The Influence of Socio-economic, Behavioural and Environmental Factors on Taenia spp. Transmission in Western Kenya: Evidence from a Cross-Sectional Survey in Humans and Pigs.
The Influence of Socio-economic, Behavioural and Environmental Factors on Taenia spp. Transmission in Western Kenya: Evidence from a Cross-Sectional Survey in Humans and Pigs.
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DOI：
10.1371/journal.pntd.0004223
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发表时间：
2015-12
影响因子：
3.8
通讯作者：
Fèvre EM
中科院分区：
文献类型：
--
作者：
Wardrop NA;Thomas LF;Atkinson PM;de Glanville WA;Cook EA;Wamae CN;Gabriël S;Dorny P;Harrison LJ;Fèvre EM
带绦虫属感染，特别是囊虫病，在流行国家造成相当大的健康影响。尽管先前的证据表明囊虫病的空间聚集性和环境因素（例如温度和湿度）在虫卵存活中的作用，但很少有研究探讨带绦虫属的这些方面。流行病学此外，我们对人类和猪感染风险因素的理解存在重大差距。本研究旨在评估社会经济、行为和环境变量对人类和猪囊虫病的影响。本文对人带绦虫病进行了横断面调查。solium和T. saginata）、人囊虫病（T. solium）和猪囊尾蚴病（T.在肯尼亚西部的416户家庭中进行了一项调查。这些数据与调查问卷答复和环境数据集相关联。多水平回归分析被用来检查协变量与人类和猪囊虫病之间的关系。人类的HP 10 Ag-ELISA血清患病率（提示猪囊尾蚴病）为6.6%（95%CI 5.6%-7.7%），猪的血清患病率为17.2%（95%CI 10.2%-26.4%）。根据带绦虫属的直接显微镜观察，人类带绦虫病患病率。卵（即仅通过显微镜检查结果）为0.2%（95% CI 0.05%-0.5%）。存在带绦虫属人和猪的抗原与一系列因素显著相关，包括与土地覆盖的正相关。人类中HP 10抗原的存在与（非线性）与1 km缓冲区内淹没农业用地和草地的土地比例（OR = 1.09和0.998;线性项和二次项分别为p = 0.03和0.03），性别（男性与女性相比，OR = 0.58，p = 0.02），教育水平（小学教育与未接受正规教育的OR = 0.62，p = 0.09），饮用井水（使用井水者与不使用井水者的OR = 2.76，p = 0.02）和降水（OR = 0.998，p = 0.02）。存在带绦虫属猪中的抗原与猪的性别和繁殖状态（与公猪相比，繁殖母猪的OR = 10.35，p = 0.01）以及1 km缓冲区内淹没农田和草地的土地比例（OR = 1.04，p = 0.004）显著相关。这些结果突出了多种社会经济，行为和环境因素在带绦虫属的作用。传输模式带绦虫属的环境污染。卵是一个关键问题，景观因素影响带绦虫属的存在。猪和人类的抗原。 带绦虫属可引起人体肠道绦虫感染，感染猪带绦虫幼虫期（囊虫病）可导致严重后果，如癫痫。传播发生在卫生条件差和缺乏适当肉类检查做法的地区，尽管我们对社会经济，行为和环境因素如何影响这些寄生虫的发生仍存在差距。对居住在肯尼亚西部地区416户家庭的人和猪进行了幼虫期感染（囊虫病）检测。统计方法被用来研究一系列社会经济、行为和环境因素与疾病发生之间的关系。结果表明，包括土地覆盖在内的几个因素影响了人和猪囊虫病感染的分布。在这一领域的进一步研究可能会提供有关环境驱动因素对带绦虫属的影响有意义的理解。感染，提供证据，以支持疾病控制活动的目标。
Taenia spp. infections, particularly cysticercosis, cause considerable health impacts in endemic countries. Despite previous evidence of spatial clustering in cysticercosis and the role of environmental factors (e.g. temperature and humidity) in the survival of eggs, little research has explored these aspects of Taenia spp. epidemiology. In addition, there are significant gaps in our understanding of risk factors for infection in humans and pigs. This study aimed to assess the influence of socio-economic, behavioural and environmental variables on human and porcine cysticercosis. A cross-sectional survey for human taeniasis (T. solium and T. saginata), human cysticercosis (T. solium) and pig cysticercosis (T. solium) in 416 households in western Kenya was carried out. These data were linked to questionnaire responses and environmental datasets. Multi-level regression was used to examine the relationships between covariates and human and porcine cysticercosis. The HP10 Ag-ELISA sero-prevalence (suggestive of cysticercosis) was 6.6% for humans (95% CI 5.6%–7.7%), and 17.2% for pigs (95% CI 10.2%–26.4%). Human taeniasis prevalence, based on direct microscopic observation of Taenia spp. eggs (i.e. via microscopy results only) was 0.2% (95% CI 0.05%–0.5%). Presence of Taenia spp. antigen in both humans and pigs was significantly associated with a range of factors, including positive correlations with land cover. The presence of HP10 antigen in humans was correlated (non-linearly) with the proportion of land within a 1 km buffer that was flooding agricultural land and grassland (odds ratio [OR] = 1.09 and 0.998; p = 0.03 and 0.03 for the linear and quadratic terms respectively), gender (OR = 0.58 for males compared to females, p = 0.02), level of education (OR = 0.62 for primary level education versus no formal education, p = 0.09), use of well water for drinking (OR = 2.76 for those who use well water versus those who do not, p = 0.02) and precipitation (OR = 0.998, p = 0.02). Presence of Taenia spp. antigen in pigs was significantly correlated with gender and breeding status of the pig (OR = 10.35 for breeding sows compared to boars, p = 0.01), and the proportion of land within a 1 km buffer that was flooding agricultural land and grassland (OR = 1.04, p = 0.004). These results highlight the role of multiple socio-economic, behavioural and environmental factors in Taenia spp. transmission patterns. Environmental contamination with Taenia spp. eggs is a key issue, with landscape factors influencing presence of Taenia spp. antigens in both pigs and humans. Taenia spp. can cause tapeworm infections in the human gut, and infection with the larval stage of Taenia solium (cysticercosis) can lead to serious outcomes, such as epilepsy. Transmission occurs in areas with poor sanitation and a lack of adequate meat inspection practices, although there are still gaps in our understanding of how socio-economic, behavioural and environmental factors influence the occurrence of these parasites. Humans and pigs residing in 416 households in an area of western Kenya were tested for larval stage infections (cysticercosis). Statistical methods were applied to examine the relationships between a range of socio-economic, behavioural and environmental factors and disease occurrence. The results indicate that several factors, including land cover, influence the distribution of cysticercosis infections in humans and pigs. Further research in this area may provide significant understanding regarding the influence of environmental drivers on Taenia spp. infections, delivering evidence to support the targeting of disease control activities.