title: A health-education intervention trial to reduce porcine cysticercosis in Mbulu District, Tanzania.
abstract: We conducted a randomised community controlled trial to estimate the effectiveness of health and pig-management education intervention in reducing the incidence rate of porcine cysticercosis caused by Taenia solium in Mbulu District, northern Tanzania, between April 2002 and July 2004. We included a random sample of 827 pig-keeping households from 42 randomly selected villages in our 27-month study. We collected baseline data on the prevalence of porcine cysticercosis based on lingual examination of live pigs, and pig-management and sanitation knowledge and practices based on questionnaire interviews and observations. We allocated 21 of the villages to the health-education intervention, developed with community participation; we used stratified randomisation to balance the village-level baseline prevalence of porcine cysticercosis. From July 2003 to March 2004 following the intervention, we gave each participant household a sentinel piglet to raise (the timing was balanced between the intervention groups). Knowledge about the transmission and prevention of porcine cysticercosis was improved >42% in both groups when measured 10-12 months post-intervention. There was no improvement in observed practices in either group throughout the study period. However, the intervention had a significant reduction in the reported cases of household consumption of infected pork (a reduction by 20%). The intervention was associated with a considerable decrease in the incidence rate of porcine cysticercosis (incidence rate ratio 0.57) as measured by antigen-ELISA in sentinel pigs. Public education could lead to a reduction of the risk of infection in humans.
authors.affiliation: Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania. h_ngowi@yahoo.com
authors.forename: H A
authors.initials: HA
authors.lastname: Ngowi
authors.forename: H
authors.initials: H
authors.lastname: Carabin
authors.forename: A A
authors.initials: AA
authors.lastname: Kassuku
authors.forename: M R S
authors.initials: MR
authors.lastname: Mlozi
authors.forename: J E D
authors.initials: JE
authors.lastname: Mlangwa
authors.forename: A L
authors.initials: AL
authors.lastname: Willingham
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D000947:Antigens, Helminth / Q000097:blood; D001499:Bayes Theorem; D003430:Cross-Sectional Studies; D003551:Cysticercosis / Q000453:epidemiology / Q000517:prevention & control / Q000662:veterinary*; D003552:Cysticercus / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D011795:Surveys and Questionnaires; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology / Q000517:prevention & control*; D041201:Taenia solium / Q000276:immunology; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000947:Antigens, Helminth