Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
International Livestock Research Institute, Nairobi, Kenya.
Front Public Health. 2022 Mar 16;10:836177. doi: 10.3389/fpubh.2022.836177. eCollection 2022.
cysticercosis is the most common cause of acquired epilepsy in pig-raising and pork-consuming parts of Africa, Latin America, and Asia. This review aimed to systematically compile and synthesize data on the epidemiology of porcine cysticercosis in the Eastern and Southern Africa (ESA) region. Comprehensive searching strategies were employed to retrieve the studies published or reported between January 1,1997 and March 1, 2021, from Pub Med, Hinari, and Google Scholar databases and search platforms. The identified studies that met the inclusion criteria were then appraised for methodological quality. Finally, 44 studies obtained from nine countries were selected and included in this review. Relevant data were extracted using standardized templates for qualitative synthesis and meta-analysis. The overall pooled prevalence estimate of porcine cysticercosis in the ESA region was 17% (95% CI: 14-20%). The prevalence level between and within countries showed high variability. The pooled estimate showed high heterogeneity among the reports (the inverse variance index value (I) of 98.99%, < 0.05). The meta-analysis sub-grouped by the type of diagnostic test showed the pooled prevalence estimate of 27% (95% CI: 9-50) by carcass dissection; 23% (95% CI: 14-33) by Antibody-based immunodiagnostic techniques; 23% (95% CI: 18-29) by antigen detecting (Ag)-ELISA, 12% (95% CI: 7-18) by meat inspection, and 9% (95% CI: 7-11) by lingual examination. The meta-analysis sub-grouped by region showed a relatively higher pooled prevalence estimate for the Southern region 22% (95% CI: 15-30) compared to 13% (95% CI: 11-15) in the Eastern region. The highest country-based pooled prevalence was obtained from South Africa (33%, 95% CI: 20-48) and Zambia (22%, 95% CI: 16-29), whereas the lowest pooled prevalence was identified in Madagascar (5%, 95% CI: 4-5) and Rwanda (7%, 95% CI: 6-8). The lack of latrine, traditional pig husbandry practices, unprotected water sources, and increase in age were identified as significant risk factors for the occurrence of porcine cysticercosis in the pooled studies. The findings of this review will provide context-specific input to prioritize the possible intervention programs for control in the ESA region. More sensitive and specific test-based prevalence estimates, detailed risk factor investigations, and financial losses analysis are needed to establish feasible control strategies.
http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021238931.
囊尾蚴病是非洲、拉丁美洲和亚洲养猪和猪肉消费地区获得性癫痫的最常见原因。本综述旨在系统地收集和综合非洲东部和南部（ESA）地区猪囊尾蚴病的流行病学数据。采用全面的搜索策略，从 Pub Med、Hinari 和 Google Scholar 数据库和搜索平台检索 1997 年 1 月 1 日至 2021 年 3 月 1 日期间发表或报告的研究。然后，对符合纳入标准的研究进行方法学质量评估。最后，从九个国家中选择了 44 项研究，并纳入了本综述。使用标准化模板提取相关数据，用于定性综合和荟萃分析。ESA 地区猪囊尾蚴病的总患病率估计为 17%（95%CI：14-20%）。国家之间和国家内部的流行水平显示出高度的可变性。报告中的汇总估计存在高度异质性（方差指数值（I）为 98.99%，<0.05）。根据诊断测试类型进行的荟萃分析亚组显示，通过尸体剖检的患病率估计为 27%（95%CI：9-50）；基于抗体的免疫诊断技术为 23%（95%CI：14-33）；基于抗原检测（Ag）-ELISA 的患病率估计为 23%（95%CI：18-29）；通过肉检为 12%（95%CI：7-18）；通过舌检为 9%（95%CI：7-11）。根据区域进行的荟萃分析亚组显示，与东部地区的 13%（95%CI：11-15）相比，南部地区的汇总患病率估计相对较高，为 22%（95%CI：15-30）。基于国家的最高患病率是南非（33%，95%CI：20-48）和赞比亚（22%，95%CI：16-29），而马达加斯加（5%，95%CI：4-5）和卢旺达（7%，95%CI：6-8）的最低患病率。未使用厕所、传统养猪实践、未受保护的水源和年龄增长被确定为猪囊尾蚴病发生的重要危险因素。本综述的结果将为 ESA 地区的可能干预计划提供特定于背景的投入，以优先控制该疾病。需要更敏感和特异的基于检测的患病率估计、详细的危险因素调查和经济损失分析，以制定可行的控制策略。
