Elimination of Taenia solium Transmission in Northern Peru

Diaz, Andre; García Lescano, Héctor Hugo; O'Neal, Seth E.; Tsang, Victor C. W.; Hightower, Allen; Gilman, Robert Hugh; Gauci, Charles G.; Rodriguez, Silvia; Lightowlers, Marshall W.; Llanos Zavalaga, Luis Fernando; Ayvar, Viterbo; Craig, Philip S.; Romero, Jaime; Gonzalvez, Guillermo; Leontsini, Elli; Moyano, Luz M.; Gonzalez Zariquiey, Armando Emiliano

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