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SWINE CYSTICERCOSIS HOTSPOTS SURROUNDING TAENIA SOLIUM TAPEWORM CARRIERS

We estimated the Taenia solium swine cysticercosis risk gradient surrounding tapeworm carriers in seven rural communities in Peru. At baseline, the prevalences of taeniasis by microscopy and swine cysticercosis by serology were 1.2% (11 of 898) and 30.8% (280 of 908), respectively. The four-month cumulative seroincidence was 9.8% (30 of 307). The unadjusted swine seroprevalence and seroincidence rates increased exponentially by 12.0% (95% confidence [CI] = 9.7–14.3%) and 32.8% (95% CI = 25.0–41.0%), respectively when distance to carriers decreased by half. Swine seroprevalence was 18.4% at > 500 meters from a carrier, 36.5% between 51 and 500 meters, and 68.9% within 50 meters (P < 0.001). Swine seroincidence also displayed a strong gradient near tapeworm carriers (3.8%, 12.2%, and 44.0%; P < 0.001). Within 50 meters, swine seroprevalence appeared unaffected if the owners harbored tapeworms, although pigs owned by a tapeworm carrier had a four times higher seroincidence compared with other pigs (P = 0.005). In rural areas, swine cysticercosis occurs in high-risk hotspots around carriers where control interventions could be delivered.

Received September 19, 2006. Accepted for publication October 26, 2006.

Acknowledgments: We thank the population of Matapalo and local health workers for their support and cooperation.

Financial support: This study was partially supported by research grants P01 AI51976 and U01 AI35894 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health. Research grants from the Wellcome Trust (063109), the Food and Drug Administration (002309), and the Bill and Melinda Gates Foundation (23981) fund ongoing cysticercosis research by the authors.

Disclaimer: The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the United States Department of the Army or Navy or any of the other organizations listed.

^* Address correspondence to Hector H. García, Cysticercosis Unit, Instituto de Ciencias Neurológicas Jirón Ancash 1271, Barrios Altos, Lima 1, Peru. E-mail: hgarcia{at}jhsph.edu

Authors’ addresses: Andres G. Lescano, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, and Public Health Training Program, United States Naval Medical Research Center Detachment, Lima, Peru. Hector H. Garcia, School of Sciences, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205 and Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Peru. Robert H. Gilman, School of Sciences, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, and Research Department, Asociación Benéfica Proyectos en Informatica, Salud, Medicina y Agricultura (PRISMA), Lima, Peru. M. Claudia Guezala, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Victor C. W. Tsang, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Chamblee, GA 30341. Cesar M. Gavidia, and Armando E. Gonzalez, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, and School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Silvia Rodriguez, Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Peru. Lawrence H. Moulton, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205. Justin A. Green, Department of Infectious Diseases, Imperial College, London W2 1PG, United Kingdom.