Knowledge, attitudes and practices with regard to the presence, transmission, impact, and control of cystic echinococcosis in Sidi Kacem Province, Morocco

Abstract

BackgroundThis study is a component of a large research project on five major neglected zoonotic diseases (NZDs) including cystic echinococcosis and was undertaken in the Province of Sidi Kacem over a period of four years (April 2009-March 2013).MethodsQuestionnaires were administered at community level in a total of 27 communes and visits were made to all of the 10 abattoirs situated in the Province, to collect qualitative data on determinants of transmission for disease in humans and animals. More specifically, community knowledge, attitudes and practices related to cystic echinococcosis were assessed, as well as the extent to which local customs and behaviours may promote transmission. Abattoir infrastructure and practices, and their role in perpetuating disease transmission were also critically evaluated.ResultsThe results show that only 50 % of people have heard of the disease, and of those, only 21 % are aware of the dog’s role in disease transmission. Sixty-seven per cent of respondents stated that dogs are fed ruminant organs deemed unfit for human consumption. Owned dogs have access to the family home, including the kitchen, in 39 % of households. The extent of this close proximity between humans and animals is even more pertinent when one considers that dogs are omnipresent in the community, with an average of 1.8 dogs owned per household. The unrestricted access of dogs to abattoirs is a huge issue, which further promotes disease transmission.ConclusionThis study would suggest that the high prevalence of cystic echinococcosis in humans and animals in Morocco is largely due to three factors: 1) abundance of dogs 2) engagement in risky behaviour of the local population and 3) poor abattoir infrastructure and practices. This has serious implications in terms of the socio-economic impact of the disease, especially for rural poor communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-015-0082-9) contains supplementary material, which is available to authorized users.

Risk factors associated with cystic echinococcosis in humans in selected pastoral and agro-pastoral areas of Uganda

“…On contrary in Nakasongola, dog ownership was not shown as risk factor among those who were infected with CE. Dog ownership has been reported as a risk factor of CE among Turkana, Kenya [4,30,31], the Chinese communities [14][15][16]19,22] and in Morocco [32]. In Kasese and Teso region, the households owning dogs were few as compared to those in Karamoja (Table-4), there was a positive correlation between those having CE and those owning dogs.…”

Global Distribution of Alveolar and Cystic Echinococcosis

“…Similar factors are present in Morocco, where the high prevalence of CE in humans and animals is influenced by (1) an abundance of dogs (1.8 dogs per household); (2) poor knowledge of CE (50% of people are aware of the disease) and (3) inadequate abattoir infrastructure and hygiene (El Berbri et al, 2015a). p1795…”

Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

“…It is interesting to note that not only “slaughter at home” but also the use of “slaughterhouses” seemed to be a proxy for acquiring this disease. This suggests that in areas where the studies were conducted (Peru and Argentina) [16, 17], dogs had access to infected offal due to the mismanagement of infected organ disposal, thus increasing the probability of CE transmission to humans [18]. Health policy strategies such as mandatory disease notification at slaughterhouses, and/or sanitation may help to define directed interventions in order to interrupt CE transmission.…”