Cross-sectional surveys were conducted to determine the prevalence and associated risk factors of
Human neurocysticercosis (NCC) is caused by larval stage of zoonotic tapeworm
Although most of Myanmar culinary habits are based on thorough cooking, new food style such as barbecue and dishes based on raw or undercooked pork or pork product becomes popular among customers. Moreover, small-scale pig husbandry has become one of the major sources of income in Myanmar farmers. So it may be high risk of getting food-borne zoonotic diseases according to the new food style and traditional husbandry method. Due to lacking of information on porcine cysticercosis in Myanmar up to now, it is important to investigate the prevalence and associated risk factors.
Nay Pyi Taw area, the capital of Myanmar, has big population of pigs (about 200,000 pigs) [
One of the main obstacles to control the
The cross-sectional studies were conducted from January to March and June to July 2014, to investigate the prevalence of
Distribution of the number of samples in pigs within the three townships for blood collection.
Number | Township | Pig population | Number of sampled pigs |
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1 | Pyinmana | 39,000 | 81 |
2 | Lewe | 86,000 | 172 |
3 | Tatkon | 55,000 | 111 |
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Total | 180,000 | 364 |
Meat inspection was carried out as described by Boa et al. [
The pig was kept under restraint at standing position and blood samples were obtained from the external jugular vein by using sterile disposable syringes and put into vacutainers with clot activators. Those vacutainers were kept in cold boxes with ice and transported to Department of Pharmacology and Parasitology, University of Veterinary Science, Nay Pyi Taw, and allowed overnight at 4°C to clot. To obtain serum, the clotted blood was separated by centrifugation at 4000 rpm for 10 minutes. The clear sera were transferred to 1.5 mL microvial tubes and stored in labeled wails and kept at −20°C until analysis.
Detection of IgG antibody of
A questionnaire was developed and used to collect information on hypothesized risk factors and other related pieces of information from sampled pig owners. Households in each township were selected by using the snowballing technique from those farmers willing to participate in the study. It is a technique for developing a research sample where existing study subjects recruit future subjects from their acquaintances.
The questionnaire interviewed data were analyzed for the relationship between the prevalence of
Seroprevalence of porcine cysticercosis in farmed pigs was 15.93% (58/364) in the study area.
Prevalence of households with pigs infected with
The prevalence of porcine cysticercosis investigated by meat inspection was 23.67% (71/300). All the infected pigs presented parasites located in the tongue. Only in one pig, another parasite was found, located in the heart. In none of the animals evaluated, parasites were found in the other locations examined. The prevalence in slaughterhouses of Pyinmana, Lewe, and Tatkon townships was 22% (44/200), 23.33% (7/30), and 28.57% (20/70), respectively.
Univariate analysis of hypothesized risk factors of gender (OR = 3.0; 95% CI = 1.7–5.4), increased age (OR = 2.3; 95% CI = 1.2–4.2), husbandry system (OR = 5.1; 95% CI = 2.4–11.2), feed type (OR = 16.9; 95% CI = 2.3–124.3), no hand washing habit before feeding (OR = 31.5; 95% CI = 4.3–230.9), not using anthelmintic in pigs (OR = 11.9; 95% CI = 5.0–28.5) and owner (OR = 2.5; 95% CI = 1.4–4.4), and pork consumption of owner (OR = 37.4; 95% CI = 9.0–156.1) was significantly associated with
Distribution and odds ratio of associated risk factors concerning porcine cysticercosis in Nay Pyi Taw area.
Factor | Level |
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Positive case | Negative case | Odds ratio |
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Gender | Male | 221 | 22 | 199 | 3.043 (1.704–5.436) | 0.000* |
Female | 143 | 36 | 107 | |||
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Age | <6 month | 291 | 39 | 252 | 2.274 (1.220–4.235) | 0.012* |
≥6 month | 73 | 19 | 54 | |||
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Husbandry system | Intensive | 146 | 8 | 138 | 5.134 (2.354–11.195) | 0.000* |
Semi-intensive | 218 | 50 | 168 | |||
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Feed type | Only commercial feed | 71 | 1 | 70 | 16.907 (2.300–124.302) | 0.000* |
Both with kitchen waste | 293 | 57 | 236 | |||
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Use of anthelmintic in pigs | Yes | 183 | 6 | 177 | 11.891 (4.957–28.526) | 0.000* |
No | 181 | 52 | 129 | |||
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Use of anthelmintic in owner | Yes | 242 | 28 | 214 | 2.492 (1.409–4.407) | 0.002* |
No | 122 | 30 | 92 | |||
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Hand-washing before feeding | Yes | 110 | 1 | 119 | 31.538 (4.307–230.92) | 0.000* |
No | 254 | 57 | 197 | |||
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Pork consumption of owner | No | 177 | 2 | 175 | 37.405 (8.965–156.068) | 0.000* |
Yes | 187 | 56 | 131 |
In Southeast Asia, pigs are an important source of food and economic important for smallholder farmers. Older pigs may be penned or tethered although common raising practice of pigs is freely roaming in the village [
The present study is the first report of
The gender of pigs (being female) was significantly associated with porcine cysticercosis in this study. It can be explained that female pigs were for kept long time for breeding purpose than male and so they have more risk to get exposed to
The present study demonstrated that the older the pigs, the greater the chance to get infection. These results are in agreement with those reported by Pouedet et al. [
The result showed that pigs from households practiced semi-intensive system (the pigs are allowed to roam freely in the environment and only panned or tethered at feeding time and night) were more likely to have porcine cysticercosis than intensive (the pigs are kept in the backyard or corral and not allowed to roam) pigs. Therefore, semi-intensive management system represented as an important risk factor for porcine cysticercosis in the study area as the pigs in this practice could access the infected human faeces. Accessibility of infected human faeces is the main source for porcine cysticercosis [
Among the feed types used in pig farms, feeding of kitchen waste is significantly associated with cysticercosis. In the farms, most of housewives usually collect swill in poor cleanliness containers from neighboring houses. This might be contaminated with
Use of anthelmintic in pigs and owners was significantly associated in this study. By interviewing the farmers and township veterinary officers, the most common used anthelmintic is albendazole in human and ivermectin in pigs. Although ivermectin cannot kill any larvae of cestode, albendazole can kill these larvae. Not having taeniasis in owners is preventive factor against cysticercosis [
Although all the farmers wash their hands after feeding the pigs, only 21.2% famers (43/203) wash their hands before feeding. All cysticercosis positive samples were from those who do not practice hand-washing habit. Therefore, hand-washing is a crucial factor for prevention of porcine cysticercosis. However, there was no literature about this factor associated with porcine cysticercosis. But health education and sanitary infrastructure are involved in the control measure for swine cysticercosis [
About half of farmers (114/203) consume the pork curry in this study. All positive samples were from the owners consumed pork (51 households). They might have taeniasis and cysticercosis due to cooking habit and poor sanitation. Pork consumption of owners is also one of the risk factors in survey of porcine cysticercosis [
Nine hypothesized risk factors not included in analysis were breed of pigs, place of purchase, presence of latrine, hand-washing after feeding the pigs, source of water for pigs, cleanliness of water, knowledge on taeniasis and cysticercosis, and occurrence of cyst in pork. In this study, all pigs are indigenously bred. All pigs were purchased from within their township. All farmers have latrines using water, but the children do not use latrine and are used for defecation out of latrine. Some farmers washed the hands before feeding the pigs and all farmers washed their hands after feeding. All farmers used water from wells having good sanitation. All farmers did not have the knowledge on taeniasis and cysticercosis and they have never seen the cysts in the pork in the study area.
The presence of zoonotic agent,
Although the occurrence of human neurocysticercosis has not been reported yet in Myanmar, all public should take awareness of potential risk factors due to the prevalence with high percentage observed in this study. Myanmar has no national monitoring program for
This prevalence with relatively high percentage of porcine cysticercosis (15.93%) in Ab-ELISA and 23.67% in slaughtered pigs indicates the presence of human taeniasis and it also leads to the associated risk of human cysticercosis and neurocysticercosis. Occurrence of porcine cysticercosis poses a serious problem to human health and the economy. Therefore, it is required to monitor porcine cysticercosis prevalence in the whole country.
The authors declare that this work has not been inappropriately influenced by any financial or personal factors and they have no competing interests.
This study was partially financially supported by Nay Pyi Taw Development Committee, Nay Pyi Taw, Myanmar. The authors are grateful to Townships Veterinary Officers from Lewe and Tatkon townships and all pig owners in three townships for their good cooperation.