Risk mapping for Taenia solium: Applying multicriteria decision analysis in Lao PDR

Andrew Larkins; Mieghan Bruce; Rattanxay Phetsouvanh; Amanda Ash

doi:10.1111/tmi.13917

Risk mapping for Taenia solium: Applying multicriteria decision analysis in Lao PDR

Trop Med Int Health. 2023 Sep;28(9):736-741. doi: 10.1111/tmi.13917. Epub 2023 Jul 20.

Authors

Andrew Larkins^{1

2}, Mieghan Bruce^{2

3}, Rattanxay Phetsouvanh⁴, Amanda Ash^{1

2}

Affiliations

¹ School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Australia.
² Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia.
³ School of Veterinary Medicine, Murdoch University, Perth, Australia.
⁴ Department of Communicable Disease Control, Ministry of Health, Vientiane, Lao PDR.

PMID: 37474449
DOI: 10.1111/tmi.13917

Abstract

Objectives: Taenia solium is ranked the most significant global foodborne parasite and the leading cause of epilepsy in low and middle-income countries. Diagnostic challenges have hampered disease control efforts to date and WHO has called for the development of risk mapping tools to assist endemic countries. This study describes the application of multicriteria decision analysis to map the risk of T. solium in Lao PDR and acts as a case study for other endemic countries.

Methods: Multicriteria decision analysis was completed using census data on relevant risk factors in Lao PDR. Factors were weighted using an analytical hierarchy process. Village risk scores were calculated using a weighted linear combination and categorised using the Fisher-Jenks algorithm into low, medium, and high risk. District risk scores and categories were calculated using the mean village risk score for a district. Sensitivity analysis was completed by doubling and halving risk factor weights, one at a time, and assessing the standard deviation of scores and categories across all scenarios.

Results: A total of 2017 (23.7%) villages were classified as high risk, with 3312 (39.0%) medium and 3170 (37.3%) low risk. This resulted in 21 (14.2%) high-risk districts, 83 (56.1%) medium and 44 (29.7%) low-risk districts. The risk maps highlight two areas of interest which are high risk and low variation. The first is the northern province of Phongsaly, which is consistent with literature and anecdotal reports. The second is the southern Salavan and Xekong provinces, which have yet to be investigated in detail.

Conclusions: Multicriteria decision analysis has provided a simple, rapid, and flexible approach to mapping the risk of T. solium in Lao PDR. The nature of the method means that it can be completed in any endemic country with available and appropriate risk factor data.

Keywords: Lao PDR; Neurocysticercosis; Taenia solium; neglected topical diseases; zoonoses.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Decision Support Techniques
Humans
Laos / epidemiology
Risk Factors
Taenia solium*
Taeniasis* / epidemiology