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Contents
DECLARATION
II
DEDICATION
III
AKNOWLEDGEMENT
IV
ABSTRACT
. V
CHAPTER ONE............................................................................................................. 2
INTRODUCTION........................................................................................................... 2
1.1 Background of the study................................................................................... 2
1.2 Problem statement............................................................................................ 5
1.3 Purpose of the study......................................................................................... 5
1.4 Objectives......................................................................................................... 5
1.4.1 Broad objective........................................................................................... 5
1.4.2 Specific objectives....................................................................................... 5
1.5 Research questions........................................................................................... 6
1.6 Hypotheses....................................................................................................... 6
1.7 Significance of the study...................................................................................6
1.8 Limitations and delimitations of the study........................................................6
1.9 Assumptions of the study..................................................................................6
CHAPTER TW0............................................................................................................ 7
LITERATURE REVIEW................................................................................................... 7
2.1 Introduction....................................................................................................... 7
2.2 Theoretical review............................................................................................. 7
2.2.1 Etiology of Taenia solium............................................................................. 7
2.2.2 Morphology of Taenia solium.......................................................................8
2.2.3 Life cycle..................................................................................................... 9
2.2.4 Pathogenesis and Pathogenicity................................................................11
2.2.5 Epidemiology of Taenia solium..................................................................12
2.2.6 Diagnosis................................................................................................... 13
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2.3 Empirical review.............................................................................................. 14
2.3.1 Limited use or absence of latrines as a factor influencing Taenia solium in
pigs.................................................................................................................... 14
2.3.2 Pig production techniques.........................................................................14
2.3.3 Information availability.............................................................................15
2.3.4 Prevalence of Taenia solium in pigs...........................................................16
2.3.5 Distribution of Taenia solium in the region................................................16
CHAPTER THREE....................................................................................................... 18
METHODOLOGY........................................................................................................ 18
3.1 Introduction..................................................................................................... 18
3.2 Research design.............................................................................................. 18
3.3 Target population............................................................................................ 18
3.4 Sample size and sampling techniques............................................................19
Table 4.4.1 Sample Frame of the Respondents table..........................................19
3.5 Research instruments...................................................................................... 19
3.6 Validity and reliability of research instruments...............................................20
3.7 Data collection procedures..............................................................................21
3.8 Data analysis techniques................................................................................ 22
3.9 Ethical considerations..................................................................................... 22
REFERENCES............................................................................................................ 23
APPENDICES............................................................................................................. 30
Appendix I: Budget................................................................................................ 30
Appendix II: Work plan.......................................................................................... 31
Appendix III: Questionnaire................................................................................... 32
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
Taenia solium parasite causes cysticercosis disease in pigs (Kabululu et al., 2015).
Although human are also the intermediate and definite hosts of this parasite, pigs are the major
intermediate host for Taenia solium cysticercosis. Cysticercosis is a major public health problem
in the world however; the disease is more prevalent in developing nations. The disease is
common in people who eat poorly cooked or raw pork. This disease is also linked to the social
and economic conditions of the community (Goussanou et al., 2013). Poor sanitation, low living
standards, polluted water, ignorance and constant unregulated movement of people are the major
reasons that promote the spread of this disease. Taenia solium cysticercosis is endemic in subSaharan Africa, Asia and Latin America.
According to Wandra et al., (2015), cysticercosis is responsible for the increased cases o
epileptic disorders, intracranial hypertension or even meningitis. The disease is also prevalent in
rural areas with high prevalence of the parasite recorded in pigs more than in humans (Okello et
al., 2015). The high prevalence of this parasite in both humans and pigs has been associated with
poor sanitation, old age, illiteracy and inability to detect infected pigs. The older pigs are at a
higher risk of infection by Taenia solium than the young ones. Diagnosis of cysticercosis is
difficult because the disease does not have visible symptoms unlike other diseases. It also
requires experts to detect the parasite presence in the pig due to its asymptomatic nature. Various
serological techniques are used in the diagnosis of Taenia solium although enzyme linked
immunoassay is the most reliable and efficient o them all.
Pig farming has been on the rise in east Africa gaining prominence among small scale
farmers (Weka et al., 2013). Lack of enough land for grazing of livestock, high returns on
investments in pig farming over a short period of time and increased consumption of pork meat
are some of the reasons that have made pig farming popular with many farmers. However, most
pig farming is under obsolete systems with poor sanitation, no housing and free roaming pigs.
this are valid reasons that explain the tremendous increase in Taenia solium cysticercosis in pigs
in rural Kenya. Increased incidences of epilepsy in countries without history of cysticercosis
have made it necessary to undertake studies on this parasite that is associated with epileptic
seizures in most people (Goussanou et al., 2013). Despite the coordinated efforts by eastern and
central African countries, the incidences of Taenia solium cysticercosis in pigs remain very high.
Cysticercosis is caused by Taenia solium and currently is slowly but steadily becoming a
major threat in public health (Wandra et al., 2015). It is estimated that the parasite infects more
than fifty thousand people in the world each year. This parasite occurs in two different forms
depending on the host. Taeniasis infects the small intestine of the human definitive host and has
never been isolated from any other animal host. Taeniasis is acquired in humans when one
ingests raw or improperly cooked pork meat harboring the larvae of this parasite. Cysticercosis
is a parasitic form of Taenia solium that infects both human and pig hosts (Jeon et al., 2013).
This parasitic form is acquired majorly through ingestion of food containing fecal contamination
by Taenia solium eggs. Cysticercosis infect pigs which are the common intermediate hosts
however, humans can also become its intermediate as well as definitive hosts in some cases.
Presence of Taenia solium cysticercosis in humans may lead to seizure disorders and
epilepsy (Robertson et al., 2014). This may result to death if uncontrolled. According to Brunetti
(2012) many patients with cysticercosis experience seizures and epileptic disorders. This parasite
is common in third world countries with sub Saharan Africa the worst hit with cysticercosis in
pigs and humans. This parasite is only absent in the Muslim community in this third world
countries due to their faith that does not allow consumption of pork meat. Infected pork meat is
also finding its way into developed countries through importation.
In Thika sub-county which is in Kiambu County in Kenya, there has been notable rise in
the reported cases of Taenia solium cysticercosis in pigs (Jayashi et al., 2014). This parasite later
finds its way into humans when they consume poorly cooked meat of these infected pigs.
1.4 Objectives
1.4.1 Broad objective
To analyze the prevalence of Taenia solium cysticercosis in pigs within Thika sub-county
1.4.2 Specific objectives
1.6 Hypotheses
1. Ho There is low prevalence of Taenia solium in pigs within Thika sub-county.
2. Ho Taenia solium is evenly distributed in all wards in Thika sub-county.
CHAPTER TW0
LITERATURE REVIEW
2.1 Introduction
This chapter discusses past literatures related to the area under study. This will consist of two
parts; the theoretical analysis and the empirical reviews.
Cysticercosis is a disease that attacks both humans and pigs that is caused by the larvae of
various species of Taenia solium (Komba et al., 2013). These species of Taenia include;
hydratigena, ovis, solium, taeniaeformis or crassiceps. Previously, the adult stage and the larval
stage of this parasite were believed to be two different species of tapeworms. The larval stage of
Taenia solium is sometimes referred to as Cysticercus cellulosae. Larval stages of other species o
Taenia are also referred with different names due to the previous thoughts that the adults and
larvae are different. Pigs are the intermediate host for Taenia solium while humans are both
definitive and intermediate hosts to the parasite (Guyatt and Fvre, 2016).
2.2.2 Morphology of Taenia solium
The adult Taenia solium inhabits the small intestines of their hosts (Gomez et al., 2015).
The name of this parasite is derived from the distinct shape of the hooks on the scolex. Its shape
is like the sun rays. According to Mwanjali et al., (2013), he adult Taenia solium has nonretractable taenid rostellum on the scolex which has two circles composed of between 22 and 32
hooks of the length of around 130 to 180 micrometers. Taenia solium is wider segments than
other species of Taenia with between 300 to 400 testes. Gravid segments of Taenia solium are
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also longer and wider and contain taenid uterus, medial stem which is branched with between
seven to thirteen lateral branches (Ito et al., 2015).
Pigs are infected by ingestion of the eggs of Taenia solium cysticercosis or ingestion of
ploglottids that contains the eggs of the parasite released into the feces of the host (Gavidia et al.,
2013). The eggs contained in the feces can easily be carried on formites and this may later be
disseminated by coprophagous insects and the birds. Grazers can ingest the eggs contained on
the pastures or drinking contaminated water. The pigs can easily ingest these eggs when they
feed on the vegetation, directly from soil or drink water that contains T. solium. Humans carrying
Taenia solium in their small intestines can infect themselves by eggs found in their feces leading
to cysticercosis disease. Reverse peristalsis of the eggs in the small intestines may result into
autoinfection according to some researcher albeit the idea is still disputable (Bobes et al., 2014).
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The eggs of Taenia solium hatch only when they make contact with the gastric secretions which
precedes intestinal secretions.
The eggs also hatch in the jejunum then penetrate the intestinal walls from where they are
carried in the blood through circulation throughout the tissues in the body. While in the tissues,
the larvae develop into either cysticerci or coenuri forms (Chawhan et al., 2015). Oncospheres on
reaching the muscular tissue of organs through circulation develop into larvae. This development
of the larvae occurs mainly in the liver or the brain in some rare cases. The larvae take about
three months to fully develop and mature. Humans can therefore, be infected by this parasite
when they feast on poorly cooked pork containing the larvae of Taenia solium (Assana et al.,
2013).
On ingestion, the scolex becomes invaginated and attach on the mucosal membrane of the
host from where they develop into adult within the period o three months. In humans the
ingested larvae of Taenia solium develop in several organs which include; the striated muscles,
brain, liver and myocardium (Devleesschauwer et al., 2013). Autoinfection may occur due to
treatment meant or the elimination of adult parasite, movement o the eggs to the stomach of the
host or even vomiting by the host. Ale (2014) asserted that autoinfection occurs in fewer than 50
percent of the hosts of Taenia solium. This shows that most hosts of this parasite do not
experience autoinfection. The size of Taenia solium may be the main reason for the least visible
clinical symptoms (Thomas et al., 2016).
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disease onset is usually very abrupt and the symptoms gradually become more severe. Prognosis
is even more serious and in most cases the mortality rate is even higher.
The most prevalent cerebral cysticercosis include; intracranial, hypertension, convulsions
and cysticercosis which occurs separately or a number o them together. Cortical localization of
cysticercosis results in the convulsions (Flisser et al., 2014). Epileptic disorders are the majorly
caused by cysticercosis in the tropics and more so in the developing countries. In a study by
Nkouawa et al., (2015) T. solium was detected in more than thirty people suffering from epilepsy.
The other study in Ecuador revealed that epilepsy is caused mainly by cysticercosis (Garcia et
al., 2014). Seizure leads to loss of consciousness in most people. Epileptic disorders manifest in
the two mal types, that is, grand and petit types. Grand mal attacks can last to around five
minutes whereas petit mal seizures occur within seconds, usually to the maximum of 30 seconds.
Epilepsy is usually accompanied by hallucinations, mental stress, emotional disturbances,
amnesia, and dementia (Pajuelo et al., 2015). Taenia solium has been detected in the eyes, spinal
cord, muscle tissues, lungs, thyroid glands and subcutaneous tissues.
There have been numerous reports of cysticercosis in many parts of the world caused by
Taenia solium (Dharmawan et al., 2013). According to Flisser (2013) patients with intraocular
cysticercosis become blind despite undergoing proper surgery. Cysts found in the spine
occasionally are intramedullar resulting into sensory symptoms. Cysts localized in subcutaneous
layers and muscles rarely cause symptoms unless when in close proximity to the nerves
(Lightowlers et al., 2016).
2.2.5 Epidemiology of Taenia solium
The new form of taenid in humans known as Asian cysticercosis has been reported in
Asian countries (Mwape et al., 2013). This is regarded as an intermediate between Taenia solium
and Taenia sagatina. Cysticercosis is prevalent in communities living in poverty and in close
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proximity with the pigs. Cysticercosis results in more than fifty thousand deaths annually in the
world (Zammarchi et al., 2013). Taenia solium spreads in areas with poor sanitation, pigs
breeding in unsanitary conditions and eating of raw or poorly cooked meat. South and Central
American countries is believed to lead in the cases o T. solium infection (Watts et al., 2014). In a
study conducted to determine the prevalence of Taenia solium in Mexican soldiers over ten
percent of the soldiers were diagnosed with cysticercosis. This confirms that the disease is a
major health problem in the world today.
A study in Nepal revealed that over 80 percent of the patients had skin nodules a clear
sign for a possible Taenia solium infection. The reports of Cysticercosis have emerged from
United States, Europe and other developed nation due to what officials believe is high number of
immigrants (Wardrop et al., 2014). Clinical symptoms may vary in case of cysticercosis due to
difference in area, number and size of the cysts in the patient. According to Nsadha et al., (2014)
seizures in developing world can be attributed to Taenia solium cysticercosis with more than 16
cases reported in Peruvian village. In Ecuador or instance, Neurocysticercosis caused by Taenia
solium was found to be a significant cause of epileptic seizures. The results were consistent with
study by Carabin et al., (2015) who revealed that high number of patients with epilepsy had
Taenia solium.
2.2.6 Diagnosis
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earliest time one can detect the T. solium in patients remains unknown and the course of reaction
reactivity and length of reaction also remain unknown. Despite these challenges, ELISA is the
most suitable method for the diagnosis of cysticercosis (Pray et al., 2016).
Poor hygiene has been cited as the major cause of Taenia solium cysticercosis in pigs in
sub-Saharan Africa where Thika lies (Jayashi et al., 2012). Pig farming is usually in rural areas
where poverty levels are high. There are few families in rural Kenya who have toilets or pit
latrines. Therefore, faecal materials are a major contaminant in foods in these areas. Braae (2015)
asserts that more than 60% of pig farmers in rural areas have no latrines. He further argues that
most of this farmers use open fields for defecation. These fecal materials containing the Taenia
solium Cysticercosis parasite often get ingested by pigs as they are restricted and roam freely. In
some cases latrines are not used perhaps due to some wild beliefs in Africa (Ngowi et al., 2013).
Disposal of human waste in open fields and bushes used in absence of latrines contaminate
vegetables, water, soil or food. These contaminants are then ingested by the pigs or even humans
which lead to the infection by this parasite. Sah et al., (2013) observed that cysticercosis in pigs
is usually due to the absence of latrines in third world countries.
2.3.2 Pig production techniques
Most pig farming in sub-Saharan Africa is curtailed by lack of enough funds and lack of
relevant feeds for the pigs (Robertson et al., 2014). Poverty in developing nations has led to poor
housing and health care services leading to adoption of poor farming methods. Coral-Almeida et
al., (2014) classified pig farming into various groups. The first technique is free system also
called scavenging where pigs are left to roam looking for their own food. The second category is
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semi-intensive where pig farming is by combination of both modern s and the other techniques.
The third technique is intensive system where pigs are fed on domestic wastes from the kitchen.
According to Madinga et al., (2016) 90 percent of pig farmers use free system where pigs
seek for their own food. These farming techniques immensely contribute to the prevalence of
Taenia solium cysticercosis due to poor sanitation. Scavenging system which is the most
common farming method in rural areas where there are no latrines make it easy for this parasite
to thrive in pigs. Brunetti (2012) believes that free system is the main route of transmission of
Taenia solium cysticercosis as they often come into contact with faeces in open fields. Taenia
solium can still be transmitted horizontally from humans to pigs as some farmers in developing
countries dispose human wastes directly in pigsties (Jayashi et al., 2014).
2.3.3 Information availability
Taenia solium cysticercosis remains one of the zoonotic diseases who farmers have little
knowledge about (Galn-Puchades et al., 2013). According to Mkupasi et al., (2015) there has
been absolutely no control programme in any sub-Saharan country for this parasite. Education
level of most pig farmers is very low which contributes to the spread of this parasite due to
limited management skills and information on this pathogen. Moreover, lack of information on
the best farming techniques to adopt makes farmers resolve to use the widely known traditional
techniques like free system that promote the spread of this pathogen. Study by Devleesschauwer
et al., (2014) revealed that majority of the farmers have no information that T. solium
cysticercosis is a parasite that is highly risky in the pigs.
Some few farmers who have limited information on the parasite do not understand its
transmission mechanisms (Jeon et al., 2013). Limited veterinary services like the inspection of
dead pigs also contribute to the transmission of this pathogen to the humans who later infect pigs
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through their poorly disposed feces (Pondja et al., 2015). Agricultural extension officers in subSaharan Africa are few making it difficult to reach farmers (Kabululu et al., 2015). This makes
education of farmers very difficult especially on animal diseases and emerging issues in farming.
2.3.4 Prevalence of Taenia solium in pigs
According to Jeon et al. (2013) pig farming is usually done by small scale farmers
keeping not more than ten pigs in their farms. These pigs are therefore, let to roam scavenging
for food over long distances (Pondja et al., 2015). These subsistence farmers then sell their pigs
in the local market where majority are slaughter and pork meat sold in the local butcheries
(Jayashi et al., 2012). Although the laws of most countries require mandatory meat inspections
by relevant regulatory bodies, pork is in most cases not inspected (Galn-Puchades et al.,
2013).). This puts the lives of the pork consumers in this case at risk of food-borne infections
such as Taenia solium.
2.3.5 Distribution of Taenia solium in the region
The study by Brunetti (2012) revealed that pork eating areas in Asia, Latin America and
Africa have reported high number of Taenia solium incidences. The study further, concluded that
in most of these areas, pork consumed meat comes from pigs reared by the local farmers.
According to Mkupasi et al., (2015), the distribution of Taenia solium in the region needs to be
clearly mapped in order to initiate control programmes in these areas. It is therefore, imperative
to carry out this study and outline those areas that require urgent action to eliminate this
pathogen. Ngowi et al. (2013) noted that Taenia solium cysticercosis is more rampant in rural
areas as compared to urban areas. This is inconsistent with findings by Madinga et al., (2016)
which revealed that cysticercosis is prevalent in regions that have low living standards regardless
whether its an urban or rural area. According to Robertson et al. (2014) religion practiced in the
area play a key role in promoting or inhibiting the incidences of cysticercosis. Sah et al., (2013)
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asserted that the distribution of this parasite depends on a combination of various factors. This is
consistent with study by Braae (2015) who observed that distribution of any epidemic disease in
the region is often due to several different reasons.
CHAPTER THREE
METHODOLOGY
3.1 Introduction
This chapter explores in detail the methods that the researcher intends to use in
conducting this research. This includes the research design, target population, sample and sample
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Wards
Sample size
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Township
Kamenu
Hospital
Gatuanyaga
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5
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is used in the data collection. Test-retest technique will be used by the researcher in order to
ensure the validity of the instruments used (Said et al., 2016). This will be done by first
administering a specific test to a small sample of the population. After one to two weeks, the
researcher will administer the same instrument to the same sample. The results of the two or
three tests will then be compared for consistency and uniformity. The data from test and retest
will then be correlated by use of Pearsons product moment correlation coefficient formula in
order to find the correlation coefficient (r) between the two sets of data obtained (Beatty et al.,
2015).
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Berry (2016) asserts that the reliability coefficient value of 0.8 and above confirms that
the instrument is reliable. When the value falls below 0.8 then the instruments of research need
to be adjusted and the test-retest done again to test reliability.
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APPENDICES
Appendix I: Budget
Item
Fare
Questionnaires
laptop
Compensation to farmers
Food
Translator
Other expenses
Total
29
30
( )
2-5 years
( )
5-10 years
( )
Above 10years
( )
( )
Female
( )
4. Age?
30
31
0-20
( )
20-30
( )
30-40
( )
40-50
( )
Above 50
( )
Section B
1. Which pig farming techniques do you employ?
Confined
( )
Semi confined
( )
Free range
( )
( )
Profit making
( )
( )
( )
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No
( )
( )
Agree
( )
Disagree
( )
Strongly disagree
( )
6. The agricultural extension officers often visit pig farmers in Thika County
Strongly agree
( )
Agree
( )
Disagree
( )
Strongly disagree
( )
( )
Weekly
( )
Monthly ( )
32
33
Never
( )
( )
Weekly
Monthly
Dont know
10. in your own opinion has the government done enough to enlighten the pig farmers
about diseases affecting farmers?
33