The evaluation of Community led total sanitation as an intervention measure for the control of Porcine Cysticerosis in Katete District in the Eastern Province of Zambia

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Bulaya, Carol
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Taenia Solium cysticercosis is a zoonotic infection endemic in many developing countries. It occurs mainly in rural communities and is associated with poverty, poor sanitation and free-range pig management. Humans act as the definitive host (taeniasis) and pigs and humans as the intermediate hosts (cysticercosis). Infection of the central nervous system leads to neurocysticercosis which manifests as epilepsy, seizures and eye blindness and may lead to death. Studies have been conducted in Zambia showing that the disease in endemic with a high prevalence of porcine cysticercosis 19.6% (Sikasunge et al., 2008) and human taeniasis 11.6% (Mwape et al., 2013). However despite the evidence, very few intervention measures against the tapeworm have yet been formulated nor implemented. The proven control measures for parasitic and infectious diseases transmitted by faeces are the improvement of basic sanitation, hygiene and health education. Community Led Total Sanitation (CLTS) is an innovative community based sanitation programme being that aims at reducing open air defecation in rural communities. It is assumed that the success of CLTS will lead to control of poor sanitation related diseases including porcine cysticercosis. The objective of this study was to determine the seroprevalence of porcine cysticercosis before and after CLTS. The study also undertook to assess any difference in the risk factors and cysticercosis awareness in pig farmers before and after CLTS. A comparative study was conducted with pre- and post-intervention assessments in the same villages to evaluate CLTS as an intervention measure for porcine cysticercosis in Katete District in the Eastern Province of Zambia. The B158/B60 Ag-ELISA was used to detect cysticerci antigens in serum from pigs. A household questionnaire was administered to respondents whose pigs were examined in order to obtain information on general characteristics, pig husbandry practices, sanitation and awareness of T. solium infections. The Wald test p-values were computed in Stata v11 to assess significant differences in the variables. A total of 379 pigs were examined (104 pre-intervention and 275 post-intervention). Of the pigs examined 14 (13.5%) and 45 (16.4 %) were T. solium positive after Ag-ELISA examination pre and post-intervention respectively showing no significant difference (p-value=0.473). From the questionnaire a total of 153 respondents were examined (64 pre-intervention, 89 post-intervention). Sanitation as a risk factor showed that the presence of latrines pre and post-intervention were 43(67.2%) and 74(84.1%) respectively, showing an increase of 31 latrines constructed in the villages and was statistically significant (p-value of 0.027).However; the proportion of latrine usage was at 41(93.2%) at baseline and lower 62(84.9%) post-intervention and this was statistically insignificant (p-value=0.151).Other important risk factors i.e. knowledge and awareness of cysticercosis ,consumption and selling of infected pork, free-range pig husbandry also showed no change after the intervention (p > 0.05). The study revealed that CLTS as an intervention did not lead to a decrease porcine cysticercosis infections in pigs (p > 0.05).The study also revealed that some of the risk factors and awareness of T. solium control were not significantly improved (p >0.05). It is recommended that besides CLTS; health education, mass drug treatment and veterinary control of pigs be incorporated, particularly to pig farmers as an essential component of prevention and control programmes.
Communicable Diseases in mammals , Mammals infections-Zambia