EFECAB: Improving pig management to prevent epilepsy in Burkina Faso

描述（由申请人提供）：本提案寻求支持一项新倡议，该倡议扩展了我们的试点项目“布基纳法索神经囊虫病的流行病学和负担”（R21 NS055353）的工作。尽管布基纳法索是世界上第二不发达的国家，但强有力的研究合作和致力于改善布基纳法索人民生活条件的努力使我们的试点项目IFICAB（“布基纳法索囊囊病的Ivaluation du Fardeau Iconomique de la囊囊病”）取得了成功。拟议项目的最终目标是制定一种可持续的，成本效益和成本效益的干预策略，以减少神经囊虫病（NCC）和相关神经系统疾病在整个生命周期中的发病率和患病率。该提案旨在通过在圣蒂科学研究所（IRSS）建立人和猪囊虫病免疫诊断参考中心和在瓦加杜古大学建立NCC放射诊断参考中心，进一步加强研究能力。这项工作将与在布基纳法索合作者的领导下建立西非和中非囊虫病工作组同时进行。拟培养2名囊虫病神经流行病学与免疫诊断方向博士生和1名公共卫生方向硕士生。将作为一种监测机制进行试点试验，将癫痫和非传染性疾病列入布基纳法索的法定通报疾病清单。初步结果表明，在研究的三个试点村庄中，癫痫、NCC和囊虫病的患病率很高。基于这些发现，我们估计针对养猪户的教育干预可以将人类和猪的感染发生率降低一半。我们还估计，从长远来看，这可能会使布基纳法索养猪村庄的复发性癫痫发病率降低25%。我们将采用“先有后有”的方法来开发教育材料，以指导农民最大限度地提高养猪健康的经济效益。将在三个省的60个村庄进行一项前后随机社区试验，对每个村庄的80名参与者进行为期12个月的基线和24个月的干预后随访。将评估教材在减少人类和猪囊虫病发病率以及作为次要后果的反复发作和严重头痛发生率方面的有效性。如果有效，这种可持续的干预措施可以输出到撒哈拉以南非洲的其他养猪国家，以减少囊虫病和癫痫的发生频率。

DESCRIPTION (provided by applicant): This proposal seeks support for a new initiative which extends the work of our pilot project, "Epidemiology and Burden of Neurocysticercosis in Bukina Faso" (R21 NS055353). Despite the fact that Burkina Faso is the second least developed country in the world, a strong research collaboration and dedication to improving the living conditions of the Burkinabi people made our pilot project, IFICAB ("Ivaluation du Fardeau Iconomique de la Cysticercose Au Burkina"), a success. The ultimate goal of the proposed project is to develop a sustainable, cost-beneficial and cost-effective intervention strategy to reduce the incidence and prevalence of neurocysticercosis (NCC) and associated neurological conditions across the lifespan. This proposal seeks to further strengthen research capacity through establishing reference centers for the immuno- diagnosis of cysticercosis in humans and pigs at the Institut de Recherche en Sciences de la Santi (IRSS) and for the radiological diagnosis of NCC at the Universiti de Ouagadougou. This will be done in conjunction with the creation of the Cysticercosis Working Group for Western and Central Africa, under the leadership of collaborators in Burkina Faso. Training two PhD students in neuroepidemiology and immunodiagnosis of cysticercosis and one masters student in public health is also proposed. Inclusion of epilepsy and NCC in the list of notifiable diseases for Burkina Faso will be pilot tested as a surveillance mechanism. Preliminary results indicate a high prevalence of epilepsy, NCC and cysticercosis in the three pilot villages studied. Based on these findings, we estimate that an educational intervention targeting pig farmers could reduce the incidence of infection in humans and pigs by one-half. We also estimate that this could result, in the long term, in reducing the incidence rate of recurrent seizures in Burkina Faso by 25% in villages where pigs are raised. We will use the PRECEDE PROCEED approach to develop educational materials to guide farmers in maximizing the monetary benefits of healthy pig raising. A pre-post randomized community trial will be conducted in 60 villages located in three provinces, using a 12-month baseline and 24 month post-intervention follow-up of 80 participants per village. The effectiveness of the educational materials in reducing the incidence rate of human and porcine cysticercosis, and of recurrent seizures and severe headaches as a secondary outcome, will be estimated. If effective, this sustainable intervention could be exported to other pig-raising countries in Sub- Saharan Africa to reduce the frequency of cysticercosis and epilepsy. PUBLIC HEALTH RELEVANCE: Neurocysticercosis is a disease caused by a tapeworm transmitted between humans and pigs that is responsible for many cases of epilepsy in countries where pigs are raised in poor sanitary conditions. This study proposes an intervention in Burkina Faso to reduce the prevalence this infection. If successful, the frequency of epilepsy will decline, greatly improving the life and health of these communities.