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Clustering of Necropsy-Confirmed Porcine Cysticercosis Surrounding Taenia solium Tapeworm Carriers in Peru

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  • 1 Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;
  • | 2 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
  • | 3 School of Public Health, Oregon Health and Science University and Portland State University, Portland, Oregon;
  • | 4 School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru;
  • | 5 Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru;
  • | 6 Research Department, Asociación Benéfica PRISMA (Proyectos en Informatica, Salud, Medicina y Agricultura), Lima, Peru;
  • | 7 Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 8 Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;
  • | 9 Instituto de Ciencias Neurológicas, Cysticercosis Unit, Lima, Peru

The pork tapeworm, Taenia solium, is among the leading causes of preventable epilepsy in the world and is common in rural areas of developing countries where sanitation is limited and pigs have access to human feces. Prior studies in rural villages of Peru have observed clusters of T. solium cysticercosis among pigs that live near human tapeworm carriers. Such spatial analyses, however, have been limited by incomplete participation and substandard diagnostic tests. In this study, we evaluated the association between necropsy-confirmed cysticercosis in pigs and their distance to T. solium tapeworm carriers in six villages in northern Peru. A total of six (1.4%) tapeworm carriers were detected using copro-antigen enzyme-linked immunosorbent assay and seven of 10 (70%) pigs belonging to the tapeworm carriers were found with viable cyst infection on necropsy. This was significantly greater than the prevalence of viable cyst infection among pigs living < 500 m (11%) and > 500 m (0.5%) from a tapeworm carrier (P < 0.001 for distance trend). Similar statistically significant prevalence gradients were observed after adjustment for possible confounders and for other pig-level outcomes including infection with > 10 viable cysts, degenerated cyst infection, and serological outcomes. This investigation confirms that porcine cysticercosis clusters strongly around tapeworm carriers in endemic rural regions of northern Peru and supports interventions that target these hotspots.

Author Notes

Address correspondence to Ian W. Pray, School of Public Health, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, E-mail: pray@ohsu.edu or Andres G. Lescano, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Ave. Honorio Delgado 430, Urb. Ingenierıa, S.M.P., Lima, Peru, E-mail: willy.lescano@upch.pe.

Financial support: This study was partially funded by research grants numbers P01 AI51976 and U01 AI35894 from the National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD. Partial support was also received by R01NS080645 from the National Institute of Neurological Disorders and Stroke. Research grants from the Wellcome Trust (063109), the Food and Drug Administration (002309), and the Bill & Melinda Gates Foundation (23981) fund ongoing cysticercosis research by the authors. A. G. L. is sponsored by the training grant D43 TW007393 awarded by the Fogarty International Center of the U.S. National Institutes of Health.

Authors’ addresses: Andres G. Lescano, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: willy.lescano@upch.pe. Ian W. Pray and Seth E. O’Neal, School of Public Health, Oregon Health and Science University and Portland State University, Portland, OR, E-mails: pray@ohsu.edu and oneals@ohsu.edu. Armando E. Gonzalez and M. Claudia Guezala, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru, E-mails: agonza41@jhu.edu and cguezala@gmail.com. Robert H. Gilman, Department of International Health, Johns Hopkins University, Baltimore, MD, E-mail: gilmanbob@gmail.com. Victor C. W. Tsang, Georgia State University, Atlanta, GA, E-mail: vct123@gmail.com. Ricardo Gamboa and Viterbo Aybar, Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: rgamboa@peruresearch.org and vayvar@peruresearch.org. Lawrence H. Moulton and Elli Leontsini, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mails: lmoulto1@jhu.edu and eleontsi@jhu.edu. Guillermo Gonzalvez and Hector H. Garcia, Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: gonzalvezg@paho.org and hgarcia1@jhu.edu.

These authors contributed equally to this work.

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