Elimination of porcine cysticercosis using an integrated approach in an endemic area of Katete district, Zambia.
| dc.contributor.author | Chembensonfu, Mwelwa | |
| dc.date.accessioned | 2023-11-30T06:44:38Z | |
| dc.date.available | 2023-11-30T06:44:38Z | |
| dc.date.issued | 2019 | |
| dc.description | Thesis | en |
| dc.description.abstract | Cysticercosis (CC) caused by the pork tapeworm Taenia solium is responsible for widespread public health problems and economic losses and is a major hindrance to pig production in many developing countries. Increasing efforts are being made to prevent and control this neglected parasitic zoonosis but more efforts are needed in order to drastically reduce the disease occurrence. A number of studies report control of porcine cysticercosis (PCC) by improving sanitation, pig husbandry, education and meat inspection but these interventions are not effective when used as single options. A vaccine designated TSOL 18 against porcine cysticercosis is now available and if combined with oxfendazole is reported to be effective. The aim of this study was to evaluate the effectiveness of integrated control methods for PCC. An experimental field trial (parallel group design) was conducted between March, 2015 and January, 2018 in CC highly endemic areas of Zambia (Katete and Sinda Districts of Eastern Province). This involved concurrent vaccination with TSOL 18 vaccine, Oxfendazole treatment in pigs, mass drug administration (MDA) of praziquantel to the community and health education. Two areas were assigned elimination (E, Nyembe) and negative control (N, Herode) study arms. Baseline and post intervention data was collected through questionnaire, full carcass pig dissections, PCR-RFLP and ELISA performed on collected blood and cysticerci. Treatment/vaccination of pigs and mass treatment of people were conducted only in the elimination study arm at intervals of four months for two years while community education on T. solium, control and prevention was carried out in both study arms. All collected data was double entered in Epidata®, cleaned and analysis performed in R, using logistic regression. The analyses looked into changes within each study arm before and after the intervention and between the E-arm and N-arm after the intervention. A significance level of 5% was used. The primary outcome was PCC as determined by necropsy and Ag-ELISA, and both pre and post-intervention prevalence were established. The questionnaire was administered to 186 households in both study areas out of which 85% had toilets but 7.7% did not use them. Sixty to 66.4% of the households left the pigs to roam freely during the day thereby, predisposing them to PCC. At baseline, the prevalence for PCC was 46% and 45.7% after full carcass dissections and Ag-ELISA respectively in the E study arm while 67.7% after dissection and 45.2% after Ag- ELISA assay was recorded in the N-arm. Six rounds of interventions were conducted in the E arm and at mid-intervention (after the third round of intervention) the prevalence of PCC dropped from 46% to 16.7% on Ag-ELISA analysis. At post intervention dissections, a marked decrease in prevalence in the E-arm from 46% to 11.5% (non-viable cysts detected only) was observed. The net effect of integrated interventions was at -1.23. There was, however, no significant decrease in prevalence (67.7% to 50%) observed in the N-arm at post intervention dissections. Taeniosis prevalences as detected by coproantigen ELISA, significantly decreased (P<0.001) in the E-arm from 16% (at baseline) to 7.0% (at mid intervention) and 2.3% (11/480, 95% CI 1.1 – 4.1%) at post-intervention. The N-arm had significantly more T. solium positive pigs than the E arm (p = 0.003), after the interventions. The positive reduction in the prevalence of PCC by this combination of control tools indicates the potential of eliminating cysticercosis using an integrated approach. This calls for further evaluation studies to determine whether this control/prevention option is cost effective and sustainable for sub-Sahara Africa. Key words: Taenia solium – taeniasis – cysticercosis – Neglected Zoonotic Disease – tapeworm intervention - control – elimination – sub-Saharan Africa – Zambia | en |
| dc.identifier.uri | https://dspace.unza.zm/handle/123456789/8248 | |
| dc.language.iso | en | en |
| dc.publisher | University of Zambia | en |
| dc.subject | Taenia solium-elimination-sub-Saharan Africa – Zambia | en |
| dc.subject | Tapeworm control –sub-Saharan Africa – Zambia | en |
| dc.subject | Cholecystitis – Neglected Zoonotic Disease | en |
| dc.title | Elimination of porcine cysticercosis using an integrated approach in an endemic area of Katete district, Zambia. | |
| dc.type | Thesis | en |