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Chege B, Ndambuki G, Owiny M, Kiyong’a A, Fèvre EM, Cook EAJ. Improved latrine coverage may reduce porcine cysticercosis: a comparative cross-sectional study, Busia County, Kenya 2021. Front Vet Sci 2023; 10:1155467. [PMID: 37476824 PMCID: PMC10354266 DOI: 10.3389/fvets.2023.1155467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Smallholder pig farming is an important economic activity for many poor, rural communities in developing countries. Porcine cysticercosis is a growing public health risk in countries where pig rearing is popular. A sanitation-based intervention to reduce the prevalence of open defecation was completed in Busia County, Kenya in 2016. We capitalized on this third party intervention to evaluate its impact on porcine cysticercosis prevalence. Methods We conducted a comparative cross-sectional survey from August through to September 2021. Household selection was done using multistage sampling. Household questionnaire data on pig production, transmission, risk factors and awareness of porcine cysticercosis were collected from 251 households. Lingual palpation was used to test for cysticerci in 370 pigs while serum was tested for circulating antigen using Ag-ELISA. We compared results of our survey to an effective baseline, which was a near equivalent cross sectional survey conducted in 2012 before the third party sanitary intervention was established. The difference in prevalence was measured using Chi-square tests. Multivariable logistic regression analysis was used to identify risk factors for lingual cysts in pigs. Results The prevalence of palpable lingual cysts was estimated to be 3.8% (95% CI 2.3-6.3%) (14/370). This was 6% (95% CI 0.8-13.9%; p-value 0.0178) lower than the prevalence reported in the pre-implementation period of 9.7% (95% CI: 4.5-17.6%). Circulating antigen was detected in 2 samples (0.54%, 95% CI: 0.2-1.9). Latrine coverage was 86% (95% CI: 81-90%), which was 11% (95% CI: 4.8-16.8%; p < 0.001) higher than the pre-implementation period coverage of 75% (95% CI: 71-79%). There was reduced prevalence of lingual cysts in pigs from households that had a latrine (OR = 0.14; 95% CI: 0.05-0.43; p < 0.001) and where pigs were confined or tethered (OR = 0.27; 95% CI: 0.07-1.02; p = 0.053). Conclusion There was a reduction in the prevalence of porcine cysticercosis in Busia County over the study period from 2012 to 2021. This was not a trial design so we are unable to directly link the decline to a specific cause, but the data are consistent with previous research indicating that improved sanitation reduces porcine cysticercosis. Programs for controlling porcine cysticercosis should include a focus on sanitation in addition to other integrated One Health approaches.
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Affiliation(s)
- Bernard Chege
- Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, Kenya
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Gideon Ndambuki
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Maurice Owiny
- Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, Kenya
| | - Alice Kiyong’a
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute (ILRI), Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Dermauw V, Van De Vijver E, Dorny P, Giorgi E, Ganaba R, Millogo A, Tarnagda Z, Cissé AK, Carabin H. Geostatistical analysis of active human cysticercosis: Results of a large-scale study in 60 villages in Burkina Faso. PLoS Negl Trop Dis 2023; 17:e0011437. [PMID: 37494329 PMCID: PMC10370738 DOI: 10.1371/journal.pntd.0011437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 06/06/2023] [Indexed: 07/28/2023] Open
Abstract
Cysticercosis is a neglected tropical disease caused by the larval stage of the zoonotic tapeworm (Taenia solium). While there is a clear spatial component in the occurrence of the parasite, no geostatistical analysis of active human cysticercosis has been conducted yet, nor has such an analysis been conducted for Sub-Saharan Africa, albeit relevant for guiding prevention and control strategies. The goal of this study was to conduct a geostatistical analysis of active human cysticercosis, using data from the baseline cross-sectional component of a large-scale study in 60 villages in Burkina Faso. The outcome was the prevalence of active human cysticercosis (hCC), determined using the B158/B60 Ag-ELISA, while various environmental variables linked with the transmission and spread of the disease were explored as potential explanatory variables for the spatial distribution of T. solium. A generalized linear geostatistical model (GLGM) was run, and prediction maps were generated. Analyses were conducted using data generated at two levels: individual participant data and grouped village data. The best model was selected using a backward variable selection procedure and models were compared using likelihood ratio testing. The best individual-level GLGM included precipitation (increasing values were associated with an increased odds of positive test result), distance to the nearest river (decreased odds) and night land temperature (decreased odds) as predictors for active hCC, whereas the village-level GLGM only retained precipitation and distance to the nearest river. The range of spatial correlation was estimated at 45.0 [95%CI: 34.3; 57.8] meters and 28.2 [95%CI: 14.0; 56.2] km for the individual- and village-level datasets, respectively. Individual- and village-level GLGM unravelled large areas with active hCC predicted prevalence estimates of at least 4% in the south-east, the extreme south, and north-west of the study area, while patches of prevalence estimates below 2% were seen in the north and west. More research designed to analyse the spatial characteristics of hCC is needed with sampling strategies ensuring appropriate characterisation of spatial variability, and incorporating the uncertainty linked to the measurement of outcome and environmental variables in the geostatistical analysis. Trial registration: ClinicalTrials.gov; NCT0309339.
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Affiliation(s)
- Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ellen Van De Vijver
- Department of Environment, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emanuele Giorgi
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | | | - Athanase Millogo
- Centre Hospitalier Universitaire Sourô Sanou, Bobo-Dioulasso, Burkina Faso
- Université Ouagadougou, Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Zékiba Tarnagda
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Assana Kone Cissé
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Hélène Carabin
- Department of Pathology and Microbiology, University of Montreal, Montreal, Canada
- Centre de Recherche en Santé Publique (CReSP), Montreal, Canada
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
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Larkins A, Bruce M, Ash A. A Spatial Autocorrelation Method for Taenia solium Risk Mapping: The Case of Lao PDR. Trop Med Infect Dis 2023; 8:tropicalmed8040221. [PMID: 37104347 PMCID: PMC10146971 DOI: 10.3390/tropicalmed8040221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/06/2023] [Accepted: 04/09/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The World Health Organization has identified Taenia solium mapping tools as an important development for intensifying control in hyperendemic areas. Taenia solium has also been identified as a priority by the Lao PDR government. There is a limited understanding of the distribution of T. solium due to inherent diagnostic challenges. METHOD Global and local autocorrelation statistics were applied to available risk factor data sourced from national censuses to map the risk of Taenia solium in Lao PDR. RESULTS Approximately 50% of villages could be considered hot spots for one or more risk factors. Different risk factor hot spots co-occurred in 30% of villages. Twenty per cent of villages were classified as hot spots for the proportion of households owning pigs and another risk factor. Northern Lao PDR was the dominant high-risk area. This is consistent with passive reports, limited surveys, and anecdotal reports. One smaller area in southern Lao PDR was also identified as high-risk. This is of particular interest because T. solium has not previously been investigated in this area. CONCLUSIONS The methods applied provide a simple, rapid, and versatile approach that allows endemic countries to begin mapping the risk of T. solium at a sub-national level.
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Affiliation(s)
- Andrew Larkins
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, WA 6150, Australia
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, WA 6150, Australia
| | - Mieghan Bruce
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, WA 6150, Australia
- School of Veterinary Medicine, Murdoch University, Perth, WA 6150, Australia
| | - Amanda Ash
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, WA 6150, Australia
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, WA 6150, Australia
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Ahmed SA, Kotepui M, Masangkay FR, Milanez GD, Karanis P. Gastrointestinal parasites in Africa: A review. ADVANCES IN PARASITOLOGY 2023; 119:1-64. [PMID: 36707173 DOI: 10.1016/bs.apar.2022.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Data on human gastrointestinal parasites (GIP) infections in the african sub-regions and countries are mainly lacking in terms of prevalence and population stratification by afflicted age group, symptomatology, multi-parasitism, and diagnostic methods. This study aims to describe the GIP reported in african countries and discuss the extent of the burden in the african context. Only 68.42% (39/57) of african countries reported human cases of GIP with helminths (45%, CI: 40-50%, I2: 99.79%) as the predominant parasitic group infecting the african population. On a regional scale, Central Africa had the highest pooled prevalence for GIP (43%, CI: 32-54%, I2: 99.74%), while the Central African Republic led all countries with a pooled prevalence of 90% (CI: 89-92%, I2: 99.96%). The vulnerable population (patients who are minorities, children, old, poor, underfunded, or have particular medical conditions) was the most affected (50%, CI: 37-62%, I2: 99.33%), with the predominance of GIP in the 6 to <20 years age group (48%, CI: 43-54%, I2: 99.68%). Reports on multi-parasitism (44%, CI: 40-48%, I2: 99.73%) were almost double the reports of single infections (43%, CI: 27-59%, I2: 99.77%) with combined molecular and non-molecular techniques demonstrating the best performance for GIP identification. The current review spans more than 40 years of GIP reports from the african continent. Geographical characteristics, environmental factors, habits of its inhabitants, and their health status play a crucial role in GIP modulation and behaviour in its captive hosts. Strategies for regular and enhanced surveillance, policy formation, and high-level community awareness are necessary to identify the true incidence in Africa and the transmission of the pathogens via water and food.
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Affiliation(s)
- Shahira A Ahmed
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Manas Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Frederick R Masangkay
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Giovanni D Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, Cologne, Germany; University of Nicosia Medical School, Nicosia, Cyprus.
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Minani S, Devleesschauwer B, Gasogo A, Ntirandekura JB, Gabriël S, Dorny P, Trevisan C. Assessing the burden of Taenia solium cysticercosis in Burundi, 2020. BMC Infect Dis 2022; 22:851. [PMID: 36376817 PMCID: PMC9661784 DOI: 10.1186/s12879-022-07849-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Taenia solium cysticercosis is a zoonotic disease that is endemic in many low- and middle-income countries where risk factors for disease transmission are present. The economic impact of cysticercosis on public health and on the pig production sector is not well known in many of those countries, including Burundi. This study aimed at estimating the burden of T. solium cysticercosis in Burundi including data on humans and pigs. METHODS Epidemiological and economic data were collected from literature up to July 30, 2021 and governmental and non-governmental agencies. Direct and indirect costs for neurocysticercosis (NCC)-associated epilepsy and losses due to porcine cysticercosis were estimated to assess the economic burden, while the health burden was estimated using zoonotic disability-adjusted life years (zDALYs). Different probability distributions (Uniform, Beta, Dirichlet and Gamma) were applied depending on the type of epidemiological parameter. Monte Carlo simulations and 100,000 iterations were used to calculate the 95% uncertainty interval (UI) for each parameter and perform sensitivity analyses. RESULTS In Burundi, 4.26 million USD (95% UI, 1,858,308-8,190,951) were estimated as economic impact due to T. solium cysticercosis in humans and pigs, of which 40.2% (95% UI, 10.3-75.1) of the total costs were due to NCC-associated epilepsy and 59.8% (95% UI, 24.9-89.7) of the losses due to porcine cysticercosis. The cost per NCC-associated epilepsy case was 72 USD (95% UI, 25-168), representing 30.8% of the GDP per capita in 2020. The probable incident cases and deaths for NCC-associated epilepsy were 9065 (95% UI, 2370-16,716) and 61 (95% UI, 16-114), respectively. More than 2 zDALYs (95% UI, 1.1-3.4) per thousand person-years was estimated, of which an average of 1.3 DALYs [0;0] (95% UI, 0.3-2.6) was due to NCC- associated epilepsy and 0.8 animal loss equivalents (ALEs) (95% UI, 0.3-1.5) due to porcine cysticercosis. CONCLUSIONS This study provides evidence of a significant burden of T. solium cysticercosis for Burundi's population. We urge policy makers to use these evidence-based results and put T. solium cysticercosis on the public health agenda of the country. This study recommends urgent action to find solutions for integrated control strategies for T. solium cysticercosis in Burundi.
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Affiliation(s)
- Salvator Minani
- Department of Biology, Faculty of Sciences, University of Burundi, Bujumbura, Burundi.
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
- Laboratory of Foodborne Parasitic Zoonoses, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Brecht Devleesschauwer
- Laboratory of Foodborne Parasitic Zoonoses, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Anastasie Gasogo
- Department of Biology, Faculty of Sciences, University of Burundi, Bujumbura, Burundi
| | - Jean-Bosco Ntirandekura
- Department of Animal Health and Productions, Faculty of Agronomy and Bio-Engineering (FABI), University of Burundi, Bujumbura, Burundi
| | - Sarah Gabriël
- Laboratory of Foodborne Parasitic Zoonoses, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
- Laboratory of Foodborne Parasitic Zoonoses, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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Larkins A, Bruce M, Di Bari C, Devleesschauwer B, Pigott DM, Ash A. A scoping review of burden of disease studies estimating disability-adjusted life years due to Taenia solium. PLoS Negl Trop Dis 2022; 16:e0010567. [PMID: 35793356 PMCID: PMC9292123 DOI: 10.1371/journal.pntd.0010567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/18/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Taenia solium is the most significant global foodborne parasite and the leading cause of preventable human epilepsy in low and middle-income countries in the form of neurocysticercosis.
Objectives
This scoping review aimed to examine the methodology of peer-reviewed studies that estimate the burden of T. solium using disability-adjusted life years.
Eligibility criteria
Studies must have calculated disability-adjusted life years relating to T. solium.
Charting methods
The review process was managed by a single reviewer using Rayyan. Published data relating to disease models, data sources, disability-adjusted life years, sensitivity, uncertainty, missing data, and key limitations were collected.
Results
15 studies were included for review, with seven global and eight national or sub-national estimates. Studies primarily employed attributional disease models that relied on measuring the occurrence of epilepsy before applying an attributable fraction to estimate the occurrence of neurocysticercosis-associated epilepsy. This method relies heavily on the extrapolation of observational studies across populations and time periods; however, it is currently required due to the difficulties in diagnosing neurocysticercosis. Studies discussed that a lack of data was a key limitation and their results likely underestimate the true burden of T. solium. Methods to calculate disability-adjusted life years varied across studies with differences in approaches to time discounting, age weighting, years of life lost, and years of life lived with disability. Such differences limit the ability to compare estimates between studies.
Conclusions
This review illustrates the complexities associated with T. solium burden of disease studies and highlights the potential need for a burden of disease reporting framework. The burden of T. solium is likely underestimated due to the challenges in diagnosing neurocysticercosis and a lack of available data. Advancement in diagnostics, further observational studies, and new approaches to parameterising disease models are required if estimates are to improve.
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Affiliation(s)
- Andrew Larkins
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
- School of Veterinary Medicine, Murdoch University, Perth, Australia
- * E-mail:
| | - Mieghan Bruce
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Carlotta Di Bari
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Brecht Devleesschauwer
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - David M. Pigott
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Amanda Ash
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
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Foodborne Parasitic Diseases in the Neotropics - A Review. Helminthologia 2021; 58:119-133. [PMID: 34248373 PMCID: PMC8256457 DOI: 10.2478/helm-2021-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
Within the Universal Declaration of Human Rights, it is stated that everyone has the right to an adequate standard of living, which ensures, as well as their family, health and well-being, and food, thereby ensuring adequate nutrition. One of the major threats to overcome this is to ensure food security, which becomes particularly challenging in developing countries due to the high incidence of parasitic diseases. The World Health Organization (WHO), considers it one of the main causes of morbidity, closely linked to poverty and related to inadequate personal hygiene, consumption of raw food, lack of sanitary services, limited access to drinking water and fecal contamination in the environment. It is estimated that more than a fifth of the world’s population is infected by one or several intestinal parasites, and that in many countries of Central and South America the average percentage of infected people is 45%, being Taenia solium, Echinococcus granulosus, Toxoplasma gondii, Cryptosporidium spp, Entamoeba histolytica, Trichinella spiralis, Ascaris spp, Trypanosoma cruzi and Fasciola hepatica some of the most important ones in the neotropics. One of the main reasons why these diseases are diffi cult to control is t he ignorance of their lifecycles, as well as symptoms and current epidemiology of the disease, which contributes to a late or erroneous diagnosis. The present work aims to discuss and make public the current knowledge as well as the general characteristics of these diseases to the general audience.
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Kayuni EN. Socio-economic and health costs of porcine/human cysticercosis, neurocysticercosis and epilepsy to small-scale pig producers in Tanzania. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2021; 45:217. [PMID: 34924747 PMCID: PMC8669219 DOI: 10.1186/s42269-021-00676-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/29/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Porcine cysticercosis, human cysticercosis, neurocysticercosis, and epilepsy pose a serious public health risk and lead to economic losses to the small-scale pig farmers in Tanzania's rural areas. It also resulted in lowering the pig's prices, high treatment expenses, lower labour productivity, and social discrimination. In Tanzania, small-scale pig producers are unaware of the methods that are used to manage and prevent the diseases associated with Taenia solium. MAIN BODY The main goal of the reviewed article was to investigate the socio-economic and health costs of porcine/human cysticercosis, neurocysticercosis, and epilepsy on small-scale pig producers in Tanzania. Several search engines yielded 80 peer-reviewed publications, 44 of which were considered to be relevant to the study. Taenia solium cysticercosis has been reported to cause huge financial losses in the management of pigs posing a burden in terms of vaccination and treatment. CONCLUSION The information on porcine/human cysticercosis, neurocysticercosis, and epilepsy is still insufficient in Tanzania. Poor habits, negative perceptions, and attitudes are the result of this misinformation. This review suggests that health education should be emphasized as one of the intervention methods for eliminating all forms of cysticercosis and epilepsy in Tanzania to promote and increase awareness about all forms of cysticercosis and epilepsy in rural areas.
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Affiliation(s)
- Emmanuel Nestory Kayuni
- Faculty of Science, Department of Biological Sciences, Mkwawa University College of Education (MUCE), Iringa, Tanzania
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