Background Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania.Methods and FindingsA cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0.05).ConclusionThe present study indicates T. solium infection in humans is highly endemic in the southern highlands of Tanzania.

BACKGROUND Ulanga, an onchocerciasis-endemic district in Tanzania, has received preventive chemotherapy for onchocerciasis by community-directed treatment with ivermectin (CDTI). With CDTI, interruption of transmission could occur after 14-17 years, yet transmission persists even after 20 years. This may be due to high baseline endemicity and other factors that can lower coverage of CDTI, including poor knowledge of the disease and negative attitudes and perceptions towards CDTI. This study examined community knowledge, attitudes and perceptions towards onchocerciasis control and acceptability of the CDTI program in Ulanga. METHODS A mixed methods cross-sectional study was carried out from June to July 2018. A quantitative questionnaire was administered to 422 household members in the community. This was complemented with qualitative in-depth interviews and focus group discussions. RESULTS A majority (94.1%) of community members had heard of onchocerciasis. Only 15.4% had a high level of knowledge about onchocerciasis; about half (49.2%) had a low level of knowledge on the disease and CDTI. Negative attitudes and perceptions towards CDTI prevailed in nearly half of participants (46.2% and 44%, respectively). A majority (83.4%) of respondents agreed that they will take ivermectin, and 74.4% were willing to comply with treatment for 12 to 15 years to eliminate onchocerciasis. In focus group discussions, participants reported mistrust of the method of dose calculation, that affects the acceptability and use of ivermectin treatment. CONCLUSION Inadequate levels of knowledge, negative attitudes and perceptions have the potential to affect participation in CDTI. This may result in continual transmission of onchocerciasis.