Abstract
BackgroundThis study is a component of a large research project on five major neglected zoonotic diseases (NZDs) including cystic echinococcosis and was undertaken in the Province of Sidi Kacem over a period of four years (April 2009-March 2013).MethodsQuestionnaires were administered at community level in a total of 27 communes and visits were made to all of the 10 abattoirs situated in the Province, to collect qualitative data on determinants of transmission for disease in humans and animals. More specifically, community knowledge, attitudes and practices related to cystic echinococcosis were assessed, as well as the extent to which local customs and behaviours may promote transmission. Abattoir infrastructure and practices, and their role in perpetuating disease transmission were also critically evaluated.ResultsThe results show that only 50 % of people have heard of the disease, and of those, only 21 % are aware of the dog’s role in disease transmission. Sixty-seven per cent of respondents stated that dogs are fed ruminant organs deemed unfit for human consumption. Owned dogs have access to the family home, including the kitchen, in 39 % of households. The extent of this close proximity between humans and animals is even more pertinent when one considers that dogs are omnipresent in the community, with an average of 1.8 dogs owned per household. The unrestricted access of dogs to abattoirs is a huge issue, which further promotes disease transmission.ConclusionThis study would suggest that the high prevalence of cystic echinococcosis in humans and animals in Morocco is largely due to three factors: 1) abundance of dogs 2) engagement in risky behaviour of the local population and 3) poor abattoir infrastructure and practices. This has serious implications in terms of the socio-economic impact of the disease, especially for rural poor communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-015-0082-9) contains supplementary material, which is available to authorized users.
Highlights
This study is a component of a large research project on five major neglected zoonotic diseases (NZDs) including cystic echinococcosis and was undertaken in the Province of Sidi Kacem over a period of four years (April 2009-March 2013)
The data collected during this study suggests that contamination is widespread given the uncontrolled roaming of dogs, which was identified as a risk factor of disease transmission for ruminants in other regions of Morocco [34, 35]
In Sidi Kacem Province 19 surgical cases of Cystic echinococcosis (CE) were reported in 2010, 84.0 % of which were from rural communes [7]
Summary
This study is a component of a large research project on five major neglected zoonotic diseases (NZDs) including cystic echinococcosis and was undertaken in the Province of Sidi Kacem over a period of four years (April 2009-March 2013). The disease has been endemic in countries of the Mediterranean region from the beginning of history [1,2,3,4] This major neglected zoonosis has a considerable socioeconomic impact including the cost of treatment of human cases and production losses in livestock. In Morocco costs associated with each surgical case have been estimated at 1500€ on average and the mortality rate of disease at 2–3 % [5, 6] When this cost is multiplied by the average of 5.1 surgical cases per 100,000 inhabitants recorded in 2003–2010 [7], the economic burden from human cases alone is substantial. It must be emphasized that these reported cases represent the ‘tip of the iceberg’ as many cases go undetected
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