Improved Latrine Coverage could Reduce the Prevalence of Porcine Cysticercosis: Evaluation of sanitation Based Intervention Strategy in Busia County, Kenya, 2021

  • Zoonotic
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Cysticercosis is a growing public health risk among smallholder pig farming rural communities with poor sanitation and low income. Globally, Cysticercosis results in a total of 2.8 million disability-adjusted life-years (DALYs) annually. Busia County, with estimated porcine cysticercosis of 17%, has pigs reared on free-range scavenging for feed, including human feces. A sanitation-based intervention the National Total Sanitation Programme (NTSP), was implemented in 2016 to reduce the prevalence. We evaluated the effect of this intervention on the prevalence of porcine cysticercosis.

We conducted a comparative cross-sectional survey targeting 370 pigs. Household selection was done using multistage sampling. Interviews were conducted in 251 households using a questionnaire to assess factors associated with a change in prevalence of porcine cysticercosis. Lingual palpation was used to test for cysticerci in selected pigs while serum was tested for circulating cysticerci using Ag-ELISA. Pre-implementation data were obtained from datasets of a similar study done in 2012, before NTSP implementation. The change in prevalence of porcine cysticercosis was determined by comparing prevalence before and after NTSP using Chi-squared tests.

Prevalence of palpable lingual cysts at NTSP pre-implementation was 9.7% while at post-implementation it was 3.8% (χ² =5.45, p= 0.0196). Prevalence of circulating cysticerci antigen by Ag-ELISA at NTSP pre-implementation period was 17.2% while at post-implementation it was 0.54% (χ² =55.104, p= < 0.001). Latrine coverage Pre-NTSP was 75%, while it was 86% (χ² =11.46, p=< 0.001) Post-NTSP. Absence of latrines at household level was associated with presence of palpable cysts in pigs (OR: 7.2; 95% CI: 2.3–21.9). Latrine availability was independently associated with a reduction in porcine cysticercosis (aOR: 0.16, 95% CI:0.05–0.48).

There was a reduction in the prevalence of porcine cysticercosis following the interventions. Increased latrine coverage was associated with a reduction in porcine cysticercosis prevalence.

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