Barriers to Participation in a Community-Based Program to Control Transmission of Taenia solium in Peru

Michelle Beam School of Medicine, Oregon Health & Science University, Portland, Oregon;

Search for other papers by Michelle Beam in
Current site
Google Scholar
PubMed
Close
,
Angela Spencer School of Public Health, Oregon Health & Science University—Portland State University, Portland, Oregon;

Search for other papers by Angela Spencer in
Current site
Google Scholar
PubMed
Close
,
Lauralee Fernandez School of Public Health, Oregon Health & Science University—Portland State University, Portland, Oregon;

Search for other papers by Lauralee Fernandez in
Current site
Google Scholar
PubMed
Close
,
Ruth Atto Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Ruth Atto in
Current site
Google Scholar
PubMed
Close
,
Claudio Muro Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Claudio Muro in
Current site
Google Scholar
PubMed
Close
,
Percy Vilchez Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Percy Vilchez in
Current site
Google Scholar
PubMed
Close
,
Ricardo Gamboa Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Ricardo Gamboa in
Current site
Google Scholar
PubMed
Close
,
Sandra Olaya Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Sandra Olaya in
Current site
Google Scholar
PubMed
Close
,
Viterbo Ayvar Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Viterbo Ayvar in
Current site
Google Scholar
PubMed
Close
,
Armando E. Gonzalez School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru;

Search for other papers by Armando E. Gonzalez in
Current site
Google Scholar
PubMed
Close
,
Hector H. Garcia Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;
Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru

Search for other papers by Hector H. Garcia in
Current site
Google Scholar
PubMed
Close
,
Seth E. O’Neal School of Public Health, Oregon Health & Science University—Portland State University, Portland, Oregon;
Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;

Search for other papers by Seth E. O’Neal in
Current site
Google Scholar
PubMed
Close
, and
for the Cysticercosis Working Group in Peru School of Medicine, Oregon Health & Science University, Portland, Oregon;
School of Public Health, Oregon Health & Science University—Portland State University, Portland, Oregon;
Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru;
School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru;
Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru

Search for other papers by for the Cysticercosis Working Group in Peru in
Current site
Google Scholar
PubMed
Close
Restricted access

Infection of the brain with Taenia solium larvae (neurocysticercosis) is a leading cause of preventable epilepsy worldwide. Effective and sustainable strategies to control parasite transmission in rural endemic communities are needed to prevent the disease. Surveillance and targeted intervention around infected pigs (ring control strategy) have been shown to be effective when carried out by research teams. However, this strategy has not been implemented or tested as a community-based program. In this small trial in northern Peru, eight villages were randomly assigned to community-led surveillance and treatment (five villages, 997 residents) or control (three villages, 1,192 residents). In intervention villages, community-led surveillance and reporting were promoted by community health workers, radio advertisement, and school and household education. Each suspected pig infection was verified, with confirmed cases resulting in treatment with niclosamide for taeniasis and oxfendazole for pigs in clusters of homes nearby. No incentives beyond human and pig treatment were offered. Control villages received basic disease education but no treatment intervention in response to reports. Despite 14 case reports, community-based replication of ring control strategy did not replicate prior results. After 12 months, there was no change in seroincidence in intervention villages between the baseline and study end, and no difference compared with control villages. There was no difference in prevalence of taeniasis or porcine cysticercosis at study end. Community members described lack of knowledge as the main reason for not reporting infected pigs. Further exploration of methods to transfer ring strategy and other control interventions for cysticercosis to the community is needed.

    • Supplemental Materials (PDF 1114 KB)

Author Notes

Address correspondence to Seth E. O’Neal, School of Public Health, Oregon Health & Science University—Portland State University, Portland, OR. E-mail: oneals@ohsu.edu

Financial support: This research was made possible with support from the UBS Optimus Foundation.

Authors’ addresses: Michelle Beam, Oregon Health & Science University, Portland, OR, E-mail: beam@ohsu.edu. Angela Spencer, Lauralee Fernandez, and Seth E. O’Neal, Oregon Health & Science University—Portland State University, Portland, OR, E-mails: angela.g.spencer@pdx.edu, fernanla@ohsu.edu, and oneals@ohsu.edu. Ruth Atto, Claudio Muro, Percy Vilchez, Ricardo Gamboa, Sandra Olaya, Viterbo Ayvar, and Hector H. Garcia, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: ratto@peruresearch.org, claudio.muro@peruresearch.org, pvilchez@peruresearch.org, rgamboa@peruresearch.org, solaya@peruresearch.org, viterboayvar@yahoo.es, and hgarcia@jhsph.edu. Armando E. Gonzalez, Universidad Nacional Mayor de San Marcos, Lima, Peru, E-mail: agonza41@jhu.edu.

  • 1.

    Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, Qian Y-J, Rainwater E, Dickey M, Reynolds S, Stoner JA, 2010. A systematic review of the frequency of neurocysticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis 4: e870.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Garcia HH, Nash TE, Del Brutto OH, 2014. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13: 12021215.

  • 3.

    Coyle CM et al. 2012. Neurocysticercosis: neglected but not forgotten. PLoS Negl Trop Dis 6: e1500.

  • 4.

    Bern C, Garcia HH, Evans C, Gonzalez AE, Verastegui M, Tsang VCW, Gilman RH, 1999. Magnitude of the disease burden from neurocysticercosis in a developing country. Clin Infect Dis 29: 12031209.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Cruz M, Davis A, Dixon H, Pawlowski ZS, Proano J, 1989. Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador. Bull World Health Organ 67: 401407.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Sarti E, Schantz PM, Avila G, Ambrosio J, Medina-Santillán R, Flisser A, 2000. Mass treatment against human taeniasis for the control of cysticercosis: a population-based intervention study. Trans R Soc Trop Med Hyg 94: 8589.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Keilbach NM, de Aluja AS, Sarti-Gutierrez E, 1989. A programme to control taeniasis-cysticercosis (T. solium): experiences in a Mexican village. Acta Leiden 57: 181189.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Allan JC, Velasquez-Tohom M, Fletes C, Torres-Alvarez R, Lopez-Virula G, Yurrita P, Soto de Alfaro H, Rivera A, Garcia-Noval J, 1997. Mass chemotherapy for intestinal Taenia solium infection: effect on prevalence in humans and pigs. Trans R Soc Trop Med Hyg 91: 595598.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Garcia HH, Gonzalez AE, Gilman RH, Moulton LH, Verastegui M, Rodriguez S, Gavidia C, Tsang VCW, 2006. Combined human and porcine mass chemotherapy for the control of T. solium. Am J Trop Med Hyg 74: 850855.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Okello AL et al. 2016. Assessing the impact of a joint human-porcine intervention package for Taenia solium control: results of a pilot study from northern Lao PDR. Acta Trop 159: 185191.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    O’Neal SE, Moyano LM, Ayvar V, Rodriguez S, Gavidia C, Wilkins PP, Gilman RH, Garcia HH, Gonzalez AE, Cysticercosis Working Group in Peru, 2014. Ring-screening to control endemic transmission of Taenia solium. PLoS Negl Trop Dis 8: e3125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Molinari JL, Rodríguez D, Tato P, Soto R, Arechavaleta F, Solano S, 1997. Field trial for reducing porcine Taenia solium cysticercosis in Mexico by systematic vaccination of pigs. Vet Parasitol 69: 5563.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Assana E, Kyngdon CT, Gauci CG, Geerts S, Dorny P, De Deken R, Anderson GA, Zoli AP, Lightowlers MW, 2010. Elimination of Taenia solium transmission to pigs in a field trial of the TSOL18 vaccine in Cameroon. Int J Parasitol 40: 515519.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Jayashi CM, Kyngdon CT, Gauci CG, Gonzalez AE, Lightowlers MW, 2012. Successful immunization of naturally reared pigs against porcine cysticercosis with a recombinant oncosphere antigen vaccine. Vet Parasitol 188: 261267.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Bulaya C, Mwape KE, Michelo C, Sikasunge CS, Makungu C, Gabriel S, Gabriel S, Dorny P, Phiri IK, 2015. Preliminary evaluation of community-led total sanitation for the control of Taenia solium cysticercosis in Katete district of Zambia. Vet Parasitol 207: 241248.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Joshi DD, Maharjan M, Johansen MV, Willingham AL, Sharma M, 2003. Improving meat inspection and control in resource-poor communities: the Nepal example. Acta Trop 87: 119127.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Sarti E et al. 1997. Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico. Am J Trop Med Hyg 56: 127132.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Ngowi HA, Mlangwa JED, Mlozi MR, Tolma EL, Kassuku AA, Carabin H, Willingham AL, 2009. Implementation and evaluation of a health-promotion strategy for control of Taenia solium infections in northern Tanzania. Int J Health Promot Educ 47: 2434.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Ngowi HA, Carabin H, Kassuku AA, Mlozi MRS, Mlangwa JED, Willingham AL, 2008. A health-education intervention trial to reduce porcine cysticercosis in Mbulu District, Tanzania. Prev Vet Med 85: 5267.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Wohlgemut J, Dewey C, Levy M, Mutua F, 2010. Evaluating the efficacy of teaching methods regarding prevention of human epilepsy caused by Taenia solium neurocysticercosis in western Kenya. Am J Trop Med Hyg 82: 634642.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    de Aluja AS, Suárez-Marín R, Sciutto-Conde E, Morales-Soto J, Martínez-Maya JJ, Villalobos N, 2014. Evaluation of the impact of a control program against taeniasis-cysticercosis (Taenia solium). Salud Publica Mex 56: 259265.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Mwidunda SA, Carabin H, Matuja WBM, Winkler AS, Ngowi HA, 2015. A school based cluster randomised health education intervention trial for improving knowledge and attitudes related to Taenia solium cysticercosis and taeniasis in Mbulu district, northern Tanzania. PLoS One 10: e0118541.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Bustos JA et al. 2012. Detection of Taenia solium taeniasis coproantigen is an early indicator of treatment failure for taeniasis. Clin Vaccine Immunol 19: 570573.

  • 24.

    Garcia HH et al. 2016. Elimination of Taenia solium transmission in northern Peru. N Engl J Med 374: 23352344.

  • 25.

    Muro C et al. 2017. Porcine cysticercosis: possible cross-reactivity of Taenia hydatigena to GP50 antigen in the enzyme-linked immunoelectrotransfer blot assay. Am J Trop Med Hyg 97: 18301832.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Guezala M-C, Rodriguez S, Zamora H, Garcia HH, Gonzalez AE, Tembo A, Allan JC, Craig PS, 2009. Development of a species-specific coproantigen ELISA for human Taenia solium taeniasis. Am J Trop Med Hyg 81: 433437.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Flecker RH, Pray IW, Santivaňez SJ, Ayvar V, Gamboa R, Muro C, Moyano LM, Benavides V, Garcia HH, O’Neal SE, 2017. Assessing ultrasonography as a diagnostic tool for porcine cysticercosis. PLoS Negl Trop Dis 11: e0005282.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Pan W, 2001. Akaike’s information criterion in generalized estimating equations. Biometrics 57: 120125.

  • 29.

    Cui J, Qian G, 2007. Selection of working correlation structure and best model in GEE analyses of longitudinal data. Commun Stat Simul Comput 36: 987996.

  • 30.

    Bardosh K, Inthavong P, Xayaheuang S, Okello AL, 2014. Controlling parasites, understanding practices: the biosocial complexity of a one health intervention for neglected zoonotic helminths in northern Lao PDR. Soc Sci Med 120: 215223.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Carabin H, Traoré AA, 2014. Taenia solium taeniasis and cysticercosis control and elimination through community-based interventions. Curr Trop Med Rep 1: 181193.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    FAO, 2011. Challenges of Animal Health Information Systems and Surveillance for Animal Diseases and Zoonoses. Proceedings of the International Workshop Organized by FAO, November 23–26, 2010, Rome, Italy. FAO Animal Production and Health Proceedings, No. 14.

    • PubMed
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 720 648 25
Full Text Views 1517 14 0
PDF Downloads 180 18 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save