Abstract
The tapeworm Taenia solium is the parasite responsible for neurocysticercosis, a neglected tropical disease of public health importance, thought to cause approximately 1/3 of epilepsy cases across endemic regions. The consumption of undercooked infected pork perpetuates the parasite’s life-cycle through the establishment of adult tapeworm infections in the community. Reducing the risk associated with pork consumption in the developing world is therefore a public health priority. The aim of this study was to estimate the risk of any one pork meal in western Kenya containing a potentially infective T. solium cysticercus at the point of consumption, an aspect of the parasite transmission that has not been estimated before. To estimate this, we used a quantitative food chain risk assessment model built in the @RISK add-on to Microsoft Excel. This model indicates that any one pork meal consumed in western Kenya has a 0.006 (99% Uncertainty Interval (U.I). 0.0002–0.0164) probability of containing at least one viable T. solium cysticercus at the point of consumption and therefore being potentially infectious to humans. This equates to 22,282 (99% U.I. 622–64,134) potentially infective pork meals consumed in the course of one year within Busia District alone. This model indicates a high risk of T. solium infection associated with pork consumption in western Kenya and the work presented here can be built upon to investigate the efficacy of various mitigation strategies for this locality.
Highlights
The zoonotic tapeworm Taenia solium, has a two host life cycle, with humans as the definitive host, and pigs as an intermediate host
The work presented in this paper aimed to understand what the risk is of acquiring T. solium taeniosis from pork slaughtered and consumed in western Kenya
In order to do this we built a stochastic risk assessment model to investigate the safety of pork reaching the consumer in terms of the risk of having viable T. solium cysts in any one portion of meat consumed
Summary
The zoonotic tapeworm Taenia solium, has a two host life cycle, with humans as the definitive host, and pigs as an intermediate host. Gravid proglottids, containing thousands of infective eggs, detach from the adult tapeworm and are excreted in faeces in an intermittent fashion [1]. Ingestion of these eggs, by either pigs or humans, results in the larval stage penetrating the intestinal wall, moving through the lymph and blood vessels to encyst in muscle, eyes or the central nervous system (CNS) as cysticerci [2]. A recent metaanalysis estimated the overall prevalence of circulating T. solium antigens in humans of 7.30% (95% CI [4.23–12.31]) for sub-Saharan Africa [6] and it has been estimated that 0.95–3.08 million people in sub-Saharan Africa may suffer from NCC-related epilepsy [7]
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