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Cultural, socioeconomic factors contribute to poor Japanese encephalitis prevention
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Swine farmers and their families should be targeted for education about Japanese encephalitis, and widespread immunization of pigs and humans is needed to control disease spread, according to recent research from Nepal.
Japanese encephalitis is the most important cause of viral encephalitis in people in Nepal and is spreading in its geographic distribution in that country. Pigs are the major amplifying hosts of Culex tritaeniorhynchus mosquitoes, and as pig farming increases in Nepal, major strategies for Japanese encephalitis prevention and control are needed, according to researchers from Nepal and Canada who reported their findings in a recent PLoS One paper.
The study evaluated the Japanese encephalitis knowledge and practices of 400 pig farmers in four districts of Nepal — Rupandehi, Kapilvastu, Morang and Kathmandu Valley — between September 2011 and June 2012. The researchers recruited 100 pig farmers per district to complete a survey about Japanese encephalitis. Farmers were incentivized to participate through offers of free veterinary examinations and treatment of the pigs.
The survey covered six main areas: farmer characteristics (sex, education, income, experience and training); farm specifications (number of pigs, farm management, and source and marketing of pigs); location of farmers in relation to risk factors such as rice fields, pig barns and standing water; farmer awareness of Japanese encephalitis and its prevention; preventive measures (vaccinations, mosquito control) taken by the farmers; and information on clinical symptoms or past diagnosis of Japanese encephalitis in humans or animals at the farm.
Significant differences were found across the four farming districts in terms of literacy (P<.001), monthly income (P<.001), land ownership (P< .001) and pig farming experience (P<.001). Nearly half of the pig farmers were illiterate, and the monthly incomes of 85% of the families did not exceed 10,000 Nepalese rupees ($100). Fewer than half (n=190) of the farmers knew they could acquire a disease from pigs, and only one farmer reported that family members had received the Japanese encephalitis vaccine. The researchers found significant variations across the four districts in terms of mosquito control efforts, and these efforts also were found to differ in frequency and potency.
The researchers said these findings emphasize the need to customize Japanese encephalitis awareness programs based on socioeconomic differences across districts.
“This study reinforces the need to attack root causes of people’s personal disease prevention behaviors, such as literacy, when aiming to have wide impacts from public health or agriculture extension and education programs,” the researchers wrote.
There were three key reasons to prioritize pig farming families for Japanese encephalitis education and control. First, study researchers showed that this occupational group lived and worked in close proximity to key Japanese encephalitis risk factors such as pigs, rice fields, ducks, wild birds, mosquitoes and standing water. Second, many families were not using any Japanese encephalitis prevention methods for humans or pigs. Third, pig production expected to continue growing.
These factors, in addition to the expanding Japanese encephalitis range linked to climate and land use changes, provide enough evidence to conclude that pig farming families should be priority targets of Japanese encephalitis control campaigns, according to the researchers, who added that more study is needed.
Disclosure: The researchers report no relevant financial disclosures.
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