zulu G, Mwape KE, Welte TM, Simuunza MC, Hachangu A, Mutale W, Chembensofu M, Sikasunge CS, Phiri IK, Winkler AS. Community knowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in Zambia. PLoS Negl Trop Dis 2023; 17:e0011375. [PMID: 37561784 PMCID: PMC10443877 DOI: 10.1371/journal.pntd.0011375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/22/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Several studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy. METHODS A community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-based survey conducted in each of the 25 purposely selected villages in Chiparamba Rural Health Centre (RHC) catchment area in Chipata district of the Eastern Province. RESULTS A total of 588 participants comprising 259 (44%) males and 329 (56%) females with median age of 42 years (range 17 to 92 years) were interviewed. Awareness of the signs and symptoms of taeniosis and human cysticercosis (HCC), including transmission and prevention measures was very low. Whilst the majority had heard about epilepsy, they were not able to link HCC to epilepsy. Most participants were aware of cysticerci in pigs (PCC) including its predilection sites but were not aware of mode of transmission and prevention measures. The pork meat inspection by trained professionals was also not a common practice in the area. Risk perception of T. solium infections was thus very low. Overall knowledge, attitude and practice scores related to T. solium infections and to epilepsy were very low with median scores of 0.38 (IQR 0.25-0.54) for knowledge, 0.25 (0.25-0.50) for attitudes, and 0.31 (0.25-0.44) for practices. Males had better knowledge on TSTC (median = 0.42, p = 0.017, r = 0.098) and better practice scores (median = 0.38, p = < 0.001, r = 0.154) compared to females though the effect size was small. With regards to sanitation and hygiene washing with soap and water was reported by many but only few had a hand washing facility near their latrines. CONCLUSION The study shows overall poor knowledge, attitudes and practices related to TSTC among the community of Chiparamba RHC in Chipata district of the Eastern Province of Zambia. This poses a serious challenge for control and elimination of T. solium infections and thus efforts to improve knowledge, attitudes and practices should be made using a One Health approach for the control and elimination of TSTC. Educational programs about TSTC transmission, signs and symptoms, prevention, management and control need to be scaled up in the study area and Zambia as a whole.
Collapse
Affiliation(s)
- Gideon Zulu
- Ministry of Health, Government of the Republic of Zambia
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Kabemba E. Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Tamara M. Welte
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, Munich, Germany
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Martin C. Simuunza
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Alex Hachangu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Wilbroad Mutale
- Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Mwelwa Chembensofu
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chummy S. Sikasunge
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Isaac K. Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Faculty of Medicine, Technical University of Munich, Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
3
|
Castillo Y, Wardle MT, Gamboa R, Elizalde M, Vilchez P, Rodriguez S, Gilman RH, Gonzalez AE, O’Neal SE, Garcia HH. Development and Laboratory Evaluation of a Simple, Field-Applicable Coproantigen Enzyme-Linked Immunosorbent Assay for Diagnosis of Taeniasis in Northern Peru. J Clin Microbiol 2023; 61:e0028223. [PMID: 37367233 PMCID: PMC10358167 DOI: 10.1128/jcm.00282-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Coproantigen detection by enzyme-linked immunosorbent assay (coAg ELISA) is a vital tool for detecting and treating cases of Taenia solium taeniasis. However, the assay's procedures require costly materials and sophisticated equipment, which are typically inaccessible in rural settings where the disease is endemic. To overcome these barriers, we developed and evaluated a field-applicable coAg ELISA. The field coAg ELISA was developed and evaluated across four phases using known positive and negative stool samples collected from northern Peru. Phase I focused on field assay development, phase II on a small-scale performance evaluation, phase III on a large-scale evaluation, and phase IV on the use and reliability of a colorimetric scale card. All samples were processed using the field and standard assay procedures and compared using signal-to-noise ratios, correlation tests, performance characteristics, and agreement statistics where appropriate. The field coAg ELISA using reagents stored at -20°C and commercially available water and milk powder, and relying on spontaneous separation of the supernatant, had performance comparable to the standard assay. The field coAg ELISA was strongly correlated with the standard in both the small- and large-scale laboratory evaluation (r = 0.99 and r = 0.98, respectively). Finally, the field assay had an almost perfect agreement between independent readers (kappa = 0.975) and between each reader and the spectrophotometer. The field coAg ELISA demonstrated performance comparable to the standard, providing a low-cost alternative to the standard assay for identifying cases of intestinal taeniasis in a low-resource setting.
Collapse
Affiliation(s)
- Yesenia Castillo
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Melissa T. Wardle
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Ricardo Gamboa
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mayra Elizalde
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia Rodriguez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Robert H. Gilman
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Seth E. O’Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Hector H. Garcia
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
4
|
Makingi G, Ngowi B, Mkupasi E, Wilson C, Winkler AS, Nzalawahe J, Ngowi H. Community Health-Education Intervention Trial against Human Taenia solium Taeniasis/Cysticercosis in Central and Southern Zones of Tanzania. Pathogens 2023; 12:955. [PMID: 37513802 PMCID: PMC10386120 DOI: 10.3390/pathogens12070955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/18/2023] [Accepted: 06/09/2023] [Indexed: 07/30/2023] Open
Abstract
Poor knowledge of human T. solium taeniasis/cysticercosis and insufficient sanitary and hygienic practices have been associated with the persistence of human T. solium infections in endemic areas. Community health education intervention measures were implemented in 42 villages of Kongwa and Songwe Districts to increase knowledge, improve good practices against infection and reduce incidences of human cysticercosis transmission using a health education package. The health education package comprised of leaflet, poster and a booklet The 42 villages were allocated into intervention group and control group, and each group consisted of 21 villages. Baseline and post-intervention information on social demography, knowledge, safe practices and incidences of human cysticercosis was collected from both village groups. The impact of the intervention was evaluated by comparing changes in knowledge, preventive practices related to human T. solium infections and the cumulative incidence of human cysticercosis between intervention and control villages. There was no significant difference in mean knowledge scores and preventive practice mean scores between the control and intervention groups at baseline. However, there were significantly higher knowledge mean scores in the intervention group compared to the control group at one year post-intervention (2.06 ± 1.45 vs. 0.94 ± 1.18, p < 0.001). There was no significant difference in the mean practice scores between the intervention and the control group at one year post-intervention (2.49 ± 1.13 vs. 2.40 ± 1.13, p = 0.31). Furthermore, there was no significant difference in the prevalence of human T. solium cysticercosis between the intervention and the control group at the baseline (1.4% vs. 1.4%, p = 0.97) by Ag-Elisa, and at one year post-intervention the cumulative incidence of human cysticercosis was 1.9 and 1.2 per cent in the control and intervention group, respectively. There was no significant difference in the cumulative incidence of human cysticercosis between the intervention and the control group at one year post-intervention (p > 0.05). Community health-education intervention is effective at improving the knowledge of human T. solium infections. The improvement in preventive practices and reduction in incidences of human cysticercosis are a gradual process, they may require sanitary and hygienic improvement and more time after the intervention to see improved changes. The study recommends a sustainable public health education on T. solium infections using the health education package through one health approach.
Collapse
Affiliation(s)
- George Makingi
- The College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Bernard Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam P.O. Box 3436, Tanzania
- Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya P.O. Box 608, Tanzania
| | - Ernatus Mkupasi
- The College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Christina Wilson
- The College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Andrea Sylvia Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0373 Oslo, Norway
| | - Jahashi Nzalawahe
- The College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Helena Ngowi
- The College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| |
Collapse
|
5
|
Rueda RG, Ospina RAK, Másmela LAO, López NG, Calambas AIO, Díaz LFN, Ippolito NGA, Fernández-Niño JA, Páez MCL. Knowledge and practices about taeniasis/cysticercosis complex within the framework of the national plan for its elimination in Colombia, 2019. Acta Trop 2023; 242:106907. [PMID: 36963599 DOI: 10.1016/j.actatropica.2023.106907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/08/2022] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination. OBJECTIVES To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia. METHODS A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n=152) (Atlantic Region) and Mercaderes, Cauca (n=152) (Andean Region). RESULTS Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities. CONCLUSION Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes.
Collapse
Affiliation(s)
| | | | | | - Natalia Gómez López
- Departamento de Historia, Facultad de Ciencias Sociales, Universidad de los Andes. Bogotá, Colombia
| | | | | | - Norman Giovanni Apráez Ippolito
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Secretaría Departamental de Salud del Cauca, Popayán, Colombia
| | | | | |
Collapse
|
6
|
The role of cooking practices in the transmission of the foodborne parasite Taenia solium: A qualitative study in an endemic area of Southern Tanzania. PLoS One 2022; 17:e0274877. [PMID: 36197909 PMCID: PMC9534410 DOI: 10.1371/journal.pone.0274877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 09/06/2022] [Indexed: 11/19/2022] Open
Abstract
The pork tapeworm Taenia solium is a zoonotic food-borne parasite endemic in many developing countries causing human cysticercosis and taeniosis as well as porcine cysticercosis. It mainly affects the health of rural smallholder pig farmers and their communities, resulting in lower health status, reduced pork quality, and economic loss due to condemnation of pigs or low pricing of pork. This qualitative study aimed to identify key food related practices linked to consumption of pork at village level, of importance for transmission of taeniosis. We used an interpretivist-constructivist paradigm in a multiple case study of exploratory qualitative research design. Data was acquired through guided and probing interviews with 64 pork cooks, and 14 direct observations in four villages in a T. solium endemic area of Mbeya Region in the Southern Highlands of Tanzania. The study showed that the informants were members of communities of practice through their pork cooking practices, one community of practice for the restaurant cooks and one for the home cooks, learning, sharing, and distributing their cooking skills. Furthermore, the analysis showed that the pork cooks generally had some awareness of there being something undesirable in raw pork, but they had very diverse understandings of what it was, or of its potential harm. Major potential transmission points were identified in restaurants and in home kitchens. It appears that the pork cooks act according to socio-cultural and economic factors guiding them in their actions, including pressure from customers in restaurants, the family values of tradition in the home kitchens, and the culturally guided risk perception and appraisal. These practices might generate potential transmission points. Future research on interventions aimed at preventing the spread of T. solium taeniosis should recognise the importance of tradition and culture in risky food practices.
Collapse
|
7
|
Ta R, Blond BN. The prevalence of and contributors to neurocysticercosis in endemic regions. J Neurol Sci 2022; 441:120393. [PMID: 36054944 DOI: 10.1016/j.jns.2022.120393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neurocysticercosis is one of the most common causes of acquired epilepsy worldwide. Caused by Taenia solium, the infection uses pigs as an intermediate host and thus is often associated with proximity to and consumption of pigs. OBJECTIVE This review explores the epidemiology of neurocysticercosis in endemic regions across Africa, Asia, and Latin America and examines common risk factors in these areas. METHODS A literature review was conducted using pubmed to search for articles with key words including neurocysticercosis, Taenia, solium, epidemiology, and the names of countries and continents in the regions of interest. FINDINGS Multiple risk factors for neurocysticercosis were identified, including inadequate regulation of pig farms and food safety, poor sanitation, and water contamination. In addition, additional barriers to appropriate diagnosis and management were found, including resource limitations and poor health literacy. CONCLUSION Despite its global prevalence, effective limitation of neurocysticercosis is still achievable through projects which address common risk factors.
Collapse
Affiliation(s)
- Ryan Ta
- Stony Brook University Renaissance School of Medicine, USA
| | | |
Collapse
|
8
|
Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries. PLoS Negl Trop Dis 2022; 16:e0010652. [PMID: 36037251 PMCID: PMC9462807 DOI: 10.1371/journal.pntd.0010652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 09/09/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Neurocysticercosis (NC) is one of the major parasitic diseases affecting the central nervous system and is endemic in much of Asia, sub-Saharan Africa, and Latin America. Its epidemiology is difficult to assess, although official registries are available in Brazil, Colombia, Ecuador, and Mexico. Methodology/Principal findings Using official statistics, we assessed trends in NC hospitalization rates during 1998–2019 in Brazil and Ecuador, during 2004–2019 in Mexico, and during 2009–2019 in Colombia. We also assessed the trend in NC mortality in Brazil (1998–2019), the trend in hospitalizations for NC in a Mexican tertiary-level hospital (Instituto Nacional de Neurología y Neurocirugía [INNN]; 1995–2019), and in Mexican primary care ambulatory clinics (1995–2019). Associations between NC hospitalization rates and the human development index (HDI) were also examined. In Brazil, Ecuador, and Mexico, statistically significant decreases in NC hospitalization rates were observed. In Mexico, a significant increase in the age of patients at INNN was observed, suggesting a decreasing incidence of recent infection. Conversely, a significant increase in NC hospitalization rate was observed in Colombia. HDI was not significantly associated with NC hospitalization rates when adjusting for time. Conclusions The downward trends in NC cases in Brazil, Ecuador, and Mexico are encouraging, especially in the context of the PAHO/WHO plan of action to eliminate neglected tropical diseases from the region. On the other hand, in Colombia, the increased NC hospitalization rate is concerning and needs further evaluation so that the authorities can take specific measures. These results should encourage health authorities in other endemic countries to establish a system of official registries to identify where the need for a control program is most urgent. However, it is also important to remember that NC persists, although less frequently in some Latin American countries, and efforts to achieve its control must continue. The present work shows the current trends in the frequency of neurocysticercosis hospitalizations in four endemic Latin American countries. Neurocysticercosis is a parasitic disease of the central nervous system that has been historically linked to poverty and poor sanitation. It is one of the neglected tropical diseases included in the PAHO/WHO action plan for their elimination. We compiled official data available from Brazil, Colombia, Ecuador, and Mexico. Our results show a clear and significant reduction in the disease burden in 3 of the 4 countries included. On the other hand, in Colombia, an increase in incidence was observed. These mixed results are of great relevance. They allow us to be optimistic about the possibility of eliminating this disease in some countries, but also allow us to consider why the disease does not seem to be controlled in other countries and direct public health measures aimed at eliminating this parasite in the countries that need it most.
Collapse
|
9
|
Wang Z, Garcia RM, Huff HV, Niquen-Jimenez M, Marcos LA, Lam SK. Neurocysticercosis control for primary epilepsy prevention: a systematic review. Pathog Glob Health 2022; 116:282-296. [PMID: 34928183 PMCID: PMC9248947 DOI: 10.1080/20477724.2021.2015869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Neurocysticercosis (NCC) is a leading cause of preventable epilepsy in lower- and upper- middle-income countries (LMICs/UMICs). NCC is a human-to-human transmitted disease caused by ingestion of Taenia solium eggs from a Taenia carrier. T. solium infection control is the key to reduce NCC incidence. This systematic review aims to identify T. solium control programs that can provide frameworks for endemic areas to prevent NCC-related epilepsy. A systematic search was conducted in PubMed/Medline, Embase, Web of Science, and Cochrane Library databases in March 2021. After title and abstract review, full texts were screened for qualitative analysis. Additional articles were identified via citation search. Of 1322 total results, 34 unique studies were included. Six major intervention types were identified: national policy (8.8%), community sanitation improvement (8.8%), health education (8.8%), mass drug administration (29.4%), pig vaccination and treatment (32.4%), and combined human and pig treatment (11.8%). Overall, 28 (82.4%) studies reported decreased cysticercosis prevalence following the intervention. Only health education and combined human and pig treatment were effective in all selected studies. NCC causes preventable epilepsy in LMICs/UMICs and its incidence can be reduced through T. solium control. Most interventions that disrupt the T. solium transmission cycle are effective. Long-term sustained results require comprehensive programs, ongoing surveillance, and collaborative effort among multisectoral agencies.
Collapse
Affiliation(s)
- Zhe Wang
- Department of Neurological Surgery, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Division of Infectious Diseases, Department of Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Department of Microbiology and Immunology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,CONTACT Zhe Wang Department of Neurological Surgery, Stony Brook University Renaissance School of Medicine, HSC T12 Rm 080, 100 Nicolls Rd, Stony Brook, NY11790, USA
| | - Roxanna M. Garcia
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hanalise V. Huff
- Fogarty Fellow, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Milagros Niquen-Jimenez
- Facultad de Medicina Humana Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis A. Marcos
- Division of Infectious Diseases, Department of Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA,Department of Microbiology and Immunology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Sandi K. Lam
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA
| |
Collapse
|
10
|
Nyangi C, Stelzle D, Mkupasi EM, Ngowi HA, Churi AJ, Schmidt V, Mahonge C, Winkler AS. Knowledge, attitudes and practices related to Taenia solium cysticercosis and taeniasis in Tanzania. BMC Infect Dis 2022; 22:534. [PMID: 35692033 PMCID: PMC9190087 DOI: 10.1186/s12879-022-07408-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungwe in Tanzania. Data on KAP were collected through questionnaire-based interviews and household infrastructure observations. Results Knowledge about porcine cysticercosis was good, particularly among pig keepers across the districts. Many participants had heard about the pork tapeworm (T. solium taeniasis), and the knowledge about signs/symptoms and treatment was fair, but the means of transmission and prevention measures were often unknown. Whilst most participants were familiar with epilepsy, no one knew anything about human cysticercosis and the link between cysticercosis and epileptic seizures. A similar trend is reflected through the attitudes toward the low risk perception of cysticercosis infection. Not surprisingly, the risk perception of the infection with the pork tapeworm was low too. Many participants reported not washing their hands before eating or after using the toilet which highlights potential risks for the development of human cysticercosis. Albeit nearly every participant reported using the toilet always, household observations revealed that toilets were either lacking or had no complete walls. Generally, household observations revealed a discrepancy between questionnaire answers on the one hand and the availability of toilet and handwashing facilities and the confinement of pigs on the other hand. Conclusion This study demonstrates knowledge gaps and adverse practices which may hinder and/or slow down the control/elimination of T. solium in endemic countries. The study results are also useful for appropriate designing of TSCT health interventions that need to be planned carefully, taking into account the local context and designing TSCT in partnership with the local communities from the beginning to the end applying a One Health approach to allow the possible sustained and best impacts. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07408-0.
Collapse
Affiliation(s)
- Chacha Nyangi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania. .,Department of Applied Sciences, Mbeya University of Science and Technology, Mbeya, Tanzania.
| | - Dominik Stelzle
- Center for Global Health, Department of Neurology, Technical University of Munich (TUM), Munich, Germany.,Chair of Epidemiology, Department of Sports and Health Sciences, Technical University Munich (TUM), Munich, Germany
| | - Ernatus M Mkupasi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Helena A Ngowi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Ayubu J Churi
- Centre for Information and Communication On Technology (CICT), Sokoine University of Agriculture, Morogoro, Tanzania
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, Technical University of Munich (TUM), Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Christopher Mahonge
- Department of Policy, Planning and Management, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Andrea S Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich (TUM), Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
11
|
Dixon MA, Winskill P, Harrison WE, Basáñez MG. Taenia solium taeniasis/cysticercosis: From parasite biology and immunology to diagnosis and control. ADVANCES IN PARASITOLOGY 2021; 112:133-217. [PMID: 34024358 DOI: 10.1016/bs.apar.2021.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infection with the pork tapeworm (Taenia solium) is responsible for a substantial global burden of disease, not only restricted to its impact on human health, but also resulting in a considerable economic burden to smallholder pig farmers due to pig cysticercosis infection. The life-cycle, parasitology and immunology of T. solium are complex, involving pigs (the intermediate host, harbouring the larval metacestode stage), humans (the definitive host, harbouring the adult tapeworm, in addition to acting as accidental intermediate hosts) and the environment (the source of infection with eggs/proglottids). We review the parasitology, immunology, and epidemiology of the infection associated with each of the T. solium life-cycle stages, including the pre-adult/adult tapeworm responsible for human taeniasis; post-oncosphere and cysticercus associated with porcine and human cysticercosis, and the biological characteristics of eggs in the environment. We discuss the burden associated, in endemic settings, with neurocysticercosis (NCC) in humans, and the broader cross-sectoral economic impact associated both with NCC and porcine cysticercosis, the latter impacting food-value chains. Existing tools for diagnostics and control interventions that target different stages of the T. solium transmission cycle are reviewed and their limitations discussed. Currently, no national T. solium control programmes have been established in endemic areas, with further work required to identify optimal strategies according to epidemiological setting. There is increasing evidence suggesting that cross-sectoral interventions which target the parasite in both the human and pig host provide the most effective approaches for achieving control and ultimately elimination. We discuss future avenues for research on T. solium to support the attainment of the goals proposed in the revised World Health Organisation neglected tropical diseases roadmap for 2021-2030 adopted at the 73rd World Health Assembly in November 2020.
Collapse
Affiliation(s)
- Matthew A Dixon
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Wendy E Harrison
- Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
| |
Collapse
|
12
|
Pinilla JC, Morales E, Muñoz AAF. A survey for potentially zoonotic parasites in backyard pigs in the Bucaramanga metropolitan area, Northeast Colombia. Vet World 2021; 14:372-379. [PMID: 33776302 PMCID: PMC7994133 DOI: 10.14202/vetworld.2021.372-379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aim: Backyard pigs farming is a rearing system associated with poor hygienic and sanitary conditions of the pig, often causing public health and food safety problems. Therefore, this study was conducted to investigate the occurrence of potentially zoonotic parasites in population pig reared under backyard farming in the Bucaramanga metropolitan area, Northeast Colombia. Materials and Methods: From September to December 2019, a total of 558 fecal samples from 64 backyard pig farms were examined for the presence of enteric protozoan infection. The coprological diagnosis was done by direct examination using Lugol’s iodine solution, buffered saline solution, and Kinyoun technique. In addition, blood samples were collected from 200 pigs. Serum was collected and used for the detection of Trichinella spiralis and Taenia solium cysticercosis infections, using the enzyme-linked immunosorbent assay. Results: The overall prevalence of zoonotic protozoa in the Bucaramanga metropolitan area was 65.2%, reporting 52.7% prevalence for Balantidium coli, 33.7% for Entamoeba coli, and 5.7% for Cryptosporidium spp. Regarding the prevalence by municipalities, there was no statistical association (p>0.05), indicating that the prevalence was similar in the region under study. Pigs >7 months of age showed to be a risk factor for B. coli infection, indicating that the prevalence increases with the age, while pigs raised at >1000 masl and access to latrines, increased infection risk for E. coli and Cryptosporidium spp. infections. In the present study, T. spiralis infection was not detected in the analyzed sera, while T. solium cysticercosis infection was found to be 40.5%. Conclusion: The high prevalence of protozoan infections and porcine cysticercosis reported in this study could be due to poor facilities, and lack of hygiene in the facilities, and suggests the possible transmission of these parasite populations between pigs and humans, thus increasing the transmission of parasites zoonotic potential. Therefore, appropriate sanitary management practices and deworming programs should be adopted to reduce the prevalence of these infectious agents.
Collapse
Affiliation(s)
- Juan Carlos Pinilla
- Department of Veterinary Medicine, Research Group in Agricultural Sciences, Faculty of Exact, Natural and Agricultural Sciences, University of Santander, Bucaramanga, Colombia
| | - Elsa Morales
- Department of Microbiology, Research Group in Clinical Sciences (CliniUdes), Faculty of Health, University of Santander, Bucaramanga, Colombia
| | - Angel Alberto Florez Muñoz
- Department of Veterinary Medicine, Research Group in Agricultural Sciences, Faculty of Exact, Natural and Agricultural Sciences, University of Santander, Bucaramanga, Colombia
| |
Collapse
|
13
|
Mendlovic F, Fleury A, Flisser A. Zoonotic Taenia infections with focus on cysticercosis due to Taenia solium in swine and humans. Res Vet Sci 2020; 134:69-77. [PMID: 33321377 DOI: 10.1016/j.rvsc.2020.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 01/12/2023]
Abstract
Zoonotic taeniasis caused by the adult stage of Taenia solium, Taenia saginata or Taenia asiatica are considered neglected tropical diseases by the World Health Organization. The life cycle of these 3 metazoan species is very similar and includes an intermediate host: pigs in the case of T. solium and T. asiatica, and cattle in the case of T. saginata. By eating meat (pork/T. solium, T. asiatica; beef/T. saginata) containing live cysticerci, humans develop taeniasis, which is practically asymptomatic but is the main risk factor for intermediate hosts to become infected. T. saginata causes bovine cysticercosis, while T. solium and T. asiatica cause swine cysticercosis, of veterinary and economic importance. T. solium cysticerci cause neurological disease in humans: neurocysticercosis. Cysticerci develop after ingesting microscopic eggs released from a human tapeworm carrier. Here we describe the life stages of the parasites, diagnosis, pathogenesis, symptomatology of neurocysticercosis, and prevention and control measures. Highlighting the need to validate diagnostic tools, treatments and vaccination in endemic areas, with the challenge of addressing the most vulnerable populations that lack resources. If people understand the transmission route, avoid eating uncooked or insufficiently cooked meat and have adequate hygienic habits, the life cycle of the 3 zoonotic Taenia species may be interrupted. In addition, we describe the growing field of immune response and immunomodulation elicited by the parasites, which may provide essential tools for diagnosis, treatment, control of taeniasis/cysticercosis, as well as for identification of parasite-derived immunomodulators that could aid in the treatment of emerging inflammatory diseases worldwide.
Collapse
Affiliation(s)
- Fela Mendlovic
- Facultad de Medicina, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico; Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, Estado de México, Mexico
| | - Agnes Fleury
- Instituto Nacional de Neurología y Neurocirugia "Manuel Velasco Suárez", SSA, Av. Insurgentes sur 3877, Col. La Fama, Tlalpan, Ciudad de México 14269, Mexico; Instituto de Investigaciones Biomédicas, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico
| | - Ana Flisser
- Facultad de Medicina, UNAM, Av. Universidad 3000, Col. Copilco-Universidad, Ciudad de México 04510, Mexico.
| |
Collapse
|
14
|
Vaernewyck V, Mwape KE, Mubanga C, Devleesschauwer B, Gabriël S, Trevisan C. Effects of 'The Vicious Worm' educational software on Taenia solium knowledge among key pork supply chain workers in Zambia. PLoS Negl Trop Dis 2020; 14:e0008790. [PMID: 33075045 PMCID: PMC7595624 DOI: 10.1371/journal.pntd.0008790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/29/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
The neglected zoonotic cestode Taenia solium is endemic in many low- and middle-income countries, including Zambia. The parasite infects humans and pigs, inflicting high socioeconomic and disease burdens in endemic areas. Health education is regarded as an important component in T. solium control and previous studies indicate that ‘The Vicious Worm’ may be an effective T. solium health education tool for Tanzanian medical and agricultural professionals and Zambian primary school students. This study aimed to assess the effects of health education using ‘The Vicious Worm’ among Zambian pork supply chain workers, because the pork supply chain greatly influences food safety and security in Zambia. Half-day educational workshops using ‘The Vicious Worm’ and subsequent follow-up sessions were organized in the Lusaka and Katete districts of Zambia in March and April 2019. Questionnaires were administered before, after, and three weeks after the use of ‘The Vicious Worm’ to assess the program’s impact on knowledge uptake and short-term retention. Focus group discussions were conducted to assess the program’s user experience and the participants’ beliefs, attitudes, and insights. In total, 47 pork supply chain workers participated: 25 from Lusaka and 22 from Katete. Overall, knowledge about T. solium was significantly higher (p<0.001) both immediately after, and three weeks after the use of ‘The Vicious Worm’ compared to baseline knowledge. Focus group discussions indicated incipient attitudinal and behavioral change, as well as a positive reception of the software; with participants describing the software as simple, educative, and useful to share knowledge. The study results indicate that workshops using ‘The Vicious Worm’ may be effective for short-term T. solium health education among key pork supply chain workers. Follow-up studies are required to assess long-term effects, transfer of knowledge and behavioral change. However, educational interventions with ‘The Vicious Worm’ could be considered for integrated T. solium control programs in sub-Saharan Africa, especially if the educational content is further simplified and clarified. The tapeworm Taenia solium causes epilepsy and severe headaches in humans and economic losses to smallholder farmers in endemic areas where free-roaming pigs, poor sanitation and informal animal slaughter are prevalent. Treatment of human taeniosis and interventions in pigs (vaccination and anthelmintic treatment) have been established as essential tools to achieve short-term control, but health education will be crucial to sustain long-term control. ‘The Vicious Worm’ is a specific T. solium health education tool aiming to convey simple and meaningful messages concerning disease prevention and control. Previous studies found significant knowledge increases after the use of the educational tool in Tanzanian medical and agricultural professionals, and Zambian primary school students. We organized half-day educational workshops using ‘The Vicious Worm’ for pork supply chain workers at two study sites in Zambia, with follow-up visits three weeks later. We found a significant increase in participants’ knowledge, both immediately and three weeks after the health education. Furthermore, the program was well received and potentially led to attitudinal and behavioral change that could deter the propagation of T. solium. We conclude that ‘The Vicious Worm’ educational interventions may contribute to a safer pork supply chain and we encourage its implementation in future T. solium control strategies.
Collapse
Affiliation(s)
- Victor Vaernewyck
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Kabemba Evans Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chishimba Mubanga
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Brecht Devleesschauwer
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| |
Collapse
|
15
|
Mital AK, Choudhary P, Jain RB. Prevalence and risk factors for neurocysticercosis in children with a first-onset seizure in rural North India. Paediatr Int Child Health 2020; 40:158-165. [PMID: 32204672 DOI: 10.1080/20469047.2020.1739381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Neurocysticercosis (NCC) is a parasitic infection acquired by consuming food and water contaminated by the faeces of a Taenia solium tapeworm carrier. It is an important cause of acquired seizures and also the common identifiable cause of new-onset seizures in children. METHODS A hospital-based prospective cross-sectional study of NCC was undertaken in a medical college in north-west India. All patients aged 1-15 years admitted to the paediatric emergency room with a first-onset seizure were selected.NCC was diagnosed and staged on the basis of MRI findings. A structured, pretested schedule was administered to each patient's parent for analysis of risk factors for NCC. RESULTS Of 79 patients with first-onset seizure, 43 (54.4% were diagnosed with NCC based on MRI findings. The association of NCC with age and pig-rearing near the patients' homes was statistically significant (p = 0.01 and 0.02, respectively). The association between NCC and other risk factors such as gender, religion, father's occupation, parents' literacy, source and storage of drinking water, the washing and peeling of fruit and vegetables and distance of refuse disposal from residential areas was not statistically significant. Although open defaecation is an important risk factor for transmission of NCC, there was no significant association with NCC. CONCLUSION In India, NCC is a common cause of first-onset seizure. The major risk factors are poor environmental sanitation and poor food and drinking water hygiene. NCC can be controlled and prevented by generating awareness of hygienic consumption of food and water and the provision of good sanitation.
Collapse
Affiliation(s)
- Amit Kumar Mital
- Department of Pediatrics, Bhagat Phool Singh Government Medical College for Women , Sonepat, India
| | | | - R B Jain
- Department of Community Medicine, PGIMS , Rohtak, India
| |
Collapse
|
16
|
Hobbs EC, Mwape KE, Phiri AM, Mambwe M, Mambo R, Thys S, Zulu G, Chembensofu M, Trevisan C, Van Damme I, Phiri IK, Devleesschauwer B, Ketzis J, Dorny P, Willingham AL, Gabriël S. Perceptions and acceptability of piloted Taenia solium control and elimination interventions in two endemic communities in eastern Zambia. Transbound Emerg Dis 2020; 67 Suppl 2:69-81. [PMID: 31231968 PMCID: PMC7496623 DOI: 10.1111/tbed.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/23/2022]
Abstract
Infections with Taenia solium cause significant public health and economic losses worldwide. Despite effective control tools, long-term sustained control/elimination of the parasite has not been demonstrated to date. Success of intervention programs is dependent on their acceptability to local communities. Focus group discussions (FGDs) and questionnaires (QS) were conducted in two study communities in eastern Zambia to assess local perceptions and acceptance of two piloted intervention strategies: one targeting pigs only ('control' study arm), and one integrated human- and pig-based ('elimination') strategy. QS (n = 227) captured data regarding participation in project activities, knowledge and perceptions of T. solium and of the interventional drugs used in the study. FGDs (n = 18) discussed perceived advantages and disadvantages of the interventions and of the project's delivery and value. QS data revealed 67% of respondents participated in at least one educational activity, and 80% correctly identified at least one disease targeted by the education. All elimination study arm respondents (n = 113) had taken the human treatment, and 98% intended to do so next time. Most (70%) indicated willingness to pay for future treatments (median 0.20 USD per dose). Of pig-owning respondents, 11/12 (92%) had allowed their pigs to be treated/vaccinated and all intended to do so again next time. Four pig owners indicated willingness to pay 0.10-0.50 USD per dose of treatment or vaccine. FGD feedback revealed positive perceptions of interventions; people reported improved health in themselves and their pigs, and fewer cysticerci in pork. Latrine use, hand washing, meat inspection and proper cooking of pork had reportedly increased since the program's inception. Preliminary assessment indicates that the piloted intervention methods are generally acceptable to the communities. The reported willingness of many respondents to pay for the medications would contribute to the feasibility of long-term, government-led T. solium intervention programs in future.
Collapse
Affiliation(s)
- Emma Clare Hobbs
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Andrew M. Phiri
- School of Veterinary MedicineUniversity of ZambiaLusakaZambia
| | - Moses Mambwe
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | - Richard Mambo
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | - Gideon Zulu
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | | | - Inge Van Damme
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | | | - Jennifer Ketzis
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
| | - Pierre Dorny
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineSaint KittsWest Indies
| | - Sarah Gabriël
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| |
Collapse
|
17
|
Garcia HH, Gonzalez AE, Gilman RH. Taenia solium Cysticercosis and Its Impact in Neurological Disease. Clin Microbiol Rev 2020; 33:e00085-19. [PMID: 32461308 PMCID: PMC7254859 DOI: 10.1128/cmr.00085-19] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
Collapse
Affiliation(s)
- Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E Gonzalez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
18
|
Zoonotic and vector-borne parasites and epilepsy in low-income and middle-income countries. Nat Rev Neurol 2020; 16:333-345. [PMID: 32427939 DOI: 10.1038/s41582-020-0361-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 12/22/2022]
Abstract
Zoonotic and vector-borne parasites are important preventable risk factors for epilepsy. Three parasitic infections - cerebral malaria, Taenia solium cysticercosis and onchocerciasis - have an established association with epilepsy. Parasitoses are widely prevalent in low-income and middle-income countries, which are home to 80% of the people with epilepsy in the world. Once a parasitic infection has taken hold in the brain, therapeutic measures do not seem to influence the development of epilepsy in the long term. Consequently, strategies to control, eliminate and eradicate parasites represent the most feasible way to reduce the epilepsy burden at present. The elucidation of immune mechanisms underpinning the parasitic infections, some of which are parasite-specific, opens up new therapeutic possibilities. In this Review, we explore the pathophysiological basis of the link between parasitic infections and epilepsy, and we consider preventive and therapeutic approaches to reduce the burden of epilepsy attributable to parasitic disorders. We conclude that a concerted approach involving medical, veterinary, parasitological and ecological experts, backed by robust political support and sustainable funding, is the key to reducing this burden.
Collapse
|
19
|
Beam M, Spencer AG, Atto R, Camizan R, Vilchez P, Muro C, Gamboa R, Pray I, Garvey B, Fernandez L, Garcia HH, O'Neal SE, For The Cysticercosis Working Group In Peru. To Really Know the Disease: Creating a Participatory Community Education Workshop about Taenia solium Focused on Physical, Economic, and Epidemiologic Evidence. Am J Trop Med Hyg 2020; 100:1490-1493. [PMID: 30938282 DOI: 10.4269/ajtmh.18-0939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cysticercosis, caused by Taenia solium, is a neglected disease that causes preventable epilepsy. We conducted an experiential learning workshop in northern Peru to educate community members on T. solium transmission and motivate participation in community-led prevention and control. The workshop included presentation of local economic and epidemiologic data, followed by hands-on participation in pig dissection, group discussion of the T. solium life cycle, and viewing of eggs and nascent tapeworms with light microscopes. Among heads of household, we used community survey data to compare knowledge of the three-stage parasite life cycle at baseline and 2 months postworkshop. Knowledge of the life cycle increased significantly after the workshop, with greater gains for workshop attendees than non-attendees. Prior knowledge and workshop attendance were significant predictors of postworkshop knowledge. The use of local evidence and experiential learning positively affected knowledge of T. solium transmission, laying the foundation for subsequent community-engaged control efforts.
Collapse
Affiliation(s)
- Michelle Beam
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Angela G Spencer
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Ruth Atto
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Roberto Camizan
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudio Muro
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Gamboa
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ian Pray
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Brian Garvey
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Lauralee Fernandez
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Hector H Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E O'Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | | |
Collapse
|
20
|
Smallholder pig farming education improved community knowledge and pig management in Angónia district, Mozambique. Trop Anim Health Prod 2019; 52:1447-1457. [PMID: 31758385 DOI: 10.1007/s11250-019-02148-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
Education on pig farming has been recognized as an important method of transferring knowledge and improving production among smallholder pig producers in rural settings, but the effectiveness of this in different rural settings remains unknown. A community-based intervention trial on smallholder pig farmers was conducted with the aim of evaluating the effectiveness of pig farming education. Baseline information was collected using interview-based questionnaires and observations regarding pig welfare and husbandry practices followed by participatory pig farming education and field demonstrations. The study was carried out between May 2014 and May 2016 and involved 90 smallholder pig farmers from six villages in Angónia district, of Tete province in Mozambique. The baseline questionnaire among several aspects regarding pig management highlighted that most farmers had an overall knowledge on aspects of transmission (55.1%) and prevention (48.9%) of African swine fever (ASF), porcine cysticercosis (PC) transmission (8.2%), and field diagnosis (36.7%), and they were not aware of the zoonotic potential of PC or the basic husbandry procedures of pigs kept under permanent confinement. Forty-nine of the 90 farmers enrolled, participated in the pig farming education, which provided the basis for making a comparison between trained (54%) and non-trained (46%) pig farmers. Since knowledge for ASF transmission (P < 0.036), pig pen design (P < 0.014), reasons for confine the pigs (P < 0.016), as well as the adoption of the new introduced pig pen model (P < 0.025), and the practices of acceptable, good hygiene of the pig pen (P < 0.009 and P < 0.014, respectively), improved significantly in both groups, a remarkable spill-over was observed, proving villagers capable of transferring knowledge within the villages. However, water provision and total confinement in both groups were still not practiced by the most farmers following the pig farming education (P > 0.174 and 0.254). It is concluded that despite improved knowledge, the farmers failed to follow several recommendations, most likely due to poverty such as lack of basic resources like food and water, which even the farmers themselves lacked for their day to day living.
Collapse
|
21
|
The World Health Organization 2030 goals for Taenia solium: Insights and perspectives from transmission dynamics modelling: CystiTeam Group for Epidemiology and Modelling of Taenia solium Taeniasis/Cysticercosis. Gates Open Res 2019; 3:1546. [PMID: 31701092 PMCID: PMC6820453 DOI: 10.12688/gatesopenres.13068.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2019] [Indexed: 12/14/2022] Open
Abstract
Taenia solium (TS), responsible for porcine cysticercosis, human taeniasis and (neuro)cysticercosis, was included in the World Health Organization neglected tropical disease (NTD) roadmap published in 2012. Targets set in this roadmap have not been met, but T. solium has been included in the consultation process for the new 2030 goals proposed for priority NTDs. Taenia solium transmission dynamics models can contribute to this process. A recent review has compared existing T. solium transmission models, identifying their similarities and differences in structure, parameterization and modelled intervention approaches. While a formal model comparison to investigate the impact of interventions is yet to be conducted, the models agree on the importance of coverage for intervention effectiveness and on the fact that human- and pig-focused interventions can be optimally combined. One of these models, cystiSim, an individual-based, stochastic model has been used to assess field-applicable interventions, some currently under evaluation in on-going trials in Zambia. The EPICYST, population-based, deterministic model has highlighted, based on simulating a generic sub-Saharan Africa setting, the higher efficacy (measured as the percentage of human cysticercosis cases prevented) of biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection. Important questions remain regarding which strategies and combinations thereof provide sustainable solutions for severely resource-constrained endemic settings. Defining realistic timeframes to achieve feasible targets, and establishing suitable measures of effectiveness for these targets that can be quantified with current monitoring and evaluation tools, are current major barriers to identifying validated strategies. Taenia solium transmission models can support setting achievable 2030 goals; however, the refinement of these models is first required. Incorporating socio-economic elements, improved understanding of underlying biological processes, and consideration of spatial dynamics are key knowledge gaps that need addressing to support model development.
Collapse
|
22
|
The World Health Organization 2030 goals for Taenia solium: Insights and perspectives from transmission dynamics modelling: CystiTeam Group for Epidemiology and Modelling of Taenia solium Taeniasis/Cysticercosis. Gates Open Res 2019. [PMID: 31701092 DOI: 10.12688/gatesopenres.13068.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Taenia solium (TS), responsible for porcine cysticercosis, human taeniasis and (neuro)cysticercosis, was included in the World Health Organization neglected tropical disease (NTD) roadmap published in 2012. Targets set in this roadmap have not been met, but T. solium has been included in the consultation process for the new 2030 goals proposed for priority NTDs. Taenia solium transmission dynamics models can contribute to this process. A recent review has compared existing T. solium transmission models, identifying their similarities and differences in structure, parameterization and modelled intervention approaches. While a formal model comparison to investigate the impact of interventions is yet to be conducted, the models agree on the importance of coverage for intervention effectiveness and on the fact that human- and pig-focused interventions can be optimally combined. One of these models, cystiSim, an individual-based, stochastic model has been used to assess field-applicable interventions, some currently under evaluation in on-going trials in Zambia. The EPICYST, population-based, deterministic model has highlighted, based on simulating a generic sub-Saharan Africa setting, the higher efficacy (measured as the percentage of human cysticercosis cases prevented) of biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection. Important questions remain regarding which strategies and combinations thereof provide sustainable solutions for severely resource-constrained endemic settings. Defining realistic timeframes to achieve feasible targets, and establishing suitable measures of effectiveness for these targets that can be quantified with current monitoring and evaluation tools, are current major barriers to identifying validated strategies. Taenia solium transmission models can support setting achievable 2030 goals; however, the refinement of these models is first required. Incorporating socio-economic elements, improved understanding of underlying biological processes, and consideration of spatial dynamics are key knowledge gaps that need addressing to support model development.
Collapse
|
23
|
Zang XZ, Li HZ, Qian MB, Chen YD, Zhou CH, Liu HK, Liu YH, Li SZ. Extensive disseminated cysticercosis: a case report in Yunnan province, China. BMC Infect Dis 2019; 19:535. [PMID: 31208369 PMCID: PMC6580573 DOI: 10.1186/s12879-019-4172-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cysticercosis is spreading all over the world and it is a major health problem in most countries of Latin America, Africa, and Asia. Extensive disseminated cysticercosis is relatively rare and fewer than 120 case have been reported in the worldwide. We reported a rare case of extensive disseminated cysticercosis in Yunan province, China. CASE PRESENTATION A rare case of extensive disseminated cysticercosis, in a 61-year-old male Chinese was detected from Yunnan province in 2018. Clinical and etiological examination was performed, as well as the epidemiological investigation. CONCLUSION The life cycle of T. solium in the area where the case came from is complete. We expect this case could raise the attentions to the control of Taenia solium infection and subsequent cysticercosis there.
Collapse
Affiliation(s)
- Xin-Zhong Zang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 China
| | - Huan-Zhang Li
- Dandong City Center for Disease Control and Prevention, Dandong, 118000 Liaoning province China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 China
| | - Ying-Dan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 China
| | - Chang-Hai Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 China
| | - Hong-Kun Liu
- Dali Prefectural Institute of Research and Control on Schistosomiasis, Dali, 671000 Yunnan province China
| | - Yu-Hua Liu
- Dali Prefectural Institute of Research and Control on Schistosomiasis, Dali, 671000 Yunnan province China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 China
| |
Collapse
|
24
|
Hobbs EC, Mwape KE, Devleesschauwer B, Van Damme I, Krit M, Berkvens D, Zulu G, Mambwe M, Chembensofu M, Trevisan C, Baauw J, Phiri IK, Speybroeck N, Ketzis J, Dorny P, Willingham AL, Gabriël S. Effects of 'The Vicious Worm' educational tool on Taenia solium knowledge retention in Zambian primary school students after one year. PLoS Negl Trop Dis 2019; 13:e0007336. [PMID: 31107880 PMCID: PMC6544326 DOI: 10.1371/journal.pntd.0007336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/31/2019] [Accepted: 03/27/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Taenia solium is a neglected zoonotic parasite endemic throughout many low-income countries worldwide, including Zambia, where it causes human and pig diseases with high health and socioeconomic burdens. Lack of knowledge is a recognized risk factor, and consequently targeted health educational programs can decrease parasite transmission and disease occurrence in endemic areas. Preliminary assessment of the computer-based education program 'The Vicious Worm' in rural areas of eastern Zambia indicated that it was effective at increasing knowledge of T. solium in primary school students. The aim of this study was to evaluate the impact of 'The Vicious Worm' on knowledge retention by re-assessing the same primary school students one year after the initial education workshops. METHODOLOGY/PRINCIPAL FINDINGS Follow-up questionnaires were administered in the original three primary schools in eastern Zambia in 2017, 12 months after the original workshops. In total, 86 pupils participated in the follow-up sessions, representing 87% of the initial workshop respondents. Knowledge of T. solium at 'follow-up' was significantly higher than at the initial 'pre' questionnaire administered during the Vicious Worm workshop that took place one year earlier. While some specifics of the parasite's life cycle were not completely understood, the key messages for disease prevention, such as the importance of hand washing and properly cooking pork, remained well understood by the students, even one year later. CONCLUSIONS/SIGNIFICANCE Results of this study indicate that 'The Vicious Worm' may be an effective tool for both short- and long-term T. solium education of rural primary school students in Zambia. Inclusion of educational workshops using 'The Vicious Worm' could be recommended for integrated cysticercosis control/elimination programs in sub-Saharan Africa, particularly if the content is simplified to focus on the key messages for prevention of disease transmission.
Collapse
Affiliation(s)
- Emma C. Hobbs
- Department of Biomedical Sciences, One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, St Kitts, West Indies
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Kabemba Evans Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Brecht Devleesschauwer
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Meryam Krit
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dirk Berkvens
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gideon Zulu
- Department of Public Health, Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia
| | - Moses Mambwe
- Department of Public Health, Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia
| | - Mwelwa Chembensofu
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jacoba Baauw
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Isaac Khozozo Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Niko Speybroeck
- Institute for Health Research and Society, Université catholique de Louvain, Institute of Health and Society (IRSS), Brussels, Belgium
| | - Jennifer Ketzis
- Department of Biomedical Sciences, One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, St Kitts, West Indies
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Arve Lee Willingham
- Department of Biomedical Sciences, One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, St Kitts, West Indies
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| |
Collapse
|
25
|
Adesokan HK, Adeoye FA. Porcine cysticercosis in slaughtered pigs and factors related to Taenia solium transmission amongst abattoir workers in Ibadan, Nigeria. Pan Afr Med J 2019; 32:145. [PMID: 31308860 PMCID: PMC6610151 DOI: 10.11604/pamj.2019.32.145.10695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 07/18/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION porcine cysticercosis is under-reported particularly in Nigeria, despite the reportedly high prevalence of epilepsy and associated life-threatening health implications. This study was aimed at determining the prevalence of porcine cysticercosis and factors related to Taenia solium transmission to humans. METHODS slaughtered pigs at a major abattoir, south-western Nigeria were randomly inspected and questionnaire was administered to pig workers/consumers while the data were analysed using Stata 12.0. RESULTS a 4.4% (11/250) prevalence of porcine cysticercosis was obtained; the age, breed, sex and body conditions of pigs were not significant for infection (p < 0.05). Further, none (0.0%) of the respondents knew that T. solium could cause epilepsy in man and 39.5% often defaecated on neighbouring open fields and farmlands. Respondents purchasing pork from home slaughter were about four and ten times less likely to demonstrate good knowledge (OR = 0.24; 95% CI: 0.08-0.74) and practice (OR = 0.10; 95% CI: 0.05-0.22) than those purchasing from abattoir. Moreover, those lacking toilet facility were about four and five times less likely to demonstrate good knowledge (OR = 0.24; 95% CI: 0.07-0.86) and practice (OR = 0.19; 95% CI: 0.08-0.45) than those who had it. Other factors associated with practices related to T. solium transmission included age (p = 0.000), sex (p = 0.000) and duration (p = 0.003). CONCLUSION the increased odds of poor knowledge and practices related to Taenia solium transmission especially among respondents purchasing home slaughter pork and lacking toilet facility provides insights into the parasite epidemiology. Above findings are important in lowering the infection prevalence in pigs and humans in this endemic area.
Collapse
Affiliation(s)
- Hezekiah Kehinde Adesokan
- Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Nigeria
| | | |
Collapse
|
26
|
Morales J, Martínez JJ, Villalobos N, Hernández M, Ramírez R, Salgado-Estrada B, Jiménez H, Figueroa A, Sánchez LM, Lazcano E, Fleury A, Aluja A, Sciutto E. PersistentTaenia soliumCysticercosis In the State of Morelos, Mexico: Human and Porcine Seroprevalence. J Parasitol 2018; 104:465-472. [DOI: 10.1645/18-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Julio Morales
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar s/n, Ciudad Universitaria, CDMX, 04510, México
| | - José Juan Martínez
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Circuito Exterior s/n, Edificio A, Ciudad Universitaria, CDMX, 04510, México
| | - Nelly Villalobos
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Circuito Exterior s/n, Edificio A, Ciudad Universitaria, CDMX, 04510, México
| | - Marisela Hernández
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar s/n, Ciudad Universitaria, CDMX, 04510, México
| | - Rubén Ramírez
- Facultad de Medicina Veterinaria y Zootecnia, Benemérita Universidad Autónoma de Puebla, Carretera Tecamachalco-Cañada Morelos Km 7.5, El Salado, Tecamachalco, 75460, Puebla, México
| | - Berenice Salgado-Estrada
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar s/n, Ciudad Universitaria, CDMX, 04510, México
| | - Herminio Jiménez
- Facultad de Medicina Veterinaria y Zootecnia, Benemérita Universidad Autónoma de Puebla, Carretera Tecamachalco-Cañada Morelos Km 7.5, El Salado, Tecamachalco, 75460, Puebla, México
| | - Alfredo Figueroa
- Unidad Académica de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Lázaro Cárdenas, El Centenario, Chilpancingo de los Bravo, 39044, Guerrero, México
| | - Luisa María Sánchez
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, SSA, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, 62100, Morelos, México
| | - Eduardo Lazcano
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, SSA, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, 62100, Morelos, México
| | - Agnes Fleury
- Unidad Periférica del Instituto de Investigaciones Biomédicas, Sede Instituto Nacional de Neurología y Neurocirugía, Insurgentes Sur, 3877, La Fama, Tlalpan 14269, CDMX, México
| | - Aline Aluja
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Circuito Exterior s/n, Edificio A, Ciudad Universitaria, CDMX, 04510, México
| | - Edda Sciutto
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar s/n, Ciudad Universitaria, CDMX, 04510, México
| |
Collapse
|
27
|
Beam M, Spencer A, Fernandez L, Atto R, Muro C, Vilchez P, Gamboa R, Olaya S, Ayvar V, Gonzalez AE, Garcia HH, O'Neal SE, For The Cysticercosis Working Group In Peru. Barriers to Participation in a Community-Based Program to Control Transmission of Taenia solium in Peru. Am J Trop Med Hyg 2018; 98:1748-1754. [PMID: 29663901 DOI: 10.4269/ajtmh.17-0929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Infection of the brain with Taenia solium larvae (neurocysticercosis) is a leading cause of preventable epilepsy worldwide. Effective and sustainable strategies to control parasite transmission in rural endemic communities are needed to prevent the disease. Surveillance and targeted intervention around infected pigs (ring control strategy) have been shown to be effective when carried out by research teams. However, this strategy has not been implemented or tested as a community-based program. In this small trial in northern Peru, eight villages were randomly assigned to community-led surveillance and treatment (five villages, 997 residents) or control (three villages, 1,192 residents). In intervention villages, community-led surveillance and reporting were promoted by community health workers, radio advertisement, and school and household education. Each suspected pig infection was verified, with confirmed cases resulting in treatment with niclosamide for taeniasis and oxfendazole for pigs in clusters of homes nearby. No incentives beyond human and pig treatment were offered. Control villages received basic disease education but no treatment intervention in response to reports. Despite 14 case reports, community-based replication of ring control strategy did not replicate prior results. After 12 months, there was no change in seroincidence in intervention villages between the baseline and study end, and no difference compared with control villages. There was no difference in prevalence of taeniasis or porcine cysticercosis at study end. Community members described lack of knowledge as the main reason for not reporting infected pigs. Further exploration of methods to transfer ring strategy and other control interventions for cysticercosis to the community is needed.
Collapse
Affiliation(s)
- Michelle Beam
- School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Angela Spencer
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Lauralee Fernandez
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Ruth Atto
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudio Muro
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Gamboa
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sandra Olaya
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Viterbo Ayvar
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.,Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E O'Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | | |
Collapse
|
28
|
Walsh JL, Aridi H, Fathallah J, Al-Shaar L, Alam S, Nasreddine L, Isma'eel H. Impact of a hospital-based educational intervention on dietary salt-related knowledge and behaviour in a cardiac care unit population in Lebanon. Cardiovasc Diagn Ther 2018; 8:146-155. [PMID: 29850405 DOI: 10.21037/cdt.2017.12.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Cardiovascular disease is the most common cause of morbidity and mortality worldwide. Numerous strategies have been effective in reducing cardiovascular disease risk, from pharmacological approaches to lifestyle modification interventions. One of these strategies includes the reduction in dietary sodium which in turn reduces cardiovascular risk by reducing high blood pressure, perhaps the most important cardiovascular risk factor. Methods We evaluated an educational dietary salt reduction intervention in a cardiac care unit population in Lebanon, assessing salt related knowledge and behaviours before and after administering an evidence-based educational leaflet to patients. Results Salt-related knowledge improved significantly immediately post-intervention and subsequently fell on 4-week follow-up, but remained above baseline. Three of the four salt-related behaviours measured improved on 4-week follow-up: trying to buy low-salt foods increased from 54% to 74% (P=0.007), adding salt at the table reduced from 44% to 34% (P=0.03) and trying to buy food with no added salt increased from 24% to 52% (P=0.02) of the cohort. Adding salt during cooking did not differ significantly. A trend towards improved behavioural risk category in the cohort overall was observed on follow-up (P=0.07), 32% of participants were categorised as high behavioural risk pre-intervention, reducing to 17% on follow-up. Multi-ordered regression modelling identified being in the high-risk behavioural category at baseline as a predictor of being in the high-risk or moderate-risk category on follow-up. Conclusions This hospital-based educational intervention had a modestly positive impact on salt-related knowledge and behaviour, with participants in the highest behavioural risk category at baseline being most resistant to behavioural improvement.
Collapse
Affiliation(s)
- Jason L Walsh
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Hussam Aridi
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Jihan Fathallah
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Laila Al-Shaar
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Samir Alam
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Hussain Isma'eel
- Vascular Medicine Programme, American University of Beirut Medical Centre, Beirut, Lebanon
| |
Collapse
|
29
|
Hobbs EC, Mwape KE, Van Damme I, Berkvens D, Zulu G, Mambwe M, Chembensofu M, Phiri IK, Masuku M, Bottieau E, Devleesschauwer B, Speybroeck N, Colston A, Dorny P, Willingham AL, Gabriël S. Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia. Trop Med Int Health 2018; 23:306-314. [PMID: 29314480 PMCID: PMC5888122 DOI: 10.1111/tmi.13029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. METHODS Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. RESULTS In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. CONCLUSION Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa.
Collapse
Affiliation(s)
- Emma C. Hobbs
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineBasseterreSt Kitts, West Indies
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Inge Van Damme
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | - Gideon Zulu
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | - Moses Mambwe
- Ministry of HealthGovernment of the Republic of ZambiaLusakaZambia
| | | | | | - Maxwell Masuku
- School of Veterinary MedicineUniversity of ZambiaLusakaZambia
| | | | | | - Niko Speybroeck
- Institute of Health and SocietyUniversité Catholique de LouvainBrusselsBelgium
| | - Angela Colston
- Global Alliance for Livestock Veterinary Medicines (GALVmed)NairobiKenya
| | - Pierre Dorny
- Institute of Tropical MedicineAntwerpBelgium
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary MedicineRoss University School of Veterinary MedicineBasseterreSt Kitts, West Indies
| | - Sarah Gabriël
- Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| |
Collapse
|
30
|
Chilundo AG, Johansen MV, Pondja A, Miambo R, Afonso S, Mukaratirwa S. Piloting the effectiveness of pig health education in combination with oxfendazole treatment on prevention and/or control of porcine cysticercosis, gastrointestinal parasites, African swine fever and ectoparasites in Angónia District, Mozambique. Trop Anim Health Prod 2017; 50:589-601. [PMID: 29139069 DOI: 10.1007/s11250-017-1474-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/08/2017] [Indexed: 11/27/2022]
Abstract
A community-based intervention combining health education (HE) and treatment of pigs for control of porcine cysticercosis (PC), gastrointestinal (GI) helminths, African swine fever (ASF) and external parasites was tested involving six villages of resource-poor smallholder pig farmers. Farmers and pigs of six rural villages were randomly allocated into group 1 (HE), which served as controls, and group 2 (HE + OFZ) pigs received a single oral dose of 30 mg/kg OFZ. Farmers were trained in pig health, housing and feeding. The proportion of farmers with confined pigs, the adoption rate of the introduced pig pen, the sero-prevalence of PC and ASF, the prevalence and intensity of GI nematodes and the prevalence of ectoparasites were measured at 9, 15 and 24 months after initiation and compared to a baseline survey to seek the effectiveness of the interventions. There was no clear effect of the intervention on the sero-prevalence of PC, but analysis of the rate of change in prevalence between the two groups showed significant effect with the rate of change to lower prevalence in the HE + OFZ group compared to the HE group. Although HE managed to improve the farmer's knowledge in the control and prevention of ASF and ectoparasites, there was no significant reduction in the sero-prevalence of ASF and the prevalence of ectoparasites throughout the two-year period. The reported ineffectiveness of the intervention in this study suggested that more research is needed to develop more effective methods for controlling PC, ASF and pig parasites.
Collapse
Affiliation(s)
- A G Chilundo
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique.
- School of Life Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
| | - M V Johansen
- Section for Parasitology and Aquatic Pathobiology, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, DK-1870, Frederiksberg C, Denmark
| | - A Pondja
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - R Miambo
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - S Afonso
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - S Mukaratirwa
- School of Life Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| |
Collapse
|
31
|
Adenuga A, Mateus A, Ty C, Borin K, Holl D, San S, Duggan V, Clark M, Smith GJD, Coker R, Vaughn A, Rudge JW. Seroprevalence and awareness of porcine cysticercosis across different pig production systems in south-central Cambodia. Parasite Epidemiol Control 2017; 3:1-12. [PMID: 29774294 PMCID: PMC5952675 DOI: 10.1016/j.parepi.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 10/30/2022] Open
Abstract
Background Taeniasis/cysticercosis, caused by the pork tapeworm Taenia solium, represents an important public health and economic burden in endemic countries. However, there is a paucity of data on infection among pigs in many parts of Southeast Asia, particularly Cambodia. We aimed to estimate seroprevalence of porcine cysticercosis, and investigate husbandary practices and knowledge of the disease among livestock workers, across different pig sector units in south-central Cambodia. Methods A cross sectional survey was conducted among pig smallholders, commercial farms, slaughterhouses and traders/middlemen from south-central Cambodia, selected through multistage sampling in proportion to local pig populations sizes. Questionnaires were administered to 163 pig workers to obtain data pig production, trading and slaughtering practices. Sera from 620 pigs were tested for Taenia antigens using a commercial ELISA-based test. Associations between seroprevalence and pig husbandry practices were assessed using generalised linear mixed models, adjusting for random-effects at herd-level. Results Of 620 pigs sampled, 29 (4.7%) tested positive for Taenia antigens. Seropositivity was associated with type of pig sector unit (P = 0.008), with the highest seroprevalence among pigs sampled from traders/middlemen (16.7%; 95% CI: 4.4%-37.8%), smallholders (7.6%; 95% CI: 3.8%-14.1%) and slaughterhouses (4.1%; 95% CI: 2.0%-7.5%), while none of the pigs sampled from small/medium or large commercial farms tested positive. Although the vast majority of pigs were penned, practices that might facilitate human-to-pig transmission, such as use of household waste and surface water sources to feed pigs, were prevalent among smallholders. However these were not found to be significantly associated with infection. Of 163 interviewed pig workers, 115 (70.5%) were aware of porcine cysticercosis, and 78 (47.8%) also knew it could affect humans. Twenty-six (16.0%) reported having noticed lesions typical of cysticercosis in their pigs. Conclusions Despite most pigs being kept confined in pens rather than raised in free-roaming systems, porcine cysticercosis appears to be endemic in south-central Cambodia and is associated with smallholder production. Further investigation is needed to identify which Taenia species are causing infections among pigs, and how seroprevalence and zoonotic risk may vary across the country, to understand the risks to public health and assess where interventions might be needed.
Collapse
Affiliation(s)
- Aderosoye Adenuga
- Royal Veterinary College, Hawkshead Campus, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK.,Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Ana Mateus
- Royal Veterinary College, Hawkshead Campus, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - Chhay Ty
- Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia
| | - Khieu Borin
- Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia
| | - Davun Holl
- National Veterinary Research Institute, Department of Animal Health and Production, Phnom Penh, Cambodia
| | - Sorn San
- National Veterinary Research Institute, Department of Animal Health and Production, Phnom Penh, Cambodia
| | - Victoria Duggan
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Madeleine Clark
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | | | - Richard Coker
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.,Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | | | - James W Rudge
- Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.,Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| |
Collapse
|
32
|
Ertel RL, Braae UC, Ngowi HA, Johansen MV. Assessment of a computer-based Taenia solium health education tool 'The Vicious Worm' on knowledge uptake among professionals and their attitudes towards the program. Acta Trop 2017; 165:240-245. [PMID: 26536396 DOI: 10.1016/j.actatropica.2015.10.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/25/2015] [Accepted: 10/29/2015] [Indexed: 11/17/2022]
Abstract
Health education has been recognised as a specific intervention tool for control of Taenia solium taeniosis/cysticercosis but evaluation of the efficacy of the tool remains. The aim of our study was to assess the effect of a computer-based T. solium health education tool 'The Vicious Worm' on knowledge uptake among professionals and investigate attitudes towards the program. The study was carried out between March and May 2014 in Mbeya Region, Tanzania, where T. solium is endemic. The study was a pre and post assessment of a health education tool based on questionnaire surveys and focus group discussions to investigate knowledge and attitudes. A total of 79 study subjects participated in the study including study subjects from both health- and agriculture sector. The health education consisted of 1½h individual practice with the computer program. The baseline questionnaire showed an overall knowledge on aspects of acquisition and transmission of T. solium infections (78%), porcine cysticercosis treatment (77%), human tapeworm in general (72%), neurocysticercosis in general (49%), and porcine cysticercosis diagnosis (48%). However, there was a lack of knowledge on acquisition of neurocysticercosis (15%), prevention of T. solium taeniosis/cysticercosis (28%), and relation between porcine cysticercosis, human cysticercosis, and taeniosis (32%). Overall, the study subject's knowledge was significantly improved both immediately after (p=0.001) and two weeks after (p<0.001) the health education and knowledge regarding specific aspects was significantly improved in most aspects immediately after and two weeks after the health education. The focus group discussions showed positive attitudes towards the program and the study subjects found 'The Vicious Worm' efficient, simple, and appealing. The study revealed a good effect of 'The Vicious Worm' suggesting that it could be a useful health education tool, which should be further assessed and thereafter integrated in T. solium taeniosis/cysticercosis control.
Collapse
Affiliation(s)
- Rebekka Lund Ertel
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Uffe Christian Braae
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Helena Aminiel Ngowi
- Department of Veterinary Medicine and Public Health, Faculty of Veterinary Medicine, Sokoine University of Agriculture, P.O. Box 3021 Morogoro, Tanzania
| | - Maria Vang Johansen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
33
|
Gabriël S, Dorny P, Mwape KE, Trevisan C, Braae UC, Magnussen P, Thys S, Bulaya C, Phiri IK, Sikasunge CS, Makungu C, Afonso S, Nicolau Q, Johansen MV. Control of Taenia solium taeniasis/cysticercosis: The best way forward for sub-Saharan Africa? Acta Trop 2017; 165:252-260. [PMID: 27140860 DOI: 10.1016/j.actatropica.2016.04.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 04/22/2016] [Accepted: 04/23/2016] [Indexed: 11/15/2022]
Abstract
Taenia solium taeniasis/cysticercosis is a neglected parasitic zoonosis with significant economic and public health impacts. Control measures can be broadly grouped into community health education, improvements in hygiene and sanitary conditions, proper meat handling at household and community level, improved standards of meat inspection, pig management, treatment of individual patients and possibly human populations, and treatment and/or vaccination of porcine populations. This manuscript looks critically into currently existing control options and provides suggestions on which (combination of) tools would be most effective in the control of T. solium taeniasis/cysticercosis in sub-Saharan Africa. Field data and disease transmission simulations suggest that implementation of a single intervention control strategy will not lead to a satisfactory reduction of disease morbidity or transmission. A feasible strategy to combat T. solium taeniasis/cysticercosis would include a combination of approaches focussing on both human (health education and treatment) and animal host (management, treatment and vaccination), which can vary for different communities and different geographical locations. Selection of the specific strategy depends on cost-effectiveness analyses based on solid field data, currently unavailable, though urgently needed; as well as on health priorities and resources of the country. A One Health approach involving medical, veterinary, environmental and social sectors is essential for T. solium to be controlled and eventually eliminated. Finally the success of any intervention is largely dependent on the level of societal and political acceptance, commitment and engagement.
Collapse
Affiliation(s)
- S Gabriël
- Institute of Tropical Medicine, Antwerp, Belgium.
| | - P Dorny
- Institute of Tropical Medicine, Antwerp, Belgium; Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K E Mwape
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C Trevisan
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - U C Braae
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - P Magnussen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - S Thys
- Institute of Tropical Medicine, Antwerp, Belgium
| | - C Bulaya
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - I K Phiri
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C S Sikasunge
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - C Makungu
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - S Afonso
- Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Q Nicolau
- Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - M V Johansen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| |
Collapse
|
34
|
Braae UC, Devleesschauwer B, Gabriël S, Dorny P, Speybroeck N, Magnussen P, Torgerson P, Johansen MV. CystiSim - An Agent-Based Model for Taenia solium Transmission and Control. PLoS Negl Trop Dis 2016; 10:e0005184. [PMID: 27984581 PMCID: PMC5161321 DOI: 10.1371/journal.pntd.0005184] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/14/2016] [Indexed: 11/19/2022] Open
Abstract
Taenia solium taeniosis/cysticercosis was declared eradicable by the International Task Force for Disease Eradication in 1993, but remains a neglected zoonosis. To assist in the attempt to regionally eliminate this parasite, we developed cystiSim, an agent-based model for T. solium transmission and control. The model was developed in R and available as an R package (http://cran.r-project.org/package=cystiSim). cystiSim was adapted to an observed setting using field data from Tanzania, but adaptable to other settings if necessary. The model description adheres to the Overview, Design concepts, and Details (ODD) protocol and consists of two entities—pigs and humans. Pigs acquire cysticercosis through the environment or by direct contact with a tapeworm carrier's faeces. Humans acquire taeniosis from slaughtered pigs proportional to their infection intensity. The model allows for evaluation of three interventions measures or combinations hereof: treatment of humans, treatment of pigs, and pig vaccination, and allows for customary coverage and efficacy settings. cystiSim is the first agent-based transmission model for T. solium and suggests that control using a strategy consisting of an intervention only targeting the porcine host is possible, but that coverage and efficacy must be high if elimination is the ultimate goal. Good coverage of the intervention is important, but can be compensated for by including an additional intervention targeting the human host. cystiSim shows that the scenarios combining interventions in both hosts, mass drug administration to humans, and vaccination and treatment of pigs, have a high probability of success if coverage of 75% can be maintained over at least a four year period. In comparison with an existing mathematical model for T. solium transmission, cystiSim also includes parasite maturation, host immunity, and environmental contamination. Adding these biological parameters to the model resulted in new insights in the potential effect of intervention measures. Taenia solium is the leading cause of preventable epilepsy and the highest ranking foodborne parasite in terms of disease burden worldwide. Currently there are no large scale control programmes implemented against T. solium, but efficacious intervention tools are there, making control programmes the next step forward. Because of the zoonotic properties of the parasite, existing in both humans and pigs, a combination of intervention tools is likely to be needed. cystiSim is an agent-based disease model that provides insight into which intervention tools, and the frequency of administration of these tools, are needed to yield an effect on disease prevalence. cystiSim is a valuable tool in designing future control programmes and will assist in the elimination of T. solium as a public health problem.
Collapse
Affiliation(s)
- Uffe Christian Braae
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
- * E-mail:
| | - Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Sarah Gabriël
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Pascal Magnussen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
- Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Paul Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Maria Vang Johansen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| |
Collapse
|
35
|
Chilundo AG, Mukaratirwa S, Pondja A, Afonso S, Miambo R, Johansen MV. Prevalence and risk factors of endo- and ectoparasitic infections in smallholder pigs in Angónia district, Mozambique. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2016; 7:1-8. [PMID: 31014649 DOI: 10.1016/j.vprsr.2016.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 11/18/2016] [Accepted: 11/28/2016] [Indexed: 11/30/2022]
Abstract
A cross-sectional study was carried out to determine the prevalence and associated risk factors of parasitic infections in pigs kept under smallholder farming system in Angónia district, Tete Province, Mozambique. A total of 262 pigs from 133 households of six villages were randomly selected. From each pig blood, faecal samples, full body searches, and skin scrapings were conducted to determine the prevalence of Taenia solium (using Ag-ELISA), gastrointestinal (GI) parasites, and ectoparasites respectively. A questionnaire survey was administered to smallholder pig farmers to assess their knowledge and perceptions of health and pig management and an observational study was conducted to determine their pig management practices. The overall prevalence of porcine cysticercosis by Ag-ELISA was 12.6%, GI nematodes 21.4%, Eimeria spp. 8.0% and ectoparasites 37.8%. Four helminths species namely, Metastrongylus spp., Hyostrongylus spp., Oesophagostomum spp., Trichostrongylus spp., were identified from by copro culture, and through faecal egg count, Ascaris suum and Trichuris suis were identified. Haematopinus suis, Rhipicephalus spp. and Echidnophaga gallinacea were found with a prevalence of 32.4%, 7.6%, and 6.9%, respectively. The only significant risk factor identified to be related to the parasite prevalence was pig origin (village), for both gastrointestinal parasites (OR=10.81[0.81-57.27]) and ectoparasites (OR=7.06[1.42-35.03]). This study provided evidence that parasitic infections in pigs constitute a major burden for smallholder pig farmers in Angónia district, and that porcine cysticercosis is a public health threat in the area and immediate attention is needed for control and prevention of the parasite.
Collapse
Affiliation(s)
- Abel G Chilundo
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique.
| | - Samson Mukaratirwa
- University of KwaZulu-Natal, School of Life Science, Westville Campus, Durban, South Africa
| | - Alberto Pondja
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - Sónia Afonso
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - Regina Miambo
- Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique
| | - Maria Vang Johansen
- Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, DK-1870 Frederiksberg C, Denmark
| |
Collapse
|
36
|
Correa D, Sarti E, Tapia-Romero R, Rico R, Alcántara-Anguiano I, Salgado A, Valdez L, Flisser A. Antigens and antibodies in sera from human cases of epilepsy or taeniasis from an area of Mexico whereTaenia soliumcysticercosis is endemic. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.1999.11813396] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
37
|
Singhi P, Saini AG. Pediatric neurocysticercosis: current challenges and future prospects. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2016; 7:5-16. [PMID: 29388588 PMCID: PMC5683283 DOI: 10.2147/phmt.s79058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Neurocysticercosis (NCC) is an acquired infection of the nervous system caused by encysted larvae of Taenia solium. It is a major cause of epilepsy in the tropics and the commonest cause of focal seizures in North Indian children. T. solium teniasis-cysticercosis is considered a parasitic “Neglected Tropical Diseases” endemic throughout Southeast Asia. NCC in children has pleomorphic manifestations depending on the location, number and viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.
Collapse
Affiliation(s)
- Pratibha Singhi
- Department of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Gahlot Saini
- Department of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
38
|
Ducrotoy MJ, Yahyaoui Azami H, El Berbri I, Bouslikhane M, Fassi Fihri O, Boué F, Petavy AF, Dakkak A, Welburn S, Bardosh KL. Integrated health messaging for multiple neglected zoonoses: Approaches, challenges and opportunities in Morocco. Acta Trop 2015; 152:17-25. [PMID: 26299194 DOI: 10.1016/j.actatropica.2015.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/11/2015] [Accepted: 08/14/2015] [Indexed: 11/17/2022]
Abstract
Integrating the control of multiple neglected zoonoses at the community-level holds great potential, but critical data is missing to inform the design and implementation of different interventions. In this paper we present an evaluation of an integrated health messaging intervention, using powerpoint presentations, for five bacterial (brucellosis and bovine tuberculosis) and dog-associated (rabies, cystic echinococcosis and leishmaniasis) zoonotic diseases in Sidi Kacem Province, northwest Morocco. Conducted by veterinary and epidemiology students between 2013 and 2014, this followed a process-based approach that encouraged sequential adaptation of images, key messages, and delivery strategies using auto-evaluation and end-user feedback. We describe the challenges and opportunities of this approach, reflecting on who was targeted, how education was conducted, and what tools and approaches were used. Our results showed that: (1) replacing words with local pictures and using "hands-on" activities improved receptivity; (2) information "overload" easily occurred when disease transmission pathways did not overlap; (3) access and receptivity at schools was greater than at the community-level; and (4) piggy-backing on high-priority diseases like rabies offered an important avenue to increase knowledge of other zoonoses. We conclude by discussing the merits of incorporating our validated education approach into the school curriculum in order to influence long-term behaviour change.
Collapse
Affiliation(s)
- M J Ducrotoy
- Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
| | - H Yahyaoui Azami
- Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - I El Berbri
- Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco
| | - M Bouslikhane
- Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco
| | - O Fassi Fihri
- Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco
| | - F Boué
- ANSES, Laboratoire de la rage et de la faunes auvagede Nancy, Unité de Surveillance Eco-épidémiologique des Animaux Sauvages, Laboratoire national de référence pour Echinococcusspp, 54220 Malzéville cedex, France
| | - A F Petavy
- Department of Parasitology and Medical Mycology, Lyon 1 University, 8 Avenue Rochefeller, 69373 Lyon Cedex 08, France
| | - A Dakkak
- Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco
| | - S Welburn
- Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - K L Bardosh
- Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; Emerging Pathogens Institute, University of Florida, Gainesville, USA
| |
Collapse
|
39
|
Edia-Asuke AU, Inabo HI, Umoh VJ, Whong CM, Asuke S, Edeh RE. Assessment of sanitary conditions of unregistered pig slaughter slabs and post mortem examination of pigs for Taenia solium metacestodes in Kaduna metropolis, Nigeria. Infect Dis Poverty 2014; 3:45. [PMID: 25671123 PMCID: PMC4322547 DOI: 10.1186/2049-9957-3-45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 11/12/2014] [Indexed: 11/23/2022] Open
Abstract
Background A number of studies document the prevalence of Taenia solium infections in Nigeria, yet these studies do not cover porcine cysticercosis in private home slaughter slabs where there is no routine meat inspection and backyard pig keeping, slaughtering and sale are common practice. Methods An environmental and sanitary assessment was conducted within two unregistered home pig slaughter slabs in selected parts of the Kaduna metropolis in Nigeria. Slaughter premises were inspected for availability of basic facilities and questionnaires were used to elicit necessary informative data. Butchers were examined for taeniasis by stool microscopy and copro-antigen enzyme linked immunosorbent assay (copro-Ag ELISA) to ascertain T. solium – taeniasis. Pigs slaughtered at the premises were examined for cysticerci. Results Home slaughter conditions were substandard, unhygienic and lacked the basic facilities of a proper slaughterhouse. Prevalence of porcine cysticercosis was 9.3%. The butchers participating in the study had very poor knowledge of T. solium infections and 30% tested positive for taeniasis by copro-Ag ELISA at the time of the study. Conclusion Home slaughter of pigs in the areas studied should be considered and integrated as a component of prevention and control programmes – particularly through educational interventions – in order to equip individuals involved with a good understanding of the risks associated with animal husbandry and human practices. Electronic supplementary material The online version of this article (doi:10.1186/2049-9957-3-45) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Agnes U Edia-Asuke
- Department of Microbiology, Ahmadu Bello University, Zaria, Kaduna Nigeria ; Biological Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Helen I Inabo
- Department of Microbiology, Ahmadu Bello University, Zaria, Kaduna Nigeria
| | - Veronica J Umoh
- Department of Microbiology, Ahmadu Bello University, Zaria, Kaduna Nigeria
| | - Clement Mz Whong
- Department of Microbiology, Ahmadu Bello University, Zaria, Kaduna Nigeria
| | - Sunday Asuke
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Shika Zaria, Kaduna Nigeria
| | - Richard E Edeh
- Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Kaduna Nigeria
| |
Collapse
|
40
|
Carabin H, Traoré AA. Taenia solium taeniasis and cysticercosis control and elimination through community-based interventions. CURRENT TROPICAL MEDICINE REPORTS 2014; 1:181-193. [PMID: 25544938 DOI: 10.1007/s40475-014-0029-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Taenia solium was declared potentially eradicable by the International Task Force for Disease Eradication in 1992. Yet, very few well-designed community-based randomized controlled trials have been conducted to measure the effectiveness of alternative control strategies. Most strategies have been tested in pre-post intervention designs in very few communities, often without a control group. The only two community-based randomized controlled trials suggest that an educational program alone or a combination of human and porcine mass treatment reduce porcine cysticercosis in the short term. A transmission dynamics model suggests that improved sanitation and pig management are more effective and sustainable than pig vaccination, human or porcine mass treatment. Current evidence does not support the eradication of Taenia solium in the foreseeable future. Investigators should follow international recommendations on the conduct of community-based randomized control trials to provide more valid estimates of the effect and cost-effectiveness of alternative control strategies for cysticercosis.
Collapse
Affiliation(s)
- Hélène Carabin
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104
| | - Aminata A Traoré
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104. Tel: 405 271-2229.
| |
Collapse
|
41
|
Bardosh K, Inthavong P, Xayaheuang S, Okello AL. Controlling parasites, understanding practices: the biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR. Soc Sci Med 2014; 120:215-23. [PMID: 25261615 DOI: 10.1016/j.socscimed.2014.09.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022]
Abstract
A parasitological survey in northern Lao PDR showed a remote ethnic minority village to be hyper-endemic for Taenia solium, a Neglected Tropical Disease (NTD) that impacts human and pig health. An intervention combining human Mass Drug Administration (MDA) with porcine vaccination and antihelmintic treatment was then implemented, targeting both T. solium and other soil-transmitted helminths. To understand the biosocial complexity of this integrated One Health intervention, we conducted a rapid ethnographic study exploring the transmission dynamics of T. solium and locally acceptable long-term control options. Informed by two years of project work in the village, this included six focus group discussions, 35 semi-structured interviews, a latrine survey, a school-based education meeting, participant observation and many unstructured interviews conducted over two weeks in October 2013. We found that risk behaviours were mediated by various social determinants including limited market access, interrelationships between alcohol, ancestral sacrifices and the consumption of raw pork, seasonal variations and poor latrine coverage. Only sixteen percent of households had latrines, attributed to the unacceptability of dry latrines, lack of water access, poor building techniques and poverty. Whilst women could explain T. solium transmission, most men and children could not, revealing that distributed posters/leaflets relied too heavily on text and ambiguous images. Compliance with MDA was high due to trust between project staff and village leaders. However understandings of pharmacology, minor side effects, human migration and children's fear of worms may lead to resistance in future programmes. Our research highlights the complexities of controlling T. solium and other soil-transmitted helminths in a remote ethnic minority village and the need to integrate biomedical and participatory approaches. Although we showcase the heuristic value of using rapid ethnography to inform intervention strategies as part of a One Health/NTD agenda, we also identify several possible paradoxes and conundrums in embedding locally-grounded biosocial analysis into NTD programmes. These need to be acknowledged and negotiated by multidisciplinary teams.
Collapse
Affiliation(s)
- Kevin Bardosh
- School of Social and Political Science, The University of Edinburgh, 58 George Square, Edinburgh, United Kingdom; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.
| | - Phouth Inthavong
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic
| | - Sivilai Xayaheuang
- CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
| | - Anna L Okello
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic; CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
| |
Collapse
|
42
|
Abstract
Therapy for neurocysticercosis has advanced during the last 20 years with the advent of albendazole (Zentel) and praziquantel (Cysticide). Albendazole is the current medication of choice for the treatment of neurocysticercosis and is recommended for symptomatic patients with multiple viable cysts in the brain parenchyma. Albendazole may also be useful in extraparenchymal cysticercosis, especially in the subarachnoid racemose form, when complete surgical resection of the cysts is usually impracticable. Currently, there is an intense debate over the value and safety of anticysticercal therapy. Causes for failure of anticysticercal therapy include high inter-individual variability in plasma concentration of albendazole sulfoxide and the complex interactions of several drugs with the albendazole metabolite. Furthermore, albendazole sulfoxide is an enantiomeric mixture of (+)- and (-)-albendazole sulfoxide with accumulation of the (+)-enantiomer in the cerebrospinal fluid. However, the question over which enantiomer is effective against cysticerci remains to be clarified.
Collapse
Affiliation(s)
- Osvaldo Massaiti Takayanagui
- Department of Neurology, Faculty of Medicine at Ribeirão Preto, University of São Paulo, 14048 900 Ribeirão Preto, Sao Paulo, Brazil.
| |
Collapse
|
43
|
Komba EV, Kimbi EC, Ngowi HA, Kimera SI, Mlangwa JE, Lekule FP, Sikasunge CS, Willingham AL, Johansen MV, Thamsborg SM. Prevalence of porcine cysticercosis and associated risk factors in smallholder pig production systems in Mbeya region, southern highlands of Tanzania. Vet Parasitol 2013; 198:284-91. [DOI: 10.1016/j.vetpar.2013.09.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/07/2013] [Accepted: 09/19/2013] [Indexed: 11/17/2022]
|
44
|
Fabiani S, Bruschi F. Neurocysticercosis in Europe: Still a public health concern not only for imported cases. Acta Trop 2013; 128:18-26. [PMID: 23871891 DOI: 10.1016/j.actatropica.2013.06.020] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/22/2013] [Accepted: 06/30/2013] [Indexed: 10/26/2022]
Abstract
Neurocysticercosis (NCC), a parasitic disease caused by the larvae of the cestode Taenia solium, is the most frequent parasitic disease of the central nervous system (CNS) in the world and the leading cause of secondary epilepsy in Central and South America, East and South Asia, and sub-Saharan Africa. It is endemic in many low- and middle-income countries of the world. Due to increased travels and immigration, NCC may be diagnosed also in non-endemic areas. In fact, tapeworm carriers from endemic zones can transmit infection to other citizens or arrive already suffering NCC. This phenomenon, occurred first in USA during the last 30 years, has been also observed in Europe, as well as in Australia, Canada, Israel, Japan and Muslim countries of the Arab World. Actually, concerning Europe, although, in some areas only few cases have been described, nevertheless the prevalence of NCC may be considered increasing, especially in Spain and Portugal. We reviewed the literature on the burden of NCC in Europe, by a search of PubMed regarding papers from 1970 to present. We only considered on PubMed published and available papers in English, French, Italian, and Spanish, the languages understood by the authors. One hundred seventy six cases of NCC have been reported in seventeen European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Netherlands, Sweden, United Kingdom, and Croatia, Norway, Switzerland). A particular epidemic situation is present in Spain and Portugal. In fact, we collected data that show, in Spain, an increasing incidence both in immigrated patients and in those which were born in certain Spanish geographical areas and, in Portugal, prevalence similar to that observed in endemic areas. Globally, it is clear that as a result of increased migrations and travels from endemic regions, NCC is becoming an emerging public health problem in high-income countries, particularly affecting communities where hygiene conditions are poor and sub-sequentially the parasite can spread from human to human through eggs even in absence of a travel to the tropics. NCC is a preventable disease, it derives that it's important to acquire a great consciousness of the epidemiology and to implement accurate surveillance systems.
Collapse
|
45
|
Abstract
Human cysticercosis, caused by accidental ingestion of eggs of Taenia solium, is one of the most pathogenic helminthiases and is listed among the 17 WHO Neglected Tropical Diseases. Controlling the life-cycle of T. solium between humans and pigs is essential for eradication of cysticercosis. One difficulty for the accurate detection and identification of T. solium species is the possible co-existence of two other human Taenia tapeworms (T. saginata and T. asiatica, which do not cause cysticercosis in humans). Several key issues for taeniasis/cysticercosis (T/C) evidence-based epidemiology and control are reviewed: (1) advances in immunological and molecular tools for screening of human and animals hosts and identification of Taenia species, with a focus on real-time detection of taeniasis carriers and infected animals in field community screenings, and (2) spatial ecological approaches that have been used to detect geospatial patterns of case distributions and to monitor pig activity and behaviour. Most recent eco-epidemiological studies undertaken in Sichuan province, China, are introduced and reviewed.
Collapse
|
46
|
Control of Taenia solium taeniasis/cysticercosis: past practices and new possibilities. Parasitology 2013; 140:1566-77. [DOI: 10.1017/s0031182013001005] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYNeurocysticercosis continues to be a major health burden on humans living in many regions of the world, despite the availability of highly effective taeniacides and identification of the cause, Taenia solium, as being potentially eradicable. Several T. solium control trials have been undertaken, generally achieving limited success and none that has been fully documented has achieved what was demonstrated to be a sustainable level of disease control. Pigs act as intermediate hosts for T. solium and two new control tools have become available for application in pigs – single-dose oxfendazole treatment of porcine cysticercosis and the TSOL18 vaccine. Three potential intervention scenarios for pigs are compared for control of cysticercosis, using either oxfendazole or vaccination. A control scenario involving vaccination plus oxfendazole treatment delivered at 4 monthly intervals was predicted to achieve the best outcome, with no pigs slaughtered at 12 months of age having viable T. solium cysticerci. Now that new control tools are available, there are opportunities to concentrate research attention on evaluation of novel control scenarios leading to the implementation of effective and sustainable control programmes and a reduction in the global burden of neurocysticercosis.
Collapse
|
47
|
Assana E, Lightowlers MW, Zoli AP, Geerts S. Taenia solium taeniosis/cysticercosis in Africa: Risk factors, epidemiology and prospects for control using vaccination. Vet Parasitol 2013; 195:14-23. [DOI: 10.1016/j.vetpar.2012.12.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 12/04/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022]
|
48
|
Gilman RH, Gonzalez AE, Llanos-Zavalaga F, Tsang VCW, Garcia HH. Prevention and control of Taenia solium taeniasis/cysticercosis in Peru. Pathog Glob Health 2013; 106:312-8. [PMID: 23265557 DOI: 10.1179/2047773212y.0000000045] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Taenia solium is endemic in most of the world, causing seizures and other neurological symptoms. Transmission is mainly maintained in rural areas by a human to pig cycle. Despite claims on its eradicability, sustainable interruption of transmission has not yet been reported. This manuscript reviews the conceptual basis for control, available diagnostic and control tools, and recent experiences on control in the field performed in Peru along the past decade.
Collapse
Affiliation(s)
- Robert H Gilman
- Department of Microbiology, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | | | | | | |
Collapse
|
49
|
Flisser A. State of the art of Taenia solium as compared to Taenia asiatica. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:43-9. [PMID: 23467388 PMCID: PMC3587748 DOI: 10.3347/kjp.2013.51.1.43] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/02/2022]
Abstract
Three species of tapeworms infect humans in their adult stage (Taenia solium, Taenia saginata and Taenia asiatica). The 3 are flat, opaque white or yellowish, and exceptional long segmented parasites, measuring 1 to 12 m in their adult stage. In this review, the development of the knowledge regarding the first species, mainly focused on understanding how the larval stage or cysticercus is transmitted to humans, is described. The second species is a cosmopolitan parasite that only causes taeniosis and not cysticercosis; therefore, it will not be included. Information on the third species, which is presently being produced, since this species was recognized as such only at the end of the 20th century, will be discussed at the end of this review.
Collapse
Affiliation(s)
- Ana Flisser
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México 04510 DF, México.
| |
Collapse
|
50
|
Rosales-Mendoza S, Govea-Alonso DO, Monreal-Escalante E, Fragoso G, Sciutto E. Developing plant-based vaccines against neglected tropical diseases: where are we? Vaccine 2012; 31:40-8. [PMID: 23142588 DOI: 10.1016/j.vaccine.2012.10.094] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/09/2012] [Accepted: 10/25/2012] [Indexed: 10/27/2022]
Abstract
Neglected tropical diseases (NTDs) impair the lives of 1 billion people worldwide, and threaten the health of millions more. Although vaccine candidates have been proposed to prevent some NTDs, no vaccine is available at the market yet. Vaccines against NTDs should be low-cost and needle-free to reduce the logistic cost of their administration. Plant-based vaccines meet both requirements: plant systems allow antigen production at low cost, and also yield an optimal delivery vehicle that prevents or delays digestive hydrolysis of vaccine antigens. This review covers recent reports on the development of plant-based vaccines against NTDs. Efforts conducted by a number of research groups to develop vaccines as a mean to fight rabies, cysticercosis, dengue, and helminthiasis are emphasized. Future perspectives are identified, such as the need to develop vaccination models for more than ten pathologies through a plant-based biotechnological approach. Current limitations on the method are also noted, and molecular approaches that might allow us to address such limitations are discussed.
Collapse
Affiliation(s)
- Sergio Rosales-Mendoza
- Laboratorio de biofarmacéuticos recombinantes, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, SLP, 78210, Mexico.
| | | | | | | | | |
Collapse
|