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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.
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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
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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.
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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
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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.
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Spatial distribution and risk factors for human cysticercosis in Colombia. Parasit Vectors 2021; 14:590. [PMID: 34838117 PMCID: PMC8626945 DOI: 10.1186/s13071-021-05092-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cysticercosis is a zoonotic neglected tropical disease (NTD) that affects humans and pigs following the ingestion of Taenia solium eggs. Human cysticercosis poses a substantial public health burden in endemic countries. The World Health Organization (WHO) aims to target high-endemicity settings with enhanced interventions in 17 countries by 2030. Between 2008 and 2010, Colombia undertook a national baseline serosurvey of unprecedented scale, which led to an estimated seroprevalence of T. solium cysticercus antibodies among the general population of 8.6%. Here, we use contemporary geostatistical approaches to analyse this unique dataset with the aim of understanding the spatial distribution and risk factors associated with human cysticercosis in Colombia to inform how best to target intervention strategies. Methods We used a geostatistical model to estimate individual and household risk factors associated with seropositivity to T. solium cysticercus antibodies from 29,253 people from 133 municipalities in Colombia. We used both independent and spatially structured random effects at neighbourhood/village and municipality levels to account for potential clustering of exposure to T. solium. We present estimates of the distribution and residual correlation of seropositivity at the municipality level. Results High seroprevalence was identified in municipalities located in the north and south of Colombia, with spatial correlation in seropositivity estimated up to approximately 140 km. Statistically significant risk factors associated with seropositivity to T. solium cysticercus were related to age, sex, educational level, socioeconomic status, use of rainwater, consumption of partially cooked/raw pork meat and possession of dogs. Conclusions In Colombia, the distribution of human cysticercosis is influenced by socioeconomic considerations, education and environmental factors related to the spread of T. solium eggs. This information can be used to tailor national intervention strategies, such as targeting spatial hotspots and more highly exposed groups, including displaced people and women. Large-scale seroprevalence surveys accompanied by geospatial mapping are an essential step towards reaching the WHO’s 2021‒2030 NTD roadmap targets. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05092-8.
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Butala C, Fyfe J, Welburn SC. The Contribution of Community Health Education to Sustainable Control of the Neglected Zoonotic Diseases. Front Public Health 2021; 9:729973. [PMID: 34738003 PMCID: PMC8562424 DOI: 10.3389/fpubh.2021.729973] [Citation(s) in RCA: 4] [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: 06/24/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Effective and sustainable control of the Neglected Zoonoses (NZDs) demands a One Health approach. NZDs largely impact on individuals in low- and middle-income countries, disproportionally affecting resource poor communities with poor access to veterinary and human health services and to clean water and which are intrinsically dependent on animals for their livelihoods. Many NZDs in humans can be treated, but treatment is often complex and expensive. Similarly, while tools for prevention of transmission may exist, they are complex and expensive to adopt at the scale required to be effective. The cost of intervention for NZDs is high when compared to the public health benefits alone, but costs are easily outweighed by full cross sector analysis and when monetary and non-monetary benefits to all stakeholders are considered. Education is a key tool, often overlooked in favor of more complex solutions for the control of NZDs. Successful education programs have been targeted to children of school age for Taenia solium in Kenya, schistosomiasis in Nigeria, and soil transmitted helminths in China. A Snakes and Ladders board game, designed to teach children about schistosomiasis and encourage compliance with mass deworming programs, deployed in Nigerian schools, showed a 67% increase in knowledge of praziquantel and 65% of children who had previously rejected treatment requested the drug at school. For soil transmitted helminths in China, presentation of health information in cartoon format rather than in poster format, showed post-assessment knowledge to be 90% higher. With the rise in affordable smart-phone technology, internet access and airtime in communities in low- and middle- income countries e-education is an increasingly attractive proposition as an intervention tool for the NZDs. The Vicious Worm, a computer based educational health tool that has been designed around the prevention of Taenia Solium has shown remarkable efficacy in affected communities in which it has been deployed with participants applying the principles learned in their communities. This review explores the successes and benefits of education as a control tool for the NZDs.
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Affiliation(s)
- Caitlin Butala
- Zhejiang University School of Medicine, Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom
| | - Jenna Fyfe
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom
| | - Susan Christina Welburn
- Zhejiang University School of Medicine, Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Scotland, United Kingdom
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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.
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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.
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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.
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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:
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Rossi GAM, Van Damme I, Gabriël S. Systematic review and meta-analysis of bovine cysticercosis in Brazil: current knowledge and way forward. Parasit Vectors 2020; 13:92. [PMID: 32085721 PMCID: PMC7035740 DOI: 10.1186/s13071-020-3971-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/14/2020] [Indexed: 12/21/2022] Open
Abstract
Background Taenia saginata taeniosis/cysticercosis has been well studied in several countries. Brazil is one of the most important beef exporting countries and has one of the highest cattle population size in the world. In this country, bovine cysticercosis (BCC) remains the most frequent reported zoonosis detected during post-mortem inspection, resulting in costs for the beef sector and public health. We performed a systematic literature review regarding data about BCC epidemiology in Brazil and meta-analyses for its prevalence in different administrative regions and the distribution over time, and based on this discussed possible control strategies. Methods A systematic review was conducted to obtain data about BCC in Brazil using the words “bovine cysticercosis” and “Brazil” to construct the search phrase. The inclusion criteria used to select articles were: (i) published from 2000 to 2018; (ii) full text available online in Portuguese or English; and (iii) contain information at least regarding one of the following aspects of BCC in Brazil: prevalence, incidence, spatial distribution, risk-factors, economic burden and measures for control. Results A set of 42 articles was included, covering the prevalence of BCC in Brazil, ranging between 0.01–18.75%. Prevalence results of 40 articles were included in a meta-analysis per administrative region. The highest prevalence was found in the South (3.4%; 95% CI: 2.0–5.2%), followed by the Southeast (2.7%; 95% CI: 1.9–3.6%), Northeast (1.5%; 95% CI: 0.6–2.7%), Central-western (0.9%; 95% CI: 0.3–1.7%) and North (0.0%; 95% CI: 0.0–0.6%) region. In addition, a reduction in prevalence over time was observed in all the evaluated states except for Alagoas and Pará. Conclusions Besides the large availability of data, a critical lack of information about BCC epidemiology remains in Brazil. Nevertheless, the available data on prevalence, high risk-areas and risk factors should contribute to a better understanding of transmission and the formulation of recommendations for control. A One Health approach will be required to reduce T. saginata taeniosis/cysticercosis prevalence and the consequent economic burden for the beef sector in Brazil, one of the most important beef exporters in the world.![]()
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Affiliation(s)
- Gabriel Augusto Marques Rossi
- Centro Universitário Central Paulista (UNICEP), Rua Miguel Petroni 5111, Postal Code 13563-470, São Carlos, São Paulo, Brazil.
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Dixon MA, Braae UC, Winskill P, Devleesschauwer B, Trevisan C, Van Damme I, Walker M, Hamley JID, Ramiandrasoa SN, Schmidt V, Gabriël S, Harrison W, Basáñez MG. Modelling for Taenia solium control strategies beyond 2020. Bull World Health Organ 2020; 98:198-205. [PMID: 32132754 PMCID: PMC7047036 DOI: 10.2471/blt.19.238485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/15/2019] [Accepted: 12/27/2019] [Indexed: 01/06/2023] Open
Abstract
The cestode Taenia solium is responsible for a considerable cross-sectoral health and economic burden due to human neurocysticercosis and porcine cysticercosis. The 2012 World Health Organization (WHO) roadmap for neglected tropical diseases called for the development of a validated strategy for control of T. solium; however, such a strategy is not yet available. In 2019, WHO launched a global consultation aimed at refining the post-2020 targets for control of T. solium for a new roadmap for neglected tropical diseases. In response, two groups working on taeniasis and cysticercosis mathematical models (cystiSim and EPICYST models), together with a range of other stakeholders organized a workshop to provide technical input to the WHO consultation and develop a research plan to support efforts to achieve the post-2020 targets. The workshop led to the formation of a collaboration, CystiTeam, which aims to tackle the population biology, transmission dynamics, epidemiology and control of T. solium through mathematical modelling approaches. In this paper, we outline developments in T. solium control and in particular the use of modelling to help achieve post-2020 targets for control of T. solium. We discuss the steps involved in improving confidence in the predictive capacities of existing mathematical and computational models on T. solium transmission, including model comparison, refinement, calibration and validation. Expanding the CystiTeam partnership to other research groups and stakeholders, particularly those operating in different geographical and endemic areas, will enhance the prospects of improving the applicability of T. solium transmission models to inform taeniasis and cysticercosis control strategies.
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Affiliation(s)
- Matthew A Dixon
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis, Imperial College London, London W2 1PG, England
| | - Uffe C Braae
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Peter Winskill
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis, Imperial College London, London W2 1PG, England
| | | | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Inge Van Damme
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Martin Walker
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, England
| | - Jonathan I D Hamley
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis, Imperial College London, London W2 1PG, England
| | - Sylvia N Ramiandrasoa
- Service de Lutte contre les Maladies Endémiques et Négligées, Ministry of Public Health, Antananarivo, Madagascar
| | - Veronika Schmidt
- Department of Neurology, Technical University Munich, Munich, Germany
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Wendy Harrison
- Schistosomiasis Control Initiative Foundation, London, England
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis, Imperial College London, London W2 1PG, England
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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.
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Maganira JD, Mwang'onde BJ, Kidima W, Mwita CJ, Höglund J. Seroprevalence of circulating taeniid antigens in pigs and associated risk factors in Kongwa district, Tanzania. Parasite Epidemiol Control 2019; 7:e00123. [PMID: 31872092 PMCID: PMC6911909 DOI: 10.1016/j.parepi.2019.e00123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/16/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022] Open
Abstract
The aim of this study was to investigate exposure to porcine cysticercosis (PC) and associated risk factors in the Kongwa District, eastern-central Tanzania. For the first time a cross-sectional investigation of the seroprevalence in pigs using a commercial genus specific cysticercosis enzyme linked immunosorbent assay (apDia Ag-ELISA) was undertaken in eastern-central Tanzania. Moreover, the identity of suspected T. solium cysts from pigs in the study area were confirmed by sequencing parasites' mitochondrial cox1 gene. Structured questionnaires and direct observations were used to investigate risk factors associated with parasite transmission. A total of 102 pig-keeping households were surveyed during the dry season between July and August 2017 and 126 households in the rainy season between March and April 2018. Of the 447 examined pigs, 77 (17%, 95% C.I. 14%-20%) tested positive in the ELISA. Seroprevalence was higher in pigs examined during the rainy (21%, 95% C.I. 16%-26%) than dry (12%, 95% C.I. 7%-17%) season (p = 0.019). Eight cyst-positive-pigs were confirmed to be infected with T. solium by sequencing. Risk factors associated with PC seropositivity included origin of piglets or pigs (OR = 0.27, 95% C.I. 0.13-0.42, p = 0.001), socioeconomic factors and pig production system (OR = 0.22, 95% C.I. 0.07-0.37, p = 0.005) and sanitation and hygiene practices (OR = 0.19, 95% C.I. 0.04-0.34, p = 0.014). This study has recorded a high Taenia spp. seroprevalence in pigs in Kongwa suggesting the presence of people in the community carrying the adult parasite, Taenia solium. Our findings also suggest risk of infection by T. solium to people in urban centres and cities consuming pigs from rural areas in Kongwa. The high seroprevalence in Kongwa calls for further studies on taeniasis and cysticercosis in the human population in order to determine suitable control strategies.
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Affiliation(s)
- Justine D. Maganira
- Department of Biosciences, Sokoine University of Agriculture, P.O. Box 3038, Morogoro, Tanzania
- Department of Zoology and Wildlife Conservation, University of Dar Es Salaam, P.O. Box 35064, Dar Es Salaam, Tanzania
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, P.O. Box 7036, SE-750 07, Uppsala, Sweden
| | - Beda J. Mwang'onde
- Department of Biosciences, Sokoine University of Agriculture, P.O. Box 3038, Morogoro, Tanzania
| | - Winifrida Kidima
- Department of Zoology and Wildlife Conservation, University of Dar Es Salaam, P.O. Box 35064, Dar Es Salaam, Tanzania
| | - Chacha J. Mwita
- Department of Aquatic Sciences and Fisheries Technology, University of Dar Es Salaam, P.O. Box 35064, Dar Es Salaam, Tanzania
| | - Johan Höglund
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, P.O. Box 7036, SE-750 07, Uppsala, Sweden
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Swasti Wulanyani NM, Pratama YS, Swastika K, Sudarmaja IM, Wandra T, Yoshida T, Budke CM, Ito A. A preliminary study to assess the use of a "Snakes and Ladders" board game in improving the knowledge of elementary school children about taeniasis. Acta Trop 2019; 199:105117. [PMID: 31369727 DOI: 10.1016/j.actatropica.2019.105117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 12/26/2022]
Abstract
The Snakes and Ladders board game was modified so that it contained information on taeniasis. A quantitative approach was used to evaluate if elementary school children were able to answer correctly more questions about Taenia saginata and Taenia solium transmission and control after playing the game compared to before playing the game. In total, 78 children (9-12 years of age) from Dukuh elementary school in Karangasem District, Bali, Indonesia, were evaluated. The children were asked to complete a pre- and post-test assessment before and after playing the game a single time. Overall proportion of correct answers was 40.3% before playing the game and 58.8% after playing the game. There was a greater proportion of correct answers for questions pertaining to the transmission route for T. saginata (p < 0.001) and T. solium (p < 0.001), human infection type with T. solium (p = 0.035) and T. saginata (p < 0.001), and animal infection type with T. solium or T. saginata (p < 0.001) after playing the game compared to before playing the game. However, there was no significant difference for any question for the youngest grade level. Use of this popular board game appears to be a promising tool for teaching older (10 years of age and above) children about taeniasis in endemic areas.
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Affiliation(s)
| | | | - Kadek Swastika
- Department of Parasitology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - I Made Sudarmaja
- Department of Parasitology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Toni Wandra
- Directorate of Postgraduate, Sari Mutiara Indonesia University, Medan, Indonesia
| | - Takahiko Yoshida
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A & M University, College Station, Texas, USA
| | - Akira Ito
- Department of Parasitology and Laboratory of NTDs, Asahikawa Medical University, Asahikawa, Japan.
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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.
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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.
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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.
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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
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Lauridsen S, Braae UC, Ngowi HA, Johansen MV. Impacts of using the electronic-health education program 'The Vicious Worm' for prevention of Taenia solium. Acta Trop 2019; 193:18-22. [PMID: 30776322 DOI: 10.1016/j.actatropica.2019.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Taenia solium is a zoonotic tapeworm widely distributed across sub-Saharan Africa. Specific health education is regarded as a central element in controlling T. solium. In 2014, an electronic health education tool called 'The Vicious Worm', which was concerned with prevention of T. solium was introduced to health and agricultural professionals in Mbeya, Tanzania, an endemic setting. Introduction to ´The Vicious Worm' of 1.5 hours significantly improved the participants' knowledge. This study revisited the same study subjects one year later to assess persistence of knowledge regarding T. solium taeniosis/cysticercosis and to assess if the health education had changed work practices for the participants and the public. METHODS The study was conducted in Tanzania between June and August 2015, with a fixed population of health and agricultural professionals recruited from a previous study testing 'The Vicious Worm'. The study used a test, a questionnaire survey, as well as semi-structured group and individual interviews. RESULTS The 79 study subjects, all health or agricultural professionals, had within one year relocated from Mbeya to 16 of 21 administrative regions of Tanzania. Sixty-four agreed to participate in the test and 48 to an interview. The test showed significant improvement in knowledge regarding T. solium taeniosis/cysticercosis, compared with the baseline knowledge level of the participants. Interview data found that the participants had used 'The Vicious Worm' as an educational tool and applied the knowledge from the program to implement new practices consisting of by-laws and practical workshops on building latrines, pig pens and hand washing stations in their communities. CONCLUSION Introduction to 'The Vicious Worm' led to changed practices and persistence in knowledge regarding T. solium. Incorporating health education as a specific health intervention tool should be encouraged and implemented at national or programmatic level.
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Overview of Taenia solium cysticercosis in West Africa. Acta Trop 2019; 190:329-338. [PMID: 30529447 DOI: 10.1016/j.actatropica.2018.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 12/15/2022]
Abstract
Human and porcine cysticercosis is endemic in West Africa, where epilepsy is relatively common, but rarely reported due to fear of stigmatization. Neurocysticercosis, caused by Taenia solium, tends to affect the poor in developing countries and control is hampered by inadequate infrastructure and financial resources coupled with lack of adequate information about its significance and distribution. The risk factors for human cysticercosis are closely associated with the characteristics of smallholder or backyard pig farming systems prevalent in this region. Poverty, ignorance and lack of political will militate against successful eradication, while tools for effective diagnosis, prevention and treatment, including vaccines for pigs, are not yet available in many countries. Cysticercosis was targeted for control by The World Health Organization global plan for 2008-2015; however, measures for control are yet to be undertaken in a coordinated manner in West Africa. Diagnostic tools, including neuroimaging facilities, should be strategically situated and made accessible to rural populations in West Africa. Community education in combination with a multipronged approach consisting of vaccination of pigs using TSOL18 vaccine and treatment with oxfendazole along with mass chemotherapy of humans with praziquantel could eliminate taeniasis and should be considered. In-depth and extensive epidemiological studies are required in West Africa in order to fully elucidate the prevalence of T. solium and to support more coordinated and effective control of human and porcine cysticercosis.
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de Coster T, Van Damme I, Baauw J, Gabriël S. Recent advancements in the control of Taenia solium: A systematic review. Food Waterborne Parasitol 2018; 13:e00030. [PMID: 32095601 PMCID: PMC7034013 DOI: 10.1016/j.fawpar.2018.e00030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 01/07/2023] Open
Abstract
The combined health and economic impact of Taenia solium urges for control and, if possible, elimination of this neglected parasitic zoonosis. Up till now there is still no consensus about the most cost-effective and feasible approaches for control. The objective of this systematic review is to identify and summarize the evidence in English scientific literature on the control and elimination of T. solium since 2014, based on the rapidly evolving field of evidence on control and elimination of T. solium. The search resulted in the identification of 458 records of which 31 were included, covering 13 field trials and 18 articles containing experimental data, mathematical models, and other information directly relevant the control of T. solium. Recent field studies confirm that combinations of interventions or multiple rounds are more successful in obtaining rapid reductions in transmission and parasite occurrence, with the quick impact of the combination of human and pig treatment confirmed in a South Asian and Peruvian context. Moreover, elimination of transmission through a one-year intensive program, combining human and pig treatment/vaccination was described in a Peruvian study. Recent studies also provide more data on the positive impact of specific health education, as well as newly developed electronic educational tools, providing opportunities for area specific community-engaged participatory interventions. Once control has been achieved, monitoring of migration of both potentially infected people and pigs from outside the control area is important for sustained disease control. Combined intervention field studies demonstrate sharp decreases in disease occurrence. New, specific, efficient, electronic educational tools are available. Elimination of Taenia solium in a Peruvian endemic area has been described. Integration of Taenia solium control in other NTD control programs can be effective.
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Affiliation(s)
- T de Coster
- Ghent University, Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - I Van Damme
- Ghent University, Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - J Baauw
- Ghent University, Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - S Gabriël
- Ghent University, Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Salisburylaan 133, 9820 Merelbeke, Belgium
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Symeonidou I, Arsenopoulos K, Tzilves D, Soba B, Gabriël S, Papadopoulos E. Human taeniasis/cysticercosis: a potentially emerging parasitic disease in Europe. Ann Gastroenterol 2018; 31:406-412. [PMID: 29991885 PMCID: PMC6033766 DOI: 10.20524/aog.2018.0260] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/30/2018] [Indexed: 12/04/2022] Open
Abstract
Taenia saginata (T. saginata)/Taenia solium (T. solium) taeniasis/cysticercosis disease complexes remain a significant challenge for food safety and public health. Human taeniasis is an infectious disease caused by the ingestion of the metacestode larval stage, the cysticerci of T. saginata in beef or T. solium in pork. Humans can also become infected via the ingestion of T. solium eggs. In this case, the cysticerci can establish in the central nervous system, causing the infection called neurocysticercosis. T. solium is of higher importance than T. saginata because the former species can cause neurocysticercosis in humans, a major cause of neurological morbidity in the world. The taeniasis/cysticercosis complex is included in the list of neglected zoonotic diseases by the World Health Organization and Food and Agriculture Organization, with T. solium being the number one foodborne parasite; it occurs mostly in developing countries, such as regions of Asia, Africa and Latin America, where the disease remains endemic. Long absent in Western Europe and other developed countries, cysticercosis has been recently re-emerged as a result of immigration, travel and commerce. In this review, cysticercosis is presented with special emphasis on some aspects of this neglected disease: the main clinical manifestations, risk factors and epidemiology. In addition, any recent advances in diagnostic approaches and treatment are discussed. Finally, the complexities involved in the control of the disease and the need to revise current management strategies are highlighted.
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Affiliation(s)
- Isaia Symeonidou
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
| | - Konstantinos Arsenopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
| | - Dimitrios Tzilves
- Gastroenterology Department, Theageneio Hospital, Thessaloniki, Greece (Dimitrios Tzilves)
| | - Barbara Soba
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia (Barbara Soba)
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium (Sarah Gabriël)
| | - Elias Papadopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
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Tsotetsi-Khambule AM, Njiro S, Katsande TC, Harrison LJS. Risk factors associated with taeniosis-cysticercosis in rural farming communities in Gauteng Province, South Africa. Trop Anim Health Prod 2018; 50:1951-1955. [PMID: 29850979 DOI: 10.1007/s11250-018-1627-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/21/2018] [Indexed: 12/01/2022]
Abstract
The aim of this study was to determine which of the livestock management and human practices known to be risk factors associated with taeniosis-cysticercosis occur in Gauteng Province. A questionnaire survey was conducted in two regions of Gauteng Province, Germiston and Pretoria. Results revealed that almost 20% of the interviewed farmers do not have toilets, most of them let their animals roam freely during the day for grazing and scavenging, and 47% use streams as the water source for their animals. This may create an infection opportunity through ingestion of Taenia-contaminated herbage or water. Furthermore, 26% mentioned that their animals might have access to human excreta. More than 70% of farmers in the province slaughter cattle and pigs for their own consumption without inspecting meat for cysticercosis. Only a few of the interviewed farmers in both regions were aware of the taeniosis-cysticercosis complex. Backyard slaughtering, consumption of uninspected meat by the public, poor livestock management, and limited sanitation in rural communities of Gauteng Province are identified as risk factors associated with the occurrence of Taenia saginata and Taenia solium infections in the province. Taenia saginata and T. solium are considered to have a global distribution; therefore, these risk factors may be applicable globally, not just in Gauteng Province. Programs on public awareness with regard to transmission and prevention of Taenia infections as well as more detailed studies on risk factors of taeniosis-cysticercosis are recommended.
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Affiliation(s)
- A M Tsotetsi-Khambule
- Epidemiology, Parasites and Vectors Programme, Onderstepoort Veterinary Research - Agricultural Research Council, Onderstepoort, 0110, South Africa.
| | - S Njiro
- Epidemiology, Parasites and Vectors Programme, Onderstepoort Veterinary Research - Agricultural Research Council, Onderstepoort, 0110, South Africa
| | - T C Katsande
- Veterinary Services, Gauteng Department of Agriculture and Rural Development, Pretoria, 0001, South Africa
| | - L J S Harrison
- Royal (Dick) School of Veterinary Science, University of Edinburgh, Scotland, UK
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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.
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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
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22
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Maganira JD, Hepelwa NI, Mwang’onde BJ. Seroprevalence of Porcine Cysticercosis in Ludewa District, Njombe, Tanzania. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/aid.2018.83014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Trevisan C, Fèvre EM, Owiny M, Ngere I, Vang Johansen M. Minyoo Matata - The Vicious Worm - A Taenia solium Computer-Based Health-Education Tool - in Swahili. Trends Parasitol 2017. [PMID: 28634004 PMCID: PMC5636612 DOI: 10.1016/j.pt.2017.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lack of knowledge is one of the main risk factors for the spread of the zoonotic parasite Taenia solium. The computer-based health-education tool 'The Vicious Worm' was developed to create awareness and provide evidence-based health education as a specific measure in control strategies. To increase the reach of the tool, a new version in Swahili was developed and can now be downloaded for free from http://theviciousworm.sites.ku.dk.
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Affiliation(s)
- Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
| | - Eric M Fèvre
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK; International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709-00100, Nairobi, Kenya
| | - Maurice Owiny
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709-00100, Nairobi, Kenya; Kenya Field Epidemiology and Laboratory Training Programme, P.O. Box 22313-00100, Nairobi, Kenya
| | - Isaac Ngere
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709-00100, Nairobi, Kenya; Kenya Field Epidemiology and Laboratory Training Programme, P.O. Box 22313-00100, Nairobi, Kenya
| | - Maria Vang Johansen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Dyrlægevej 100, 1870 Frederiksberg C, Denmark
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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.
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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
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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.
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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
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Trevisan C, Devleesschauwer B, Schmidt V, Winkler AS, Harrison W, Johansen MV. The societal cost of Taenia solium cysticercosis in Tanzania. Acta Trop 2017; 165:141-154. [PMID: 26756713 DOI: 10.1016/j.actatropica.2015.12.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 12/11/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Abstract
Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers, researchers and relevant governmental agencies, is taken to find sustainable solutions for prevention, control and elimination of T. solium.
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27
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Why pigs are free-roaming: Communities' perceptions, knowledge and practices regarding pig management and taeniosis/cysticercosis in a Taenia solium endemic rural area in Eastern Zambia. Vet Parasitol 2016; 225:33-42. [PMID: 27369573 DOI: 10.1016/j.vetpar.2016.05.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/18/2016] [Accepted: 05/23/2016] [Indexed: 11/22/2022]
Abstract
Taenia solium cysticercosis is a neglected parasitic zoonosis in many developing countries including Zambia. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. Socio-cultural determinants related to free range pig management and their implications for control of T. solium remain unclear. The study objective was to assess the communities' perceptions, reported practices and knowledge regarding management of pigs and taeniosis/cysticercosis (including neurocysticercosis) in an endemic rural area in Eastern Zambia, and to identify possible barriers to pig related control measures such as pig confinement. A total of 21 focus group discussions on pig husbandry practices were organized separately with men, women and children, in seven villages from Petauke district. The findings reveal that the perception of pigs and their role in society (financial, agricultural and traditional), the distribution of the management tasks among the family members owning pigs (feeding, building kraal, seeking care) and environmental aspects (feed supply, presence of bush, wood use priorities, rainy season) prevailing in the study area affect pig confinement. People have a fragmented knowledge of the pork tapeworm and its transmission. Even if negative aspects/health risks of free-range pigs keeping are perceived, people are ready to take the risk for socio-economic reasons. Finally, gender plays an important role because women, and also children, seem to have a higher perception of the risks but lack power in terms of economic decision-making compared to men. Currently pig confinement is not seen as an acceptable method to control porcine cysticercosis by many farmers in Eastern Zambia, vaccination and treatment seemed to be more appropriate. Embedded in a One Health approach, disease control programs should therefore ensure a complementary appropriate set of control strategies by engaging new sectors such as agronomy, spatial ecology and finally consider the socio-cultural context, which is likely to enhance the development of control methods that could be accepted by the communities.
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Abstract
The World Health Organization announced in November 2014 at the fourth international meeting on ‘the control of neglected zoonotic diseases – from advocacy to action’, that intervention tools for eliminating Taenia solium taeniosis/cysticercosis (TSTC) are in place. The aim of this work was to elucidate theoretical outcomes of various control options suggested for TSTC elimination in sub-Saharan Africa (SSA) over a 4-year period. Our current knowledge regarding T. solium epidemiology and control primarily builds on studies from Latin America. A simple transmission model – built on data from Latin America – has been used to predict the effect of various interventions such as mass treatment of humans, vaccination and treatment of pigs, and health education of communities, potentially leading to change in bad practices and reducing transmission risks. Based on simulations of the transmission model, even a 4-year integrated One Health approach fails to eliminate TSTC from a small community and in all simulations, the prevalence of human taeniosis and porcine cysticercosis start to rise as soon as the programmes end. Our current knowledge regarding transmission and burden of TSTC in SSA is scarce and while claiming to be tool ready, the selection of diagnostic and surveillance tools, as well as the algorithms and stepwise approaches for control and elimination of TSTC remain major challenges.
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29
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Gordon CA, McManus DP, Jones MK, Gray DJ, Gobert GN. The Increase of Exotic Zoonotic Helminth Infections: The Impact of Urbanization, Climate Change and Globalization. ADVANCES IN PARASITOLOGY 2016; 91:311-97. [PMID: 27015952 DOI: 10.1016/bs.apar.2015.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Zoonotic parasitic diseases are increasingly impacting human populations due to the effects of globalization, urbanization and climate change. Here we review the recent literature on the most important helminth zoonoses, including reports of incidence and prevalence. We discuss those helminth diseases which are increasing in endemic areas and consider their geographical spread into new regions within the framework of globalization, urbanization and climate change to determine the effect these variables are having on disease incidence, transmission and the associated challenges presented for public health initiatives, including control and elimination.
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Affiliation(s)
- Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Malcolm K Jones
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Veterinary Science, University of Queensland, Brisbane, QLD, Australia
| | - Darren J Gray
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Geoffrey N Gobert
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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30
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Pawlowski Z. Taeniosis/Neurocysticercosis Control as a Medical Problem—A Discussion Paper. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/wjns.2016.62020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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31
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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.
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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
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32
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The neglected zoonoses—the case for integrated control and advocacy. Clin Microbiol Infect 2015; 21:433-43. [DOI: 10.1016/j.cmi.2015.04.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 03/23/2015] [Accepted: 04/12/2015] [Indexed: 12/14/2022]
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