Cysticercosis in a population of epileptics in western Kenya: relating human and pig risk factors

Grace D and Downie K. 2011. Cysticercosis in a population of epileptics in Western Kenya: relating human and pig risk factors. Presentation at the 1st International One Health Congress, Melbourne, Australia, 14-16 February 2011. Nairobi: ILRI.

One Health recognizes the inter-dependence of human, animal and environmental health and is especially relevant to understanding zoonotic diseases such as cysticercosis. Cysticercosis, caused by larval stages of the pig tapeworm Taenia solium, is an important disease in developing countries and a major cause of adult onset epilepsy. We report on a study of 1051 epileptics in western Kenya. In total, 628 respondents answered a detailed questionnaire on risk factors on socio-economic determinants including pig husbandry. We describe the profile of a typical epileptic in western Kenya and their typical pig husbandry system. We also assess risk factors related to pig husbandry, pork consumption, poverty, occupation, practices around water and sanitation, education and knowledge. A quarter of households kept pigs at the time of survey and half had kept pigs in the past, most kept local breeds and at most pigs were at least partially free-range. Meat inspection was infrequently practiced. One third of the epileptics reported observing nodules in pork meat and one half had observed tapeworm segments in their own faeces. Sanitation practices, spatial location and occupation were the most important risk factors. Contrary to our initial hypotheses, neither poverty nor intensifying pig-keeping were predictive of disease, and possible reasons for this are discussed. By conducting disease surveys that simultaneously address humans and animal risk factors additional insights can be gained into zoonoses epidemiology.