Nationwide spatial dynamics of taeniasis in Thailand: declining prevalence but shifting focus and One Health risk factors across 2008-2014.

Background: The prevalence of taeniasis in Thailand has decreased over the past six decades. However, it remains a public health concern, particularly in focal areas, especially along the border regions where migration between Thailand and neighboring endemic countries is frequent. Spatial distribution analysis provides a useful method for identifying high-risk areas and implementing targeted integrated control measures. This study aimed to examine the spatial patterns of taeniasis in 2008 and 2014, along with their associated One Health risk factors at the sub-district level.

Methods: National surveys of helminthiases and taeniasis were conducted in Thailand in 2008 and 2014. We used data from these surveys and integrated publicly available spatial covariates. A Bayesian spatial model with geostatistical random effects and covariates, implemented using integrated nested Laplace approximation (INLA), was applied to predict the spatial distribution of taeniasis in each survey year.

Results: The prevalence of taeniasis in 2008 was 0.9% (95% CI 0.7-1.1%), while in 2014, it decreased to 0.5% (95% CI 0.4-0.6%). In 2008, higher prevalence was observed in the north, northeast, and parts of the west. In contrast, the 2014 predictions showed a more focal distribution, especially in the western border regions of Thailand, near the Myanmar border. Bangkok was identified as another hotspot, warranting further investigation. One Health factors, including human population density, livestock (cattle and pig) density, antimicrobial use in livestock, and environmental factors (including altitude, precipitation, travel time to cities and healthcare facilities, and normalized difference vegetation index [NDVI]), were associated with high prevalence of taeniasis.

Conclusions: One Health factors significantly influenced the spatial distribution of taeniasis in Thailand. High-risk areas, particularly along the Thai-Myanmar border, require integrated control efforts that involve cross-border collaboration. Cooperation between the Ministry of Public Health and the Department of Livestock Development will be crucial for more effective control measures.