Demand for Taenia solium Cysticercosis Vaccine: Lessons and Insights From the Pig Production and Trading Nodes of the Uganda Pig Value Chain

Gender considerations in One Health: a framework for researchers

One Health research and intervention outcomes are strongly influenced by gender dynamics. Women, men, girls, and boys can be negatively affected by gender-based disadvantage in any of the three One Health domains (animal, human, and environmental health), and where this occurs in more than one domain the result may be a compounding of inequity. Evidence worldwide shows that women and girls are more likely to suffer from such gender-based disadvantage. A thoughtfully implemented One Health intervention that prioritizes gender equity is more likely to be adopted, has fewer unintended negative consequences, and can support progress toward gender equality, however there is limited evidence and discussion to guide using a gender lens in One Health activities. We propose a framework to identify key gender considerations in One Health research for development - with a focus on Low-and Middle-Income Countries. The framework encourages developing two types of research questions at multiple stages of the research process: those with a bioscience entry-point and those with a gender entry-point. Gender considerations at each stage of research, institutional support required, and intervention approaches is described in the framework. We also give an applied example of the framework as it might be used in One Health research. Incorporation of gender questions in One Health research supports progress toward more equitable, sustainable, and effective One Health interventions. We hope that this framework will be implemented and optimized for use across many One Health challenge areas with the goal of mainstreaming gender into One Health research.

Insights into the diagnosis, vaccines, and control of Taenia solium, a zoonotic, neglected parasite

Taenia solium taeniasis/cysticercosis (TSTC) is a foodborne, zoonotic neglected tropical disease affecting predominately low- and middle-income countries. Humans are definitive hosts for T. solium, whereas pigs act as intermediate hosts. Taeniasis, i.e. intestinal infection with adult T. solium in the human host, occurs through ingestion of undercooked pork infected with the larval stage (porcine cysticercosis, PCC). Human cysticercosis occurs after humans ingest T. solium eggs, acting as accidental intermediate hosts. Migration of cysticerci to the human brain results in neurocysticercosis (NCC), manifesting in a variety of clinical symptoms, most notably epilepsy. NCC is the leading cause of acquired epilepsy cases in endemic areas. PCC results in reduced pork value because of condemnation or the risk of condemnation of the meat. Available serological diagnostic tests for porcine and human cysticercosis are characterized by low sensitivity and are not cost-effective. An effective vaccine for T. solium cysticercosis in pigs has been developed, although it is not yet commercially available in all endemic countries, and still no vaccine is available for use in humans. This primer highlights the recent development in the field of diagnostic tests and vaccine production and explores possible strategies for future control and eradication of T. solium. In the absence of highly specific diagnostic tests and human vaccines, treatment of infected pigs and tapeworm carriers and prevention of disease transmission remain the principal means to interrupt the zoonotic cycle of T. solium in endemic countries.

Stakeholders' Knowledge, Attitude, and Perceptions on the Control of Taenia solium in Kamuli and Hoima Districts, Uganda

Taenia (T.) solium is a zoonotic parasite causing three diseases: Taeniasis and cysticercosis in humans and porcine cysticercosis in pigs. Although biomedically, the transmission of the parasite can be easily interrupted at six points along the life cycle, the contextual factors that may influence the adoption of these control strategies in Uganda remain unclear. This study assessed the stakeholders' knowledge, attitudes, and perceptions relating to the six control strategies for T. solium infections in Kamuli and Hoima districts, Uganda. A total of 22 focus group discussions (FGD) were conducted with pig farmers, community leaders, pig/pork traders, animal health assistants, and human health assistants. In addition, nine key informant interviews were held with senior officials in the ministries of agriculture and health and other relevant agencies at the district level. The results showed differential, limited, and fragmented knowledge on T. solium infections among stakeholders. Pig farmers, community leaders, and pig/pork traders had almost no knowledge and were often confused regarding the differences existing between T. solium and other gastro-intestinal infections in pigs and humans. Pig confinement, pit latrine construction, coverage, maintenance, and sustained use are influenced by cultural, socio-economic, and physical/ environmental factors of the study population and area. Proper sensitisation programmes and health education interventions should target all, but with appropriately focused material to suit the different stakeholder categories. Reminders or nudges may be needed to ensure that increase in knowledge translates to changes in practise. Intervention programmes should also aim to overcome challenges created by the various contextual factors operating in the specific endemic areas.

Maximising Societal Benefit From the Control of Neglected Zoonoses: Identifying Synergies and Trade-Offs in the Control of Taenia solium

Interventions to control or eradicate neglected zoonoses are generally paid for through the public purse and when these interventions focus on the animal hosts, they are often expected to be performed and financed through the state veterinary service. The benefits of control, however, accrue across the human, animal, and environmental spaces and enhance both public and private interests. Additionally, disease control interventions do not take place in a vacuum and the indirect impacts of our actions should also be considered if the societal benefit of interventions is to be maximised. With the caveat that unintended consequences can and will occur, pre-identifying potential synergies and trade-offs in our disease control initiatives allows for them to be considered in intervention design and monitored during programme roll-out. In this paper, using a One Health approach with the example of Taenia solium control, we identify potential indirect impacts which may arise and how these may influence both our choice of intervention and opportunities to optimise the animal, environmental, and societal benefits of control through maximising synergies and minimising trade-offs.