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A combined (human and porcine) mass chemotherapy program was tested in a controlled design in 12 village hamlets in the Peruvian highlands. A single dose of 5 mg of praziquantel was given to eliminate intestinal taeniasis in humans, and two rounds of oxfendazole (30 mg/kg) were administered to all pigs. The total population in the study villages was 5,658 resident individuals, and the porcine population at the beginning of the study was 716 pigs. Human treatment coverage was 75%, ranging from 69% to 80%. There were only a few refusals of owners for porcine treatment of their animals. The effect of the intervention was measured by comparing incidence rates (seroconversion in pigs who were seronegative 4 months before) in treatment versus control villages, before and up to 18 months after treatment. There was a clear effect in decreasing prevalence (odds ratio, 0.51; P < 0.001) and incidence (odds ratio, 0.39; P < 0.013) in the treatment area after the intervention, which did not leave to extinction of the parasite but stabilized in slightly decreased rates persisting along the follow-up period. Mass chemotherapy was effective in decreasing infection pressure in this hyperendemic area. However, the magnitude of the effect was small and did not attain the goal of eliminating transmission.
Received October 13, 2005. Accepted for publication December 6, 2005.
Acknowledgments: We thank the population of Quilcas, who made it possible to realize the study. Help from E. Perez, Y. Arana, V. Mallqui, J. B.Phu, and D. Sara in sample management and data collection is also acknowledged.
Financial support: This study was funded by Grants U19-A145431, ABC, and ITREID from the National Institutes for Health and Fogarty Foundation. Research Grants P01 AI51976, U01 AI35894, and TW05562 from the National Institutes of Health, 01107 from Food and Drug Administration, 063109 from The Wellcome Trust, and 23981 from The Bill and Melinda Gates Foundation fund other cysticercosis research by the authors. The sponsors had no role in the design or writing of this work.
Other members of the Cysticercosis Working Group in Perú include H. Mayta, J. Jimenez, P. Castillo (Universidad Peruana Cayetano Heredia, Lima, Peru); Martinez SM (Instituto de Ciencias Neurologicas, Lima, Peru); C.A.W. Evans (Cambridge University, Cambridge, UK).
* Address correspondence to Hector H. Garcia, Department of Microbiology, Universidad Peruana Cayetano Heredia. Av. H. Delgado 430, SMP, Lima 31, Peru. E-mail: hgarcia{at}jhsph.edu
Authors’ addresses: Hector H. Garcia, Manuela Verastegui, and Silvia Rodriguez, Biology Department of Microbiology, Universidad Peruanan Cayetano Heredia. Av. H. Delgado 430, SMP, Lima 31, Peru, E-mail: hgarcia{at}jhsph.edu. Armando E. Gonzalez and Cesar M. Gavidia, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos. Av. Circunvalacion s/n, San Borja, Lima 3, Peru, E-mail: emico{at}terra.com.pe. Robert H. Gilman and Lawrence H. Moulton, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, E-mail: rgilman{at}jhsph.edu. Victor C.W. Tsang, Immunology Branch, Division of Parasitic Diseases, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-13, Atlanta, GA 30341-3724, E-mail: vct1{at}cdc.gov.
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