Burniston Stephanie, Okello Anna L, Khamlome Boualam, Inthavong Phouth, Gilbert Jeffrey, Blacksell Stuart D, Allen John, Welburn Susan C
Division of Infection and Pathway Medicine, College of Medicine and Veterinary, Medicine, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB UK.
Division of Infection and Pathway Medicine, College of Medicine and Veterinary, Medicine, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB UK ; CSIRO Animal Food and Health Sciences, Australian Animal Health Laboratory (AAHL), Regional Programme, 5 Portarlington Road, East Geelong, Victoria 3219 Australia.
Infect Dis Poverty. 2015 Mar 2;4:11. doi: 10.1186/2049-9957-4-11. eCollection 2015.
Pig rearing is an important income source in the Lao People's Democratic Republic (PDR), with many smallholder farmers using traditional free-range pig production systems. Despite the potentially significant health risks posed by pig production regarding pig-associated zoonoses, information on the sociocultural drivers of these zoonoses is significantly lacking. This review summarises the existing sociocultural knowledge on eight pig-associated zoonoses suspected to be endemic in Southeast Asia: brucellosis, Q fever (Coxiella burnetii), trichinellosis, hepatitis E virus, leptospirosis, Japanese encephalitis, Streptococcus suis and Taenia solium taeniasis-cysticercosis. It summarises current knowledge on these diseases grouped according to their clinical manifestations in humans to highlight the propensity for underreporting. A literature search was conducted across multiple databases for publications from 1990 to the present day related to the eight pig-associated zoonoses and the risk and impact connected with them, with Lao PDR as a case study. Many of these pig-associated zoonoses have similar presentations and are often diagnosed as clinical syndromes. Misdiagnosis and underreporting are, therefore, substantial and emphasise the need for more robust diagnostics and appropriate surveillance systems. While some reports exist in other countries in the region, information is significantly lacking in Lao PDR with existing information coming mainly from the capital, Vientiane. The disease burden imposed by these zoonoses is not only characterised by morbidity and mortality, but directly impacts on livelihoods through income reduction and production losses, and indirectly through treatment costs and lost work opportunities. Other factors crucial to understanding and controlling these diseases are the influence of ethnicity and culture on food-consumption practices, pig rearing and slaughter practices, hygiene and sanitation, health-seeking behaviours and, therefore, risk factors for disease transmission. Published information on the knowledge, attitudes and beliefs of people regarding pig zoonoses and their risk factors is also extremely limited in Lao PDR and the broader Southeast Asian region. The need for more transdisciplinary research, using a One Health approach, in order to understand the underlining social determinants of health and their impacts on health-seeking behaviours, disease transmission and, ultimately, disease reporting, cannot be more emphasized.
养猪是老挝人民民主共和国的一项重要收入来源，许多小农户采用传统的散养猪生产系统。尽管养猪生产可能带来与猪相关的人畜共患病的重大健康风险，但关于这些人畜共患病的社会文化驱动因素的信息却严重匮乏。本综述总结了关于东南亚疑似地方性流行的八种与猪相关的人畜共患病的现有社会文化知识：布鲁氏菌病、Q热（伯氏考克斯氏体）、旋毛虫病、戊型肝炎病毒、钩端螺旋体病、日本脑炎、猪链球菌和猪带绦虫病-囊尾蚴病。它总结了根据这些疾病在人类中的临床表现进行分组的当前知识，以突出报告不足的倾向。以老挝人民民主共和国为案例研究，在多个数据库中进行了文献检索，以查找1990年至今与八种与猪相关的人畜共患病及其相关风险和影响的出版物。许多这些与猪相关的人畜共患病有相似的表现，并且经常被诊断为临床综合征。因此，误诊和报告不足的情况严重，强调需要更强大的诊断方法和适当的监测系统。虽然该地区其他国家有一些报告，但老挝人民民主共和国的信息严重缺乏，现有信息主要来自首都万象。这些人畜共患病造成的疾病负担不仅表现为发病率和死亡率，还通过收入减少和生产损失直接影响生计，并通过治疗成本和工作机会丧失间接影响生计。对于理解和控制这些疾病至关重要的其他因素包括种族和文化对食物消费习惯、养猪和屠宰习惯、卫生和环境卫生、就医行为以及疾病传播风险因素的影响。在老挝人民民主共和国和更广泛的东南亚地区，关于人们对猪源性人畜共患病及其风险因素的知识、态度和信念的已发表信息也极其有限。使用“同一健康”方法进行更多跨学科研究以了解健康的潜在社会决定因素及其对就医行为、疾病传播以及最终疾病报告的影响的必要性再怎么强调也不为过。
