Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

Skrip, Laura; Dermauw, Véronique; Dorny, Pierre; Ganaba, Rasmané; Millogo, Athanase; Tarnagda, Zékiba; Carabin, Hélène

doi:10.1371/journal.pntd.0009234

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…One might expect that consumption of partially cooked/raw pork meat would be associated with increased odds of seropositivity, given that taeniasis (adult tapeworm) carriers are at risk of autoinfection. However, more research is needed to understand the relative contribution of this route of transmission to overall cysticercosis risk [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Spatial distribution and risk factors for human cysticercosis in Colombia

et al. 2021

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Background Cysticercosis is a zoonotic neglected tropical disease (NTD) that affects humans and pigs following the ingestion of Taenia solium eggs. Human cysticercosis poses a substantial public health burden in endemic countries. The World Health Organization (WHO) aims to target high-endemicity settings with enhanced interventions in 17 countries by 2030. Between 2008 and 2010, Colombia undertook a national baseline serosurvey of unprecedented scale, which led to an estimated seroprevalence of T. solium cysticercus antibodies among the general population of 8.6%. Here, we use contemporary geostatistical approaches to analyse this unique dataset with the aim of understanding the spatial distribution and risk factors associated with human cysticercosis in Colombia to inform how best to target intervention strategies. Methods We used a geostatistical model to estimate individual and household risk factors associated with seropositivity to T. solium cysticercus antibodies from 29,253 people from 133 municipalities in Colombia. We used both independent and spatially structured random effects at neighbourhood/village and municipality levels to account for potential clustering of exposure to T. solium. We present estimates of the distribution and residual correlation of seropositivity at the municipality level. Results High seroprevalence was identified in municipalities located in the north and south of Colombia, with spatial correlation in seropositivity estimated up to approximately 140 km. Statistically significant risk factors associated with seropositivity to T. solium cysticercus were related to age, sex, educational level, socioeconomic status, use of rainwater, consumption of partially cooked/raw pork meat and possession of dogs. Conclusions In Colombia, the distribution of human cysticercosis is influenced by socioeconomic considerations, education and environmental factors related to the spread of T. solium eggs. This information can be used to tailor national intervention strategies, such as targeting spatial hotspots and more highly exposed groups, including displaced people and women. Large-scale seroprevalence surveys accompanied by geospatial mapping are an essential step towards reaching the WHO’s 2021‒2030 NTD roadmap targets. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Spatial distribution and risk factors for human cysticercosis in Colombia

et al. 2021

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“…Interventional public health programs have been implemented and identified further challenges to change community practices 59 . Serial vaccination of pigs with the TSOL18 vaccine and medication with oxfendazole eliminated Taenia solium transmission by pigs in a study in Uganda 60 .…”

Section: Resultsmentioning

confidence: 99%

“…57,58 Interventional public health programs have been implemented and identified further challenges to change community practices. 59 Serial vaccination of pigs with the TSOL18 vaccine and medication with oxfendazole eliminated Taenia solium transmission by pigs in a study in Uganda. 60 The World Health Organization (WHO) includes addressing T solium as one of the 2030 goals, noting the debate between biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection with insight into the need for sustainable solutions for severely resource-constrained endemic settings.…”

Section: Neurocysticercosismentioning

confidence: 99%

Epilepsy research in Africa: A scoping review by the ILAE Pediatric Commission Research Advocacy Task Force

et al. 2022

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Objective Despite the high prevalence of epilepsy in Africa, evaluation of epilepsy research trends on the continent is lacking. Without establishing effective research, improvement in care for people with epilepsy cannot be effectively strategized or targeted. Methods A scoping review of the peer‐reviewed literature on epilepsy from Africa (1989–2019) was conducted. The aim was to understand from this what areas are well researched versus underresearched based on published epilepsy topics. Results A total of 1227 publications were identified and assessed. A significant increase in publications occurred over the 30 years assessed. African author leadership was evident in most reports. Nine countries had >50 publications identified; the remaining 45 countries had <50 or no publications. Research studies were typically of lower quality (case series and observational studies). Research themes were more focused on clinical epilepsy (descriptive observational studies) and social aspects (qualitative surveys). However, there were a number of unique and strong themes, specifically for neurocysticercosis and nodding syndrome, where strong research collaborations were evident, basic science understandings were explored, and interventional models were established. Significance Despite Africa being the continent with the most countries, it is lacking in the quantity, quality, and for some areas, relevance of research on epilepsy. Targeted approaches are needed to upskill the strength of research undertaken with more basic science, interventional, and randomized controlled studies. Themes of research need to promote those with unique African content but also to align with current international research areas that have impact on care delivery, such as epilepsy surgery and epilepsy genetics. For this to be possible, it is important to strengthen research hubs with collaborations that empower Africa to own its epilepsy research journey.

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“…Since then, various control interventions have been developed in order to control or eliminate the disease [ 16 , 22 ] and T . solium transmission models were also developed to evaluate the relative cost-effectiveness of these strategies [ 23 – 29 ]. However, development of these models is hampered by persistent limitations in the understanding of fundamental processes of transmission, such as the probability of human-to-pig infection upon exposure to eggs.…”

Section: Introductionmentioning

confidence: 99%

Development of a dose-response model for porcine cysticercosis

et al. 2022

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Taenia solium is an important cause of acquired epilepsy worldwide and remains endemic in Asia, Africa, and Latin America. Transmission of this parasite is still poorly understood despite the design of infection experiments to improve our knowledge of the disease, with estimates for critical epidemiological parameters, such as the probability of human-to-pig infection after exposure to eggs, still lacking. In this paper, a systematic review was carried out and eight pig infection experiments were analyzed to describe the probability of developing cysts. These experiments included different pathways of inoculation: with ingestion of proglottids, eggs, and beetles that ingested eggs, and direct injection of activated oncospheres into the carotid artery. In these experiments, different infective doses were used, and the numbers of viable and degenerated cysts in the body and brain of each pig were registered. Five alternative dose-response models (exponential, logistic, log-logistic, and exact and approximate beta-Poisson) were assessed for their accuracy in describing the observed probabilities of cyst development as a function of the inoculation dose. Dose-response models were developed separately for the presence of three types of cysts (any, viable only, and cysts in the brain) and considered for each of the four inoculation methods (“Proglottids”, “Eggs”, “Beetles” and “Carotid”). The exact beta-Poisson model best fit the data for the three types of cysts and all relevant exposure pathways. However, observations for some exposure pathways were too scarce to reliably define a dose-response curve with any model. A wide enough range of doses and sufficient sample sizes was only found for the “Eggs” pathway and a merged “Oral” pathway combining the “Proglottids”, “Eggs” and “Beetles” pathways. Estimated parameter values from this model suggest that a low infective dose is sufficient to result in a 50% probability for the development of any cyst or for viable cyst infections. Although this is a preliminary model reliant on a limited dataset, the parameters described in this manuscript should contribute to the design of future experimental infections related to T. solium transmission, as well as the parameterization of simulation models of transmission aimed at informing control.

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Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

Cited by 4 publications

References 41 publications

Spatial distribution and risk factors for human cysticercosis in Colombia

Spatial distribution and risk factors for human cysticercosis in Colombia

Epilepsy research in Africa: A scoping review by the ILAE Pediatric Commission Research Advocacy Task Force

Development of a dose-response model for porcine cysticercosis

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