Factors Associated with the 18-Month Cumulative Incidence of Seroconversion of Active Infection with Taenia solium Cysticercosis: A Cohort Study among Residents of 60 Villages in Burkina Faso

Dermauw, Véronique; Carabin, Hélène; Ganaba, Rasmané; Cissé, Assana; Tarnagda, Zékiba; Gabriël, Sarah; Dorny, Pierre; Millogo, Athanase

doi:10.4269/ajtmh.18-0294

Cited by 13 publications

(15 citation statements)

References 27 publications

(45 reference statements)

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“…free roaming, feeding wastes, drinking free water, among others). These findings contrast with those reported in other studies in Latin America and other geographical settings, in which human cysticercosis has been associated with owning pigs [ 2 , 33 , 52 ]. Some farming practices, such as using waste or water and mix concentrate as feed, and the lack of drainage systems were non-significantly associated with increased seropositivity.…”

Section: Discussioncontrasting

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: Discussioncontrasting

confidence: 99%

Spatial distribution and risk factors for human cysticercosis in Colombia

et al. 2021

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“…Our infection loss rates for HTT indicate that the duration of adult tapeworm infection (the reciprocal of ρinf) ranges from 1.3 to 1.4 years (with uncertainty bounds from 1.0 to 2.8 years), aligning with literature estimates suggesting that adult tapeworms live for less than 5 years (Garcia et al, 2014), although our values are only based on two studies. HCC Ab-seroreversion rates (or infection loss rates) from this analysis are also consistently larger than HCC Ab-seroconversion rates (or infection acquisition rates), in agreement with comparisons of HCC Ab-seroreversion to Abseroconversion (or Ag-seroreversion to Ag-seroconversion) estimates in the literature, which are (Dermauw et al, 2018;Garcia et al, 2001;Coral-Almeida et al, 2015;Mwape et al, 2013). Some of the modelled estimates presented here indicate large differences between FoI and Abseroreversion/infection loss rates.…”

Section: Discussionsupporting

confidence: 87%

Global Force-of-Infection Trends for Human Taenia solium Taeniasis/Cysticercosis

Dixon

Winskill

Harrison³

et al. 2022

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Infection by Taenia solium poses a major burden across endemic countries. The World Health Organization (WHO) 2021–2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified T. solium control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab-seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab-seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in T. solium transmission rates indicate the need for setting-specific intervention strategies to achieve the WHO goals.

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“…The results from this model become very useful in elucidating the observed effectiveness of the educational intervention tested as part of the clustered randomized controlled trial conducted in these villages. The trial showed that the intervention was most effective in Sanguié and Nayala, but not in Boulkiemdé [ 23 ]. The model suggested that more intensive improvements in latrine use and pork cooking habits were needed in Boulkiemdé than in Nayala and Sanguié to eliminate the infection ( Fig 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Improvements in sanitation were assumed to be associated with behavioral changes in response to the education intervention used in the cluster randomized controlled trial of the parent study [ 23 ]. Improved sanitation was expected to reduce the rate of transmission associated with human exposure to T .…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2021

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Background The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Methodology/Principal findings Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Conclusions/Significance Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis.

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Factors Associated with the 18-Month Cumulative Incidence of Seroconversion of Active Infection with Taenia solium Cysticercosis: A Cohort Study among Residents of 60 Villages in Burkina Faso

Cited by 13 publications

References 27 publications

Spatial distribution and risk factors for human cysticercosis in Colombia

Spatial distribution and risk factors for human cysticercosis in Colombia

Global Force-of-Infection Trends for Human Taenia solium Taeniasis/Cysticercosis

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

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