title: Control of Taenia solium taeniasis/cysticercosis: The best way forward for sub-Saharan Africa?
abstract: Taenia solium taeniasis/cysticercosis is a neglected parasitic zoonosis with significant economic and public health impacts. Control measures can be broadly grouped into community health education, improvements in hygiene and sanitary conditions, proper meat handling at household and community level, improved standards of meat inspection, pig management, treatment of individual patients and possibly human populations, and treatment and/or vaccination of porcine populations. This manuscript looks critically into currently existing control options and provides suggestions on which (combination of) tools would be most effective in the control of T. solium taeniasis/cysticercosis in sub-Saharan Africa. Field data and disease transmission simulations suggest that implementation of a single intervention control strategy will not lead to a satisfactory reduction of disease morbidity or transmission. A feasible strategy to combat T. solium taeniasis/cysticercosis would include a combination of approaches focussing on both human (health education and treatment) and animal host (management, treatment and vaccination), which can vary for different communities and different geographical locations. Selection of the specific strategy depends on cost-effectiveness analyses based on solid field data, currently unavailable, though urgently needed; as well as on health priorities and resources of the country. A One Health approach involving medical, veterinary, environmental and social sectors is essential for T. solium to be controlled and eventually eliminated. Finally the success of any intervention is largely dependent on the level of societal and political acceptance, commitment and engagement.
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: sgabriel@itg.be.
authors.forename: S
authors.initials: S
authors.lastname: Gabriël
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium; Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Dorny
authors.affiliation: School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
authors.forename: K E
authors.initials: KE
authors.lastname: Mwape
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Trevisan
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
authors.forename: U C
authors.initials: UC
authors.lastname: Braae
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Magnussen
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Thys
authors.affiliation: School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
authors.forename: C
authors.initials: C
authors.lastname: Bulaya
authors.affiliation: School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
authors.forename: I K
authors.initials: IK
authors.lastname: Phiri
authors.affiliation: School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
authors.forename: C S
authors.initials: CS
authors.lastname: Sikasunge
authors.affiliation: School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
authors.forename: C
authors.initials: C
authors.lastname: Makungu
authors.affiliation: Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique.
authors.forename: S
authors.initials: S
authors.lastname: Afonso
authors.affiliation: Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique.
authors.forename: Q
authors.initials: Q
authors.lastname: Nicolau
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
authors.forename: M V
authors.initials: MV
authors.lastname: Johansen
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D003551:Cysticercosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008460:Meat / Q000469:parasitology*; D008875:Middle Aged; D011634:Public Health; D034421:Sus scrofa / Q000469:parasitology; D013552:Swine; D013553:Swine Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D041201:Taenia solium / Q000187:drug effects*; D013622:Taeniasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D014611:Vaccination; D055815:Young Adult; D015047:Zoonoses / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000871:Anthelmintics
keywords: Control; One health; Sub-Saharan africa; Taenia solium