The control of human (neuro)cysticercosis: which way forward?

Abstract

Taenia solium cysticercosis, and its public health and economic consequences, appears to be a growing problem in poor areas of Africa, Asia and Latin America where people eat pork and traditional pig husbandry is practiced (and expanding). Its burden is counted in terms of human disease (mainly neurocysticercosis related epilepsy) and economic losses, in a context of both commercial and traditional subsistence pig farming. Although substantial fragmentary information seems to be available from local settings, national and global burdens due to T. solium cysticercosis are still to be comprehensively assessed. With regard to control, several strategies have been checked out at a small or medium scale and have proven to be successful. Yet, no intervention programmes have been implemented so far at the national level with proven success. Although T. solium cysticercosis is considered to be a potentially eradicable disease, there is no evidence yet that it is feasible and recommendable to envisage this within a reasonable time frame. However, it appears realistic to aim for the rapid definition of a simple package of interventions, which can routinely be carried out by existing services and structures, and will give an optimal, long-term return in terms of burden relief. Also, a number of international initiatives and opportunities currently exist in which a more pro-active attitude towards the control of T. solium cysticercosis can be integrated and promoted. Commitment of both national and local authorities to control the disease needs to be convincingly solicited and, as for most zoonotic diseases, an interdisciplinary approach is essential.