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Serological prevalence of human trichinellosis and cysticercosis in Hoa Binh Province of northwest Vietnam

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Presentation by Luong Nguyen-Thanh, Meghan Cook, Sinh Dang-Xuan, Phuc Pham-Duc, Hung Nguyen-Viet, Anne Mayer-Scholl, Dianna Meemken and Fred Unger at the 13th SafePork Conference, Berlin, Germany, 26-29 August 2019.

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Serological prevalence of human trichinellosis and cysticercosis in Hoa Binh Province of northwest Vietnam

  1. 1. 13th SAFEPORK 2019, One Health – Tear down interdisciplinary walls Berlin, 27 August 2019 Luong Nguyen-Thanh1, Meghan Cook1, Sinh Dang-Xuan1,2, Phuc Pham-Duc1, Hung Nguyen-Viet2, Anne Mayer-Scholl3, Dianna Meemken4, Fred Unger2 1 Center for Public Health and Ecosystem Research, Hanoi University of Public Health 2 International Livestock Research Institute (ILRI), Vietnam 3 Federal Institute for Risk Assessment, National Laboratory for Trichinella, Germany 4 Freie Universitaet Berlin, Institute of Food Safety and Food Hygiene, Section Meat Hygiene Federal Institute for Risk Assessment, National Laboratory for Trichinella, Germany Serological prevalence of human trichinellosis and cysticercosis in Hoa Binh Province of Northwest Vietnam
  2. 2. CONTENTS INTRODUCTION OBJECTIVES METHODS RESULTS AND DISCUSSION CONCLUSION
  3. 3. INTRODUCTION 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 • In Vietnam, pork and pork products play an important role in food security which contributes more than 56% of total meat intake. • Each Vietnamese consumed approximately 29,7 kg pork/year, among the highest countries in the world
  4. 4. INTRODUCTION • According to the joint report of FAO and WHO in 2014, Taenia spp. ranks 1st and Trichinella spp. ranks 8th of 24 food-borne parasites assessed Source: WHO, 2010
  5. 5. INTRODUCTION Global distribution of Taenia solium cysticercosis/taeniasis (Willingham et al., 2010)
  6. 6. INTRODUCTION (1) Che Tao village, Mu Cang Chai district, Yen Bai Province, outbreak of 1970. (2) Quai To village, Tuan Giao district, Dien Bien Province, outbreaks of 2001 and 2004 and 2010–2012 survey on people living in the Quai To village and people hospitalized in the Dien Bien Hospital. (3) Lang Cheu village, Bac Yen district, Son La Province, outbreak of 2008 and 2010–2012 survey on people living in the Lang Cheu village and people hospitalized in the Son La Hospital. (4) Muong Lat village, Muong Lat district, Thanh Hoa Province, outbreak of 2012. Ha = Hanoi capital where Trichinella sp. was first detected in two pigs (0.04%) in 1923 30/100 positive Ho = Ho Chi Minh city (formerly Saigon) where a trichinellosis outbreak from the consumption of pork from a wild boar was documented in 1953.
  7. 7. INTRODUCTION • In Vietnam, there were about 0.1-12.0% of people be affected with trichinellosis and cysticercosis, depending to the research area • Sporadic outbreaks of those parasites have been recorded in Vietnam, and linked to the indigenous pig raised in ethnic community • In the past 18 year, there were 5 trichinellosis outbreaks with 140 cases and 15 deaths, concentrated in the Northern mountainous area in Vietnam • Human cysticercosis is distributed in over 50 of 63 provinces, with the prevalence was 1.0-7.2% in the North and 4.3% in the South of the country
  8. 8. INTRODUCTION Risk factors to parasitic diseases among pork value chain  Free or semi roaming raising  Pig is slaughtered at home or uninspected slaughterhouse  Consume raw/uncooked pork Pig Middeman Pig Collector Pig from Farms Large scale Pig Slaughterhouse Small/medium scale Pig Slaughterhouse Pork butchers/ wholesalers Pork retailers Pork plant for Export Pork retailers in urban Domestic consumption (98-99%) Export (1-2%) Super- market
  9. 9. OBJECTIVES • Determine the seroprevalence of human trichinellosis and cysticercosis in Da Bac district, Hoa Binh province, Vietnam in 2018 • Describe eating behavior and factors associated with the risk of trichinellosis and cysticercosis among people living in mountainous area in Vietnam
  10. 10. METHODS Commune No. HH % HH No. sample Cao Son 1074 0,24 70 Doan Ket 744 0,17 51 Giap Dat 493 0,11 35 Muong Chieng 640 0,15 44 Tan Minh 962 0,22 66 Trung Thanh 496 0,11 34 Total 4409 1,00 300 A total of 300 respondents from 6 communes were enrolled in the study
  11. 11. METHODS Data and sample collection + Interview with structured questionnaire + Blood sampling: The required volume were approximately 3-4 ml, Blood samples were kept at 4 degrees Celsius during transportation and were preserved at -20 degrees Celsius in the laboratory before testing. + Trichinellosis: Demeditec ® Trichinella spiralis IgG ELISA DETRIG0480, Germany + Cysticercosis: Apdia ® Cysticercosis Antigen ELISA Ref 650501, Belgium) Additional on-farm sampling in pig farms of the same communities (to be presented by Hung Nguyen)
  12. 12. RESULTS & DISCUSSION 74,8 73,2 16,5 54,9 46,2 7,5 Commune Total of sample Trichinellosis Cysticercosis Positive Suspected Positive Suspected Cao Son 70 0 (0) 1 (0.33) 0 (0) 1 (0.33) Doan Ket 51 0 (0) 0 (0) 0 (0) 0 (0) Giap Dat 35 1 (0.33) 0 (0) 0 (0) 0 (0) Muong Chieng 44 0 (0) 0 (0) 0 (0) 0 (0) Tan Minh 66 1 (0.33) 2 (0.67) 2 (0.67) 0 (0) Trung Thanh 34 0 (0) 0 (0) 0 (0) 0 (0) Total 300 2 (0.67) 3 (1.0) 2 (0.67) 1 (0.33) Figure 1. Seroprevalence of trichinellosis and cysticercosis
  13. 13. RESULTS & DISCUSSION Figure 2. The difference of OD value between male and female Negative zone Negative zone
  14. 14. RESULTS & DISCUSSION Study Location Disease Prevalence Nga et al (2014) Dien Bien & Son La; Vietnam Trichinellosis 3.5% Duong et al (2017) Dien Bien, Son La, Yen Bai, Thanh Hoa; Vietnam Trichinellosis 5.1% Okello et al (2014) Lao PDR Human taeniasis Cysticercosis 46.7% 66.7% Lin. H et al (2017) Ha Tinh; Vietnam Bac Kan; Vietnam Cysticercosis Cysticercosis 0.6% 5.3% Our Study (2018) Hoa Binh, Vietnam Trichinellosis Cysticercosis 0.67% 0.67%
  15. 15. RESULTS & DISCUSSION 74,8 73,2 16,5 54,9 46,2 7,5 Figure 3. Characteristics of positive and suspected cases of trichinellosis and cysticercosis
  16. 16. RESULTS & DISCUSSION 74,8 73,2 16,5 54,9 46,2 7,5Figure 4. Risk factors and further details related to positive and suspected cases of trichinellosis and cysticercosis
  17. 17. RESULTS & DISCUSSION 81.9 81.5 81.7 18.1 18.5 18.3 0 10 20 30 40 50 60 70 80 90 100 Male Female Total Tay ethnic Others ethnic 0 10 20 30 40 50 60 Flushing toilet Double-vault Pit-latrine No toilet Toilet model Figure 5. Demographic of participants
  18. 18. RESULTS & DISCUSSION 74,8 73,2 16,5 54,9 46,2 7,5 Figure 6. Eating behaviour comparing between male and female 74.8% 73.2% 16.5% 46.2% 54.9% 7.5%
  19. 19. CONCLUSION 74,8 73,2 16,5 54,9 46,2 7,5 - Trichinellosis and cysticercosis occur sporadic in the study area and can pose a public health risk to consumers - Knowledge on both zoonoses was limited - Further research and services are required to identify and treat areas where infections are concentrated, acting as reservoirs - Qualitative research to explore drivers that underlie reported risk factors and observed trends would be beneficial - Using a One Health approach can help the intervention more effective.
  20. 20. NEXT STEP 74,8 73,2 16,5 54,9 46,2 7,5 - Link human results with results for pigs including farm management risk factors - Joint One Health awareness campaigns combined with other food safety project (SAFE Pork) targeting: - consumers - pig farmers - butchers
  21. 21. Acknowledgement 74,8 73,2 16,5 54,9 46,2 7,5

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