Contribution of livestock marketing chains and role played by stakeholders’ knowledge, attitude and practice in spreading cystic hydatidosis to Busia Town, Kenya, 2018.

Abstract

Background Cystic hydatidosis (CH), a neglected parasitic zoonosis, is endemic in many parts of Kenya and could be spread along livestock marketing chains. Poor knowledge, attitude and practices (KAP) enables this spread in remote areas with inadequate public health services. We estimated prevalence, identified possible origin of CH to Busia, Kenya and assessed KAP among cattle owners and abattoir workers.

Methods and Principal Findings We conducted a cross-sectional study on slaughtered livestock and interviewed their owners and abattoir workers in Busia in May–June 2018. We used visual observation, palpation and incision to identify cysts. Polymerase chain reaction (PCR) was used for confirmatory diagnosis. Epi Info 7 was used to calculate descriptive and associative statistics. Of 302 carcasses inspected, cysts were visualized in nine (2.98%, 95% Confidence Interval (CI): 1.46–5.78). Fourteen samples were collected and 13 (92.86%) were positive on PCR (sensitivity=92%, specificity=95%). All carcasses with cysts were from West Pokot County, which borders Busia to the north. We interviewed 310 participants: 260 were males (83.87%, 95% CI: 79.19 – 87.69); median age was 41 years (range=21-69). Dogs were kept by 221 (71.99%, 95% CI: 66.55 – 76.87), of which 83 (37.56%, 95% CI: 28.33 – 48.52) improperly disposed of dog faeces. Home slaughtering was practiced by 196 (63.23%, 95% CI: 58.78-69.80), of which 115 (58.67%, 95% CI: 51.44-65.64) were not inspected and 85 (43.37%, 95% CI: 36.32-50.62) fed raw organs to dogs. Adequate knowledge was associated with butcher ownership (P-value = 0.002), age ≥35 years (P-value = 0.002) and higher literacy level (P-value <0.001).

Conclusions and Significance There is non-negligible risk of CH in Busia communities which might worsen with time given that the county is connected to endemic areas through livestock trade. Poor KAP by the people on the disease calls for need to implement information, education and communication campaigns to improve KAP on CH in the area.

Author summary Cystic hydatidosis is a globally neglected parasitic zoonosis which is endemic in many parts of the world including Kenya. It is majorly a problem among pastoral communities where there is close contact between human, livestock and dogs. Busia County, in Western Kenya is part of a livestock marketing chain between Kenya and Uganda. Animals from high endemic regions in Uganda and Kenya can easily spread the parasite to Busia through improper disposal of their infested organs. Non-pastoral communities like Busia may not have much cumulative experience about the disease though their practices may contribute to the perpetuation of the parasite in their environment. The parasite is gradually spreading to new areas and it is very important to the public health players in Kenya to take action so as to prevent further spread of this disease. Findings from this study show that the disease is no longer limited to pastoral communities only. There is need for the implementation of information, education and communication campaigns to improve the knowledge, attitude and practices of Busia community and other non-endemic regions on the disease.