EFECAB: Improving pig management to prevent epilepsy in Burkina Faso

说明(由申请人提供)：本提案寻求支持一项新的倡议，该倡议扩展了我们试点项目的工作，即“布基纳脑囊虫病的流行病学和负担”(R21 NS055353)。尽管布基纳法索是世界上第二个最不发达国家，但强大的研究合作和对改善布基纳法索人民生活条件的奉献使我们的试点项目IFICAB(“Ivaluating du Fardeau Iconomique de la Cystiercose au布基纳法索”)取得了成功。拟议项目的最终目标是开发一种可持续的、具有成本效益和成本效益的干预策略，以减少脑囊虫病(NCC)及相关神经疾病的发病率和患病率。这项建议旨在通过在圣迭戈科学研究所(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。这项工作将与成立西非和中部非洲囊虫病工作组一起进行，该工作组由布基纳法索的合作者领导。还建议培养两名囊虫病神经流行病学和免疫诊断博士生和一名公共卫生硕士研究生。将癫痫和NCC列入布基纳法索应通报疾病清单将作为监测机制进行试点试验。初步结果表明，在所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反复癫痫发生率降低25%。我们将利用先行一步的方法开发教材，指导农民最大限度地利用健康养猪的经济利益。将在三个省份的60个村庄进行事后随机社区试验，每个村庄对80名参与者进行为期12个月的基线和24个月的干预后跟踪调查。将评估这些教育材料在减少人和猪囊虫病以及作为次要结果的反复发作和严重头痛的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出口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.