Prevention and control of bovine cysticercosis: a Delphi study

Abstract

Bovine cysticercosis is a zoonotic parasitic infection caused by the larval stage (Cysticercus bovis) of Taenia saginata. This study aimed to identify prevention and control measures for bovine cysticercosis indicated by experts in the fields of public and animal health. The study was conducted through three rounds of the Delphi method and had the participation of 44 experts from 13 Brazilian states in 30 educational institutions, research institutions, and sanitary inspection services. The first round comprised an open question, the answers to which formed the basis for structuring the second and third questionnaire. To reach a consensus in the second and third rounds, experts were asked to express their agreement or disagreement of each proposition on the questionnaire using a five-point Likert scale. A descriptive statistical analysis was performed at the end of each round. Twenty-three specialists (52.27%) participated in all three rounds. The first round resulted in 28 proposals categorized into six areas: health education, methods of diagnosis and treatment, sanitation measures, epidemiological studies, legislation and sanitary supervision, and intersectorality. In the second round, the experts reached a consensus on 16 propositions (57.14%). This percentage increased by 3.54% during the third round. At the end of the third round, the experts had reached a consensus on 17 of the 28 initial propositions (60.71%). The highest percentage of agreement (29.4%) was observed in the category of health education. This study allowed us to identify 17 recommendations pertaining to the prevention and control of bovine cysticercosis. These measures are not mutually exclusive, and require an integrated approach to the establishment of intervention actions at various points in the life cycle of the parasite.Key words: Environment. Parasitosis. Public health. ResumoA cisticercose bovina é uma infecção parasitária zoonótica causada pelo estágio larval (Cysticercus bovis) da Taenia saginata. Este estudo teve como objetivo identificar as medidas de prevenção e controle da cisticercose bovina indicadas por especialistas na área da saúde pública e animal. O estudo foi realizado através de três rodadas do método Delphi e contou com a participação de 44 especialistas de 13 estados brasileiros em trinta instituições de ensino, pesquisa e serviços de inspeção sanitária. A primeira rodada foi composta de uma questão aberta cujas respostas serviram de base para a estruturação do segundo e terceiro questionário. Para obtenção de consenso, na segunda e terceira rodada, os especialistas foram convidados a expressarem sua concordância ou discordância para cada proposição do questionário através de uma escala de Likert de cinco pontos. A análise estatística descritiva foi realizada no final de cada rodada. Vinte e três (52,27%) especialistas participaram das três rodadas. A primeira rodada resultou em 28 propostas classificadas em seis áreas: educação em saúde, métodos de 1 M.e em Ciências da Saúde, Universidade Comunitária da Re...

Systematic review and meta-analysis of bovine cysticercosis in Brazil: current knowledge and way forward

“…In addition, we found 12 articles containing information about the spatial distribution of BCC inside/within the states (Table 1), 13 articles describing risk factors or variables associated with BCC occurrence ( Table 2) and 4 describing the economic burden of BCC [7,22,28,30]. Furthermore, a set of 10 studies performed in Brazil were also included, regarding at least one aspect presented in discussion section, such as efficacy of chemical treatment (n = 1) [62], preferential infection sites (n = 2) [63,64], development of serological tests (n = 4) [65][66][67][68] and measures for BCC control (n = 3) [69][70][71].…”

“…Considering the low sensitivity of meat inspection and problems related to the detection of infected carcasses using other methods, other strategies for BCC control are required in Brazil, in order to interrupt taeniosis/ cysticercosis transmission. According to a Delphy study performed by experts in BCC epidemiology, there are six categories of control measures: (i) health education; (ii) health intersectorality; (iii) health surveillance and legislation; (iv) sanitation measures; (v) epidemiological studies; and (vi) methods of diagnosis and treatment [70].…”

“…Johansen et al [97] highlighted that "ignorance is the major obstacle for the effective control of diseases"; indeed, educating the population about amongst others sanitation and the consumption of well-cooked beef is an important strategy to interrupt T. saginata taeniosis/ cysticercosis transmission [70]. Children are recognized as excellent health change agents [98,99], highlighting the need to include them in educational programmes.…”

“…The detection of cysticercosis during post-mortem exams should be communicated to health departments, including origin and farm location, so that actions, i.e. including health education programmes and human treatment, may be taken on the different levels including integrated activities among professionals of the program for family health, educators and workers [70].…”

“…Another control measure that needs improvement in Brazil is the combat against illegal slaughter [70], a recognized practice that occurs in Brazil, allowing infected animals to enter in food supply chain. There are no official data for the current situation of illegal slaughter in Brazil.…”