A participatory Ecohealth study of smallholder pig system in upland and lowland of Lao PDR
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Transcript of A participatory Ecohealth study of smallholder pig system in upland and lowland of Lao PDR
A participatory Ecohealth study of smallholder pig
system in upland and lowland of Lao PDR
P. Inthavong, K. Blaszak, P. Durr, B. Khamlome, V. Somoulay, J. Allen, J. Gilbert, H. Holt and K. Graham
Purpose and background of the project
Research methodology
Results
Intervention options
Discussion and recommendation
To conduct baseline seroprevalence
surveys of key pig diseases and pig related zoonoses
To evaluate public health risks of pig-raising and pork consumption in one upland and one lowland province in Lao PDR
- Smallholder pigs owned by 50-70% of village households
- No prior epidemiological prevalence surveys and risk analysis
- Regional increase in zoonoses and increasing disease outbreaks
- Health and production risks
A cross-sectional data collection including blood sampling from HUMAN and PIGS with questionnaire survey for risk factors 3 sets of questionnaires Village head to get general village information Human Pig owners
Introduction of the principle of Ecohealth with participatory sessions in teams that included
Introduction of the project, diseases and known zoonoses risks
Conducting practice random sampling, questionnaire interviews
How to collect pig and human blood samples under ethical conditions
Study designs
2 provinces were selected 1 represent upland 1 represent lowland
30 villages from each province 15 persons and 15 pigs per village
Study designs Multistage random sampling random selection of village: PPP:Villages
are randomly sampled weighted by human population
random selection of HH random selection of individuals
Structuring sampling frames for humans and pigs ◦ Sampling based primarily on human population (not pig
population)
Ethical issues informed and signed consent forms for human participants
individual results within each village not identified by household names
Appropriate modest health practical gifts to participating households
Village level feedback of overall results
Humans
JEV
Hep E
Taenia/cysticercosis
Trichinella
Pigs
JEV, Hep E, Trichinella
CSF
PRRS
Erysipelas
FMD (Types O, A and Asia 1)
Data entry and manipulation using new web based program: SurVet
Data analysis on Stata program
Results
Number of pigs and people sampled
Study location People Pig
ILRI Luangprabang (north)
447 310
ILRI Savannakhet (south)
435 365
Total 882 675
Sample test
All tests carried out in Laos using commercial kits
Human samples were tested NCLE
Pig sample NAHC
Results: Crude seroprevalence
* Prevalence data reported above has not been adjusted for
population weighting factors
Disease Humans Pigs
JEV IgM 4.4% 8.5%
JEV IgG 75.2%
Hep E IgG 64% 61.4%
Trichinella 47.3% 13.7%
Taenia solium IgG 2.9%
Cysticercosis IgG 4.7%
Erysipelas 47.5%
CSF 10.3%
PRRS 8.2%
FMD (ABC non-structural ELISA) 2.1%
Antibody test Nth (n= 310) Crude
Seroprev
Sth (n= 365) Crude
Seroprev
JEV IgG 75.4% 81.8%
JEV IgM 12.2% 6.7%
HEV 81.9% 50.0%
Trich 13.5% 9.0%
CSF 7.4% 14.7%
PRRS 11.3% 9.6%
Erysipelas 63.5% 30.2%
FMD 2.0% 2.8%
Multivariate analysis of HEV in pigs
Factors OR (95% CI) p-value
Age 1.58 (1.26 to 1.99) <0.001
South 0.14 (0.08 to 0.24) <0.001
Sow catergories 1.55 (1.10 to 2.18) 0.01
Adjusted risk factors for human hepatitis E
Adjusted ORs were derived from a multivariate logistic analysis with random effects
Adj. OR (95% CI) P-value
Slaughter Pigs 1.64 (1.00, 2.70) 0.05
Southern vs. Northern Province 4.52 (2.93, 7.00) <0.001
Age of person 1.71 (1.42, 2.05) <0.001
Increased distance from pigs 0.82 (0.69, 0.98) 0.04
Female vs. male 0.67 (0.46, 0.99) 0.04
Investigation of risk factors for human cysticercosis or Taenia
Risk factors associated with higher cysticercosis or Taenia sero-positive
levels:
Odds Ratio (95% CI)
Non-use of toilets is clear risk factor 2.65 (1.37, 5.12)*
Investigation of risk factors for human JEV
Risk factors associated with higher JEV seropositive levels:
Odds Ratio (95% CI)
Age , > 20 years tended to be associated
with greater seropositive 6.50 (0.89, 47.66)
Nearly all people answered that they used mosquito nets – so no real
comparison of non-use as a risk factor
Data do not support that distance from pigs up to 150 metres is associated
with reduced risk
Combined Human Combined Pig Prev 61.4% Prev 64.0%
North – Upland South- Lowland
50.00% 81.9%
77.9% 50.00%
Information Communication and Education (ICE) materials development workshop
Result feedback meetings Village ICE pilot testing Human health risk reduction
options Village biosecurity for pigs
Modification and finalization of IEC materials for pig and human health ris reduction need to be done
Significant level of exposure of tested diseases were found in this atudy
Detailed risk related analysis have been done just only for HE
Detailed risk factor analysis and interpretation and report for all diseases need to be done
Using collected serums to test for other diseases
Risk reduction PA
Time constraints
Geographical/seasonal aspects
Multisectorial involment
Test validation
Data analysis skills
Blaszak, K1., Durr, P.2, Khamlome, B.3, Somoulay, V.4, Allen, J.2 and Gilbert, J.5 Holt, H.5
1 NAHC, Lao PDR; 2 AAHL, CSIRO Austria; 3 DHP, Lao PDR; 4 NCLE, Lao PDR; 5ILRI, Lao PDR