Abstract
Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people’s approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective.
Highlights
Taenia solium taeniosis/cysticercosis is an important neglected parasitic zoonosis prevailing in many developing countries
By assessing the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia, we found that more than health, seeking privacy underlies motivation to use latrines or not
The adult tapeworm lives in the intestines of humans, causing taeniosis, while the metacestode larval stage usually develops in pigs following the ingestion of eggs excreted with the stool of tapeworm carriers, causing cysticercosis
Summary
Taenia solium taeniosis/cysticercosis is an important neglected parasitic zoonosis prevailing in many developing countries. NCC is the most important parasitic neurological infection, to which almost 30% of acquired epilepsy cases are attributed in endemic areas [2]. Many sanitation projects, implemented by governments or NGOs, which led to the construction of latrines in rural areas, faced refusal of the communities to use them and adopt safe hygienic practices [9,10,11] because the drives to motivate latrine adoption were often not identified and interpreted in messages and strategies to promote sanitation grounded in a given cultural context [12]. In many African rural communities, open defecation practices were not adequately analyzed or taken into account before project formulation and implementation. Practicing open air defecation is linked to the presence or absence of water or latrines, and to social and cultural determinants [13]
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