De impact van Taenia solium op de volksgezondheid in Nepal

Brecht Devleesschauwer
 
Nepal – Van kastendiscriminatie tot hersenwormen
 
Tijdens de voorbije VN-top in New York heeft België de nadruk gelegd op de toenemende ongelijkheid binnen ontwikkelingslanden en de gevolgen hiervan voor de algemene ontwikkeling van deze landen. Hoe belangrijk is dit probleem en hoe gaat de internationale gemeenschap hiermee om?

De impact van Taenia solium op de volksgezondheid in Nepal

 

Nepal – Van kastendiscriminatie tot hersenwormen

 

Tijdens de voorbije VN-top in New York heeft België de nadruk gelegd op de toenemende ongelijkheid binnen ontwikkelingslanden en de gevolgen hiervan voor de algemene ontwikkeling van deze landen. Hoe belangrijk is dit probleem en hoe gaat de internationale gemeenschap hiermee om? Een studie naar het belang van de varkenslintworm in Nepal bleek hier enkele antwoorden op te bieden.

 

De varkenslintworm, Taenia solium in wetenschappelijke termen, is een parasiet die in België al enige decennia verdwenen en vergeten is, maar in ontwikkelingslanden nog steeds voor problemen zorgt. De volwassen lintworm, die tot vier meter lang kan worden, leeft in de darm van de mens, die wordt besmet door het eten van onvoldoende verhit varkensvlees. In tegenstelling tot de runderlintworm, die bij ons wel nog voorkomt, kunnen de eitjes van de varkenslintworm ook rechtstreeks mensen besmetten en verder uitgroeien tot blaasvormige larven in de hersenen. Het is dan dat het belang van deze parasiet duidelijk wordt: epilepsie en obstructie van de hersenholten zijn namelijk courante verschijnselen van deze “hersenworm”.

 

Armoede en onderontwikkeling spelen een belangrijke rol bij het in stand houden van de varkenslintworm. Enkel wanneer varkens vrije toegang hebben tot de uitwerpselen van lintwormdragers, kan de levenscyclus worden voltooid. Een gebrek aan adequate sanitaire voorzieningen en een primitieve manier van varkenshouderij zijn dan ook de belangrijkste redenen waarom vele ontwikkelingslanden nog steeds te kampen hebben met deze parasiet.

 

Een studie in Nepal toont echter aan dat de realiteit complexer is. Hoewel Nepal beschreven wordt als een van de armste en minst ontwikkelde landen van Azië, blijkt er binnen het land een grote ongelijkheid te bestaan tussen de verschillende bevolkingsgroepen. Het kastenstelsel heeft er van oudsher voor gezorgd dat vooral de hogere kasten meer kansen kregen om zich te ontwikkelen, ten nadele van de lagere kasten en kastelozen, die tot op vandaag achterblijven qua opleidingsniveau en tewerkstelling. Dit heeft ook gevolgen op het vlak van hun gezondheid, wat goed geïllustreerd wordt door deze lintworm. Het zijn namelijk net deze laagste kasten die moeite hebben om de primitieve manier van leven achter zich te laten, waardoor zij een duidelijk hoger risico lopen op deze parasiet. Een van de gevolgen van de hersenworm, epilepsie, wordt daarenboven nog al te vaak beschouwd als een bovennatuurlijke aandoening, waardoor de sociale status en de mogelijkheden tot verdere ontwikkeling van deze mensen alleen maar afnemen.

 

Het belang van de varkenslintworm is de internationale gemeenschap niet ontgaan. Een van de programma’s van de Wereldgezondheidsorganisatie richt zich op het in kaart brengen van de gezondheidsimpact van ruim honderd ziekten en aandoeningen, wereldwijd. Hiervoor wordt voornamelijk gebruik gemaakt van ziekenhuisgegevens, en net hier wringt het schoentje. Het zijn namelijk vooral de meer ontwikkelde bevolkingsgroepen die de middelen hebben om de ziekenhuiskosten te betalen, waardoor de aandoeningen die vooral bij de lagere kastengroepen voorkomen, opnieuw uit de boot vallen.

 

Het verhaal van de varkenslintworm illustreert goed hoe belangrijk de ongelijkheid binnen een land is voor de algemene ontwikkeling ervan en hoe de huidige systemen er niet steeds in slagen om de vicieuze cirkel van armoede en ongelijkheid te doorbreken. Nu blijft alleen de vraag of de stem van België gehoord zal worden en of er in de toekomst effectief niemand nog over het hoofd gezien zal worden.

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Universiteit of Hogeschool
Diergeneeskunde
Publicatiejaar
2010
Kernwoorden
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