Abstract
Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA) of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. “Track-and-treat” of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤15) from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8%) was significantly lower (p=0.031, OR 0.40, CI: 0.17–0.89), compared to baseline (4.1%). The prevalence of porcine cysticercosis (8%) had also dropped significantly (p=0.002, OR 0.49, CI: 0.32–0.76) in this district compared to baseline (13%), whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with ‘track-and-treat’ contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on adults in treated areas as well as reducing the prevalence of T. solium in the intermediate pig host population. Elimination of T. solium in this area would require a One Health approach.
Highlights
The zoonotic tapeworm Taenia solium is prevalent throughout sub-Saharan Africa (Braae et al, 2015c), and constitutes a serious, but preventable, agricultural and public health problem
This study aimed to investigate the impact of a school based National Schistosomiasis Control Programme (NSCP) on taeniosis and porcine cysticercosis by assessing the effect of repeated rounds of praziquantel Mass drug administration (MDA) at 40 mg/kg in combination with treatment of taeniosis cases identified during the study, in two areas co-endemic for T. solium taeniosis/cysticercosis and schistosomiasis
1501b 43 57 1076 425 7 (0.5) 4 (0.4) 3 (0.7). This is the first study to assess the impact of control programmes targeting schistosomiasis on T. solium taeniosis/cysticercosis measured using both human and porcine outcome variables
Summary
The zoonotic tapeworm Taenia solium is prevalent throughout sub-Saharan Africa (Braae et al, 2015c), and constitutes a serious, but preventable, agricultural and public health problem. In 1993 T. solium taeniosis/cysticercosis was declared eradicable by the International Task Force on Disease Eradication (ITFDE), but to date no large-scale control programmes have been implemented in sub-Saharan Africa. Due to the zoonotic properties of T. solium, a cross-disciplinary One Health approach involving both the agricultural sector and the human health sector, targeting both human and porcine hosts is likely to be essential to eliminate the parasite. Schistosomiasis is found throughout sub-Saharan Africa and co-endemic in many areas with T. solium taeniosis/cysticercosis (Braae et al, 2015c). National scale control programmes targeting schistosomiasis have been implemented in over 30 African countries. In Tanzania the National Schistosomiasis Control Programme (NSCP) carries out school based MDA with praziquantel at 40 mg/kg. Therefor there is potential for MDA using praziquantel on both helminth species
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