title: Endemicity of Zoonotic Diseases in Pigs and Humans in Lowland and Upland Lao PDR: Identification of Socio-cultural Risk Factors.
abstract: In Lao People's Democratic Republic pigs are kept in close contact with families. Human risk of infection with pig zoonoses arises from direct contact and consumption of unsafe pig products. This cross-sectional study was conducted in Luang Prabang (north) and Savannakhet (central-south) Provinces. A total of 59 villages, 895 humans and 647 pigs were sampled and serologically tested for zoonotic pathogens including: hepatitis E virus (HEV), Japanese encephalitis virus (JEV) and Trichinella spiralis; In addition, human sera were tested for Taenia spp. and cysticercosis. Seroprevalence of zoonotic pathogens in humans was high for HEV (Luang Prabang: 48.6%, Savannakhet: 77.7%) and T. spiralis (Luang Prabang: 59.0%, Savannakhet: 40.5%), and lower for JEV (around 5%), Taenia spp. (around 3%) and cysticercosis (Luang Prabang: 6.1, Savannakhet 1.5%). Multiple correspondence analysis and hierarchical clustering of principal components was performed on descriptive data of human hygiene practices, contact with pigs and consumption of pork products. Three clusters were identified: Cluster 1 had low pig contact and good hygiene practices, but had higher risk of T. spiralis. Most people in cluster 2 were involved in pig slaughter (83.7%), handled raw meat or offal (99.4%) and consumed raw pigs' blood (76.4%). Compared to cluster 1, cluster 2 had increased odds of testing seropositive for HEV and JEV. Cluster 3 had the lowest sanitation access and had the highest risk of HEV, cysticercosis and Taenia spp. Farmers which kept their pigs tethered (as opposed to penned) and disposed of manure in water sources had 0.85 (95% CI: 0.18 to 0.91) and 2.39 (95% CI: 1.07 to 5.34) times the odds of having pigs test seropositive for HEV, respectively. The results have been used to identify entry-points for intervention and management strategies to reduce disease exposure in humans and pigs, informing control activities in a cysticercosis hyper-endemic village.
authors.affiliation: Department of Production and Population Health, Royal Veterinary College, London, United Kingdom.
authors.forename: Hannah R
authors.initials: HR
authors.lastname: Holt
authors.affiliation: National Animal Health Laboratory, Department of Livestock and Fisheries, Ministry of Agriculture and Forestry, Vientiane, Lao PDR.
authors.forename: Phouth
authors.initials: P
authors.lastname: Inthavong
authors.affiliation: Department of Communicable Diseases Control, Ministry of Health, Vientiane, Lao PDR.
authors.forename: Boualam
authors.initials: B
authors.lastname: Khamlome
authors.affiliation: Australian Animal Health Laboratory, CSIRO, Geelong, Australia.|World Animal Protection, Melbourne, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Blaszak
authors.affiliation: National Animal Health Laboratory, Department of Livestock and Fisheries, Ministry of Agriculture and Forestry, Vientiane, Lao PDR.
authors.forename: Chattouphone
authors.initials: C
authors.lastname: Keokamphe
authors.affiliation: National Centre for Laboratory and Epidemiology, Vientiane, Lao PDR.|Veterinary Service Division, Department of Livestock and Fisheries, Ministry of Agriculture and Forestry, Vientiane, Lao PDR.
authors.forename: Virasack
authors.initials: V
authors.lastname: Somoulay
authors.affiliation: Veterinary Service Division, Department of Livestock and Fisheries, Ministry of Agriculture and Forestry, Vientiane, Lao PDR.
authors.forename: Anousone
authors.initials: A
authors.lastname: Phongmany
authors.affiliation: Australian Animal Health Laboratory, CSIRO, Geelong, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Durr
authors.affiliation: Australian Animal Health Laboratory, CSIRO, Geelong, Australia.
authors.forename: Kerryne
authors.initials: K
authors.lastname: Graham
authors.affiliation: Australian Animal Health Laboratory, CSIRO, Geelong, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Allen
authors.affiliation: International Livestock Research Institute, Nairobi, Kenya.
authors.forename: Blánaid
authors.initials: B
authors.lastname: Donnelly
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.|Centre for Tropical Medicine & Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Blacksell
authors.affiliation: International Livestock Research Institute, Nairobi, Kenya.
authors.forename: Fred
authors.initials: F
authors.lastname: Unger
authors.affiliation: International Livestock Research Institute, Nairobi, Kenya.
authors.forename: Delia
authors.initials: D
authors.lastname: Grace
authors.affiliation: International Livestock Research Institute, Nairobi, Kenya.
authors.forename: Silvia
authors.initials: S
authors.lastname: Alonso
authors.affiliation: International Livestock Research Institute, Nairobi, Kenya.
authors.forename: Jeff
authors.initials: J
authors.lastname: Gilbert
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D003551:Cysticercosis / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control; D004664:Encephalitis Virus, Japanese / Q000276:immunology; D004672:Encephalitis, Japanese / Q000453:epidemiology* / Q000276:immunology; D019353:Endemic Diseases / Q000706:statistics & numerical data / Q000662:veterinary; D016751:Hepatitis E / Q000453:epidemiology* / Q000276:immunology; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D007812:Laos / Q000453:epidemiology; D000069466:Red Meat / Q000009:adverse effects / Q000469:parasitology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D066252:Sociological Factors; D034421:Sus scrofa; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control; D041201:Taenia solium / Q000276:immunology; D013622:Taeniasis; D017160:Trichinella spiralis / Q000276:immunology; D014235:Trichinellosis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015047:Zoonoses / Q000453:epidemiology*