Doctoral Thesis
Techniques for mapping Taenia solium in the Lao People’s Democratic Republic
Doctor of Philosophy (PhD), Murdoch University
2023
Abstract
Taenia solium is the leading cause of preventable epilepsy in low and middle-income countries, yet inadequate diagnostics and limited resources impede control efforts. The World Health Organization has called for intensified control in hyperendemic areas; however, such areas have rarely been identified in endemic countries. The Lao People’s Democratic Republic (PDR) recognises T. solium as a priority and this thesis endeavours to support the control of T. solium through the application of mapping techniques.
Two synergistic scoping reviews identify that a lack of T. solium-specific diagnostics currently hampers efforts to measure disease frequency. Burden of disease estimates are uncertain and simply attribute a proportion of epilepsy to T. solium. However, this proportion is often extrapolated from observational studies conducted in other populations with considerably different epidemiological contexts.
Spatial autocorrelation statistics and multicriteria decision analysis overcame the lack of disease frequency data in Lao PDR by examining risk factors. Both risk-mapping methods consistently identified two major high-risk areas. The northern area is aligned with current knowledge, whereas the southern area is of interest as it has yet to be investigated.
If control efforts against T. solium are to be scaled up in high-risk areas, activation of the One Health network will be required. Mixed-methods analysis demonstrated that the network is currently sparse and centralised. Organisations are required to harness pre-existing relationships to maximise scarce resources, and capacity is stretched by externally funded projects with donor-driven priorities.
Future efforts must focus on applying molecular diagnostics to routinely collected samples to generate more disease frequency data, whilst foundational epidemiological studies in high-risk areas will enhance the understanding of disease associations. These immediate next steps will rapidly increase the understanding of T. solium in Lao PDR, allowing for advanced risk mapping and locally acceptable interventions to be trialled by the One Health network.
Details
- Title
- Techniques for mapping Taenia solium in the Lao People’s Democratic Republic
- Authors/Creators
- Andrew Larkins
- Contributors
- Amanda Ash (Supervisor) - Murdoch University, Centre for Biosecurity and One HealthMieghan Bruce (Supervisor) - Murdoch University, Centre for Biosecurity and One Health
- Awarding Institution
- Murdoch University; Doctor of Philosophy (PhD)
- Identifiers
- 991005648769707891
- Murdoch Affiliation
- Centre for Biosecurity and One Health; School of Medical, Molecular and Forensic Sciences
- Resource Type
- Doctoral Thesis
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