The pork tapeworm, Taenia solium, is among the leading causes of preventable epilepsy in the world and is common in rural areas of developing countries where sanitation is limited and pigs have access to human feces. Prior studies in rural villages of Peru have observed clusters of T. solium cysticercosis among pigs that live near human tapeworm carriers. Such spatial analyses, however, have been limited by incomplete participation and substandard diagnostic tests. In this study, we evaluated the association between necropsy-confirmed cysticercosis in pigs and their distance to T. solium tapeworm carriers in six villages in northern Peru. A total of six (1.4%) tapeworm carriers were detected using copro-antigen enzyme-linked immunosorbent assay and seven of 10 (70%) pigs belonging to the tapeworm carriers were found with viable cyst infection on necropsy. This was significantly greater than the prevalence of viable cyst infection among pigs living < 500m(11%) and > 500m(0.5%) from a tapeworm carrier (P < 0.001 for distance trend). Similar statistically significant prevalence gradients were observed after adjustment for possible confounders and for other pig-level outcomes including infection with > 10 viable cysts, degenerated cyst infection, and serological outcomes. This investigation confirms that porcine cysticercosis clusters strongly around tapeworm carriers in endemic rural regions of northern Peru and supports interventions that target these hotspots.
Bibliographical noteFunding Information:
Financial support: This study was partially funded by research grants numbers P01 AI51976 and U01 AI35894 from the National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD. Partial support was also received by R01NS080645 from the National Institute of Neurological Disorders and Stroke. Research grants from the Wellcome Trust (063109), the Food and Drug Administration (002309), and the Bill & Melinda Gates Foundation (23981) fund ongoing cysticercosis research by the authors. A. G. L. is sponsored by the training grant D43 TW007393 awarded by the Fogarty International Center of the U.S. National Institutes of Health.
© 2019 by The American Society of Tropical Medicine and Hygiene.