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Elimination of Taenia solium Transmission in Northern Peru

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dc.contributor.author García Lescano, Héctor Hugo
dc.contributor.author Gonzalez Zariquiey, Armando Emiliano
dc.contributor.author Tsang, Victor C. W.
dc.contributor.author O'Neal, Seth E.
dc.contributor.author Llanos Zavalaga, Luis Fernando
dc.contributor.author Gonzalvez, Guillermo
dc.contributor.author Romero, Jaime
dc.contributor.author Rodriguez, Silvia
dc.contributor.author Moyano, Luz M.
dc.contributor.author Ayvar, Viterbo
dc.contributor.author Diaz, Andre
dc.contributor.author Hightower, Allen
dc.contributor.author Craig, Philip S.
dc.contributor.author Lightowlers, Marshall W.
dc.contributor.author Gauci, Charles G.
dc.contributor.author Leontsini, Elli
dc.contributor.author Gilman, Robert Hugh
dc.date.accessioned 2019-02-06T14:45:33Z
dc.date.available 2019-02-06T14:45:33Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5065
dc.description.abstract BACKGROUND: Taeniasis and cysticercosis are major causes of seizures and epilepsy. Infection by the causative parasite Taenia solium requires transmission between humans and pigs. The disease is considered to be eradicable, but data on attempts at regional elimination are lacking. We conducted a three-phase control program in Tumbes, Peru, to determine whether regional elimination would be feasible. METHODS: We systematically tested and compared elimination strategies to show the feasibility of interrupting the transmission of T. solium infection in a region of highly endemic disease in Peru. In phase 1, we assessed the effectiveness and feasibility of six intervention strategies that involved screening of humans and pigs, antiparasitic treatment, prevention education, and pig replacement in 42 villages. In phase 2, we compared mass treatment with mass screening (each either with or without vaccination of pigs) in 17 villages. In phase 3, we implemented the final strategy of mass treatment of humans along with the mass treatment and vaccination of pigs in the entire rural region of Tumbes (107 villages comprising 81,170 people and 55,638 pigs). The effect of the intervention was measured after phases 2 and 3 with the use of detailed necropsy to detect pigs with live, nondegenerated cysts capable of causing new infection. The necropsy sampling was weighted in that we preferentially included more samples from seropositive pigs than from seronegative pigs. RESULTS: Only two of the strategies implemented in phase 1 resulted in limited control over the transmission of T. solium infection, which highlighted the need to intensify the subsequent strategies. After the strategies in phase 2 were implemented, no cyst that was capable of further transmission of T. solium infection was found among 658 sampled pigs. One year later, without further intervention, 7 of 310 sampled pigs had live, nondegenerated cysts, but no infected pig was found in 11 of 17 villages, including all the villages in which mass antiparasitic treatment plus vaccination was implemented. After the final strategy was implemented in phase 3, a total of 3 of 342 pigs had live, nondegenerated cysts, but no infected pig was found in 105 of 107 villages. CONCLUSIONS: We showed that the transmission of T. solium infection was interrupted on a regional scale in a highly endemic region in Peru. en_US
dc.language.iso eng
dc.publisher Massachusetts Medical Society
dc.relation.ispartofseries New England Journal of Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Taenia solium/isolation & purification en_US
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Animals en_US
dc.subject Anthelmintics/therapeutic use en_US
dc.subject Cysticercosis/prevention & control/transmission/veterinary en_US
dc.subject Disease Transmission, Infectious/prevention & control en_US
dc.subject Endemic Diseases/prevention & control en_US
dc.subject Feasibility Studies en_US
dc.subject Female en_US
dc.subject Health Education en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Mass Screening en_US
dc.subject Middle Aged en_US
dc.subject Peru en_US
dc.subject Sus scrofa/parasitology en_US
dc.subject Taeniasis/prevention & control/transmission en_US
dc.subject Vaccines en_US
dc.subject Young Adult en_US
dc.title Elimination of Taenia solium Transmission in Northern Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1056/NEJMoa1515520
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00
dc.relation.issn 1533-4406


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