Madinga Joule, Kanobana Kirezi, Lukanu Philippe, Abatih Emmanuel, Baloji Sylvain, Linsuke Sylvie, Praet Nicolas, Kapinga Serge, Polman Katja, Lutumba Pascal, Speybroeck Niko, Dorny Pierre, Harrison Wendy, Gabriel Sarah
Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Acta Trop. 2017 Jan;165:100-109. doi: 10.1016/j.actatropica.2016.03.013. Epub 2016 Mar 17.
Taenia solium infections are mostly endemic in less developed countries where poor hygiene conditions and free-range pig management favor their transmission. Knowledge on patterns of infections in both human and pig is crucial to design effective control strategies. The aim of this study was to assess the prevalence, risk factors and spatial distribution of taeniasis in a rural area of the Democratic Republic of Congo (DRC), in the prospect of upcoming control activities.
A cross-sectional study was conducted in 24 villages of the health zone of Kimpese, Bas Congo Province. Individual and household characteristics, including geographical coordinates were recorded. Stool samples were collected from willing participants and analyzed using the copro-antigen enzyme-linked immunosorbent assay (copro-Ag ELISA) for the detection of taeniasis. Blood samples were collected from pigs and analyzed using the B158/B60 monoclonal antibody-based antigen ELISA (sero-Ag ELISA) to detect porcine cysticercosis. Logistic regression and multilevel analysis were applied to identify risk factors. Global clustering and spatial correlation of taeniasis and porcine cysticercosis were assessed using K functions. Local clusters of both infections were identified using the Kulldorff's scan statistic.
A total of 4751 participants above 5 years of age (median: 23 years; IQR: 11-41) were included. The overall proportion of taeniasis positivity was 23.4% (95% CI: 22.2-24.6), ranging from 1 to 60% between villages, with a significant between-household variance of 2.43 (SE=0.29, p<0.05). Taeniasis was significantly associated with age (p<0.05) and the highest positivity was found in the 5-10 years age group (27.0% (95% CI: 24.4-29.7)). Overall, 45.6% (95% CI: 40.2-51) of sampled pigs were sero-positive. The K functions revealed a significant overall clustering of human and pig infections but no spatial dependence between them. Two significant clusters of taeniasis (p<0.001; n=276 and n=9) and one cluster of porcine cysticercosis (p<0.001; n=24) were found.
This study confirms high endemicity and geographical dispersal of taeniasis in the study area. The role of age in taeniasis patterns and significant spatial clusters of both taeniasis and porcine cysticercosis were evidenced, though no spatial correlation was found between human and pig infections. Urgent control activities are needed for this endemic area.
猪带绦虫感染在欠发达国家大多为地方性流行，这些国家卫生条件差且猪采用放养管理方式，有利于其传播。了解人和猪的感染模式对于制定有效的控制策略至关重要。本研究的目的是评估刚果民主共和国（DRC）一个农村地区猪带绦虫病的患病率、危险因素和空间分布，为即将开展的控制活动做准备。
在刚果民主共和国下刚果省金佩塞卫生区的24个村庄开展了一项横断面研究。记录了个人和家庭特征，包括地理坐标。从自愿参与者中采集粪便样本，并使用粪抗原酶联免疫吸附测定（粪抗原ELISA）进行分析，以检测猪带绦虫病。从猪身上采集血液样本，并使用基于B158/B60单克隆抗体的抗原ELISA（血清抗原ELISA）进行分析，以检测猪囊尾蚴病。应用逻辑回归和多水平分析来确定危险因素。使用K函数评估猪带绦虫病和猪囊尾蚴病的全局聚类和空间相关性。使用Kulldorff扫描统计量确定两种感染的局部聚类。
共纳入4751名5岁以上参与者（中位数：23岁；四分位距：11 - 41岁）。猪带绦虫病阳性的总体比例为23.4%（95%置信区间：22.2 - 24.6），各村之间的比例在1%至60%之间，家庭间方差显著为2.43（标准误 = 0.29，p < 0.05）。猪带绦虫病与年龄显著相关（p < 0.05），5 - 10岁年龄组的阳性率最高（27.0%（95%置信区间：24.4 - 29.7））。总体而言，45.6%（95%置信区间：40.2 - 51）的采样猪血清呈阳性。K函数显示人和猪的感染总体上有显著聚类，但它们之间不存在空间依赖性。发现了两个显著的猪带绦虫病聚类（p < 0.001；n = 276和n = 9）和一个猪囊尾蚴病聚类（p < 0.001；n = 24）。
本研究证实了研究区域内猪带绦虫病的高流行率和地理扩散情况。年龄在猪带绦虫病模式中的作用以及猪带绦虫病和猪囊尾蚴病的显著空间聚类得到了证实，尽管人和猪的感染之间未发现空间相关性。该流行地区需要开展紧急控制活动。
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