Regional Variation in Pig Farmer Awareness and Actions Regarding Japanese Encephalitis in Nepal: Implications for Public Health Education

Abstract

Japanese encephalitis (JE) is a mosquito-borne zoonotic disease that has pigs as the major amplifying hosts. It is the most important cause of viral encephalitis in people in Nepal and is spreading in its geographic distribution in that country. Pig farming is increasing in Nepal due to reducing cultural biases against pigs and government programs to support pig farming for poverty alleviation. Major strategies for JE prevention and control include education, vector control, and immunization of people and pigs. This study used a survey of 400 pig farmers in 4 areas of Nepal with different JE and pig farming histories to explore regional variations in farmer awareness and actions towards JE, the association of awareness and actions with farm and farmer variables, and the implications of these associations for public health education. Exposure to JE risk factors was common across pig farms and pig farming districts but there were significant district level differences in knowledge and practices related to on-farm JE risk reduction. Social factors such as literacy, gender, and cultural practices were associated with farmer attitudes, knowledge and practices for JE control. JE vaccine uptake was almost non-existent and mosquito control steps were inconsistently applied across all 4 districts. Income was not a determining factor of the differences, but all farmers were very poor. The low uptake of vaccine and lack of infrastructure or financial capacity to house pigs indoors or away from people suggest that farmer personal protection should be a priority target for education in Nepal. This study re-enforces the need to attack root causes of people’s personal disease prevention behaviours and take into account local variation in needs and capacities when designing health or agriculture education programs.

Epidemiology of Japanese encephalitis: past, present, and future prospects

“…JEV Serological data in pig indicated a serious risk for farmers, residents, and travelers. 111 – 114 …”

Japanese Encephalitis: Estimating Future Trends in Asia

“…Pig farming is also highly contingent on cultural factors that may not be represented in the data. For example, pig farming in Nepal has significantly increased after the year 1950 due to changing religious views and the tourism industry [33] . Thus, the data shows an upward trend that may stabilize in the near future.…”

Japanese encephalitis: Challenges and intervention opportunities in Nepal

“…The farms are however, maintained under unsanitary practices [ 30 ]. Rao’s proposal of 5 kilometre distance between household and pig farming for JE control is also not feasible in Nepal because of peri-urban migration; small pig population; farming not on own land and mobile population, which directly affect on policy making to set distances between people and pigs [ 31 , 32 ]. (iii) Climate change and vector adaptation to high altitude region (iv) Close pig-human-rice field interaction (v) poverty and access to health care: like other tropical disease, JE also disproportionately affects the poor more frequently and more severely.…”

“…However, many major issues like the length of immunity provided by vaccine, targeting only children or all age groups for vaccination, conducting vaccination only at endemic areas or whole country etc. are still unanswered [ 29 , 32 ].…”

“…Pig houses should be separated from human dwellings and should follow basic hygienic and sanitary standards. Further problem based research must be carried out to ascertain the complex transmission dynamics of disease in the country [ 29 , 32 ].…”