Movements of free-range pigs in rural communities in Zambia: an explorative study towards future ring interventions for the control of Taenia solium.

BACKGROUND: Taenia solium typically affects resource-poor communities where pigs are allowed to roam freely, and sanitation and hygiene levels are suboptimal. Sustainable, long-term strategies are urgently needed to control the disease. Geographically targeted interventions, i.e. screening or treatment of taeniosis among people living near infected pigs (defined as ring screening and ring treatment, respectively), have been shown to be effective control options in Peru. However, these results might not be directly generalizable to sub-Saharan African settings. Pig movements play a vital role in the transmission and, consequently, the success of ring interventions against T. solium. The aim of the present study was to explore roaming patterns of pigs in T. solium endemic communities in Zambia as a first step toward evaluating whether ring interventions should be considered as a treatment option in Zambia. METHODS: In total, 48 free-roaming pigs in two rural neighborhoods in the Eastern Province of Zambia were tracked using a Global Positioning System (GPS) receiver. Tracking took place in April (end of the rainy season) 2019 and October (end of the dry season) 2019. The number of revisitations and the time spent within rings of different radii (50, 100 and 250 m) around the coordinates of each pig owner's household were calculated for each pig. RESULTS: The total tracking time for 43 pigs in the final analysis set ranged between 43 and 94 h. Pigs spent a median of 31% and 13% of the tracked time outside the 50- and 100-m radius, respectively, although large variations were observed between pigs. Overall, 25 pigs (58%) went outside the 250-m ring at least once, and individual excursions lasting up to 16 h were observed. In the dry season, 17 out of 23 pigs went outside the 250-m radius compared to only eight out of 20 pigs in the rainy season (P = 0.014). CONCLUSIONS: In our study sites in Zambia, the majority of pigs spent most of their time within 50 or 100 m of their owner's home, and these results are comparable with those on Peruvian pigs. Both radii could therefore be considered reasonable options in future ring interventions.

Mucosal Vaccination Against Periodontal Disease: Current Status and Opportunities.

Approximately 9 out of 10 adults have some form of periodontal disease, an infection-induced inflammatory disease of the tooth-supporting tissues. The initial form, gingivitis, often remains asymptomatic, but this can evolve into periodontitis, which is typically associated with halitosis, oral pain or discomfort, and tooth loss. Furthermore, periodontitis may contribute to systemic disorders like cardiovascular disease and type 2 diabetes mellitus. Control options remain nonspecific, time-consuming, and costly; largely relying on the removal of dental plaque and calculus by mechanical debridement. However, while dental plaque bacteria trigger periodontal disease, it is the host-specific inflammatory response that acts as main driver of tissue destruction and disease progression. Therefore, periodontal disease control should aim to alter the host's inflammatory response as well as to reduce the bacterial triggers. Vaccines may provide a potent adjunct to mechanical debridement for periodontal disease prevention and treatment. However, the immunopathogenic complexity and polymicrobial aspect of PD appear to complicate the development of periodontal vaccines. Moreover, a successful periodontal vaccine should induce protective immunity in the oral cavity, which proves difficult with traditional vaccination methods. Recent advances in mucosal vaccination may bridge the gap in periodontal vaccine development. In this review, we offer a comprehensive overview of mucosal vaccination strategies to induce protective immunity in the oral cavity for periodontal disease control. Furthermore, we highlight the need for additional research with appropriate and clinically relevant animal models. Finally, we discuss several opportunities in periodontal vaccine development such as multivalency, vaccine formulations, and delivery systems.

Effects of 'The Vicious Worm' educational software on Taenia solium knowledge among key pork supply chain workers in Zambia.

The neglected zoonotic cestode Taenia solium is endemic in many low- and middle-income countries, including Zambia. The parasite infects humans and pigs, inflicting high socioeconomic and disease burdens in endemic areas. Health education is regarded as an important component in T. solium control and previous studies indicate that 'The Vicious Worm' may be an effective T. solium health education tool for Tanzanian medical and agricultural professionals and Zambian primary school students. This study aimed to assess the effects of health education using 'The Vicious Worm' among Zambian pork supply chain workers, because the pork supply chain greatly influences food safety and security in Zambia. Half-day educational workshops using 'The Vicious Worm' and subsequent follow-up sessions were organized in the Lusaka and Katete districts of Zambia in March and April 2019. Questionnaires were administered before, after, and three weeks after the use of 'The Vicious Worm' to assess the program's impact on knowledge uptake and short-term retention. Focus group discussions were conducted to assess the program's user experience and the participants' beliefs, attitudes, and insights. In total, 47 pork supply chain workers participated: 25 from Lusaka and 22 from Katete. Overall, knowledge about T. solium was significantly higher (p<0.001) both immediately after, and three weeks after the use of 'The Vicious Worm' compared to baseline knowledge. Focus group discussions indicated incipient attitudinal and behavioral change, as well as a positive reception of the software; with participants describing the software as simple, educative, and useful to share knowledge. The study results indicate that workshops using 'The Vicious Worm' may be effective for short-term T. solium health education among key pork supply chain workers. Follow-up studies are required to assess long-term effects, transfer of knowledge and behavioral change. However, educational interventions with 'The Vicious Worm' could be considered for integrated T. solium control programs in sub-Saharan Africa, especially if the educational content is further simplified and clarified.