Taenia solium Taeniasis and Cysticercosis Control and Elimination Through Community-Based Interventions

Abstract

Taenia solium was declared potentially eradicable by the International Task Force for Disease Eradication in 1992. Yet, very few well-designed community-based randomized controlled trials have been conducted to measure the effectiveness of alternative control strategies. Most strategies have been tested in pre-post intervention designs in very few communities, often without a control group. The only two community-based randomized controlled trials suggest that an educational program alone or a combination of human and porcine mass treatment reduce porcine cysticercosis in the short term. A transmission dynamics model suggests that improved sanitation and pig management are more effective and sustainable than pig vaccination, human or porcine mass treatment. Current evidence does not support the eradication of Taenia solium in the foreseeable future. Investigators should follow international recommendations on the conduct of community-based randomized control trials to provide more valid estimates of the effect and cost-effectiveness of alternative control strategies for cysticercosis.

Taenia solium Taeniasis and Cysticercosis in Southeast Asia

“…A recent study searched all published literature and analyzed the effectiveness of community-based control strategies, employing either a single or a combination of multiple interventions that used pre-and post-intervention designs. 6 Unfortunately, it found paucity of high-quality data to definitively support any form of intervention. Available data from only two communitybased randomized controlled trials suggested that education program alone or a combination of porcine and human mass treatment reduce porcine cysticercosis only in the short term.…”

“…6,80 In addition, there has been no pig vaccine trial in SEA to date and sustainability of vaccination in resource-limited settings is also questionable. A theoretical transmission dynamics modeling suggested that improved sanitation and pig management are more effective than vaccination, human or porcine mass treatment.…”

“…5 Since this declaration, several pilot programs on case detection and management of taeniasis/cysticercosis have emerged in many countries worldwide, but all with varying success rates. 6 However, taking into account the definitions proposed by Molyneux and others 7 where "eradication" is defined as the permanent reduction to zero of the worldwide incidence of infection, current available evidence suggests that eradication of T. solium remains far from possible in a foreseeable future. 6 Nevertheless, in 2013, IFTDE reaffirmed their opinion regarding the eradicability of T. solium, putting forth further key recommendations to interrupt the parasite life cycle and disease transmission.…”

“…6 However, taking into account the definitions proposed by Molyneux and others 7 where "eradication" is defined as the permanent reduction to zero of the worldwide incidence of infection, current available evidence suggests that eradication of T. solium remains far from possible in a foreseeable future. 6 Nevertheless, in 2013, IFTDE reaffirmed their opinion regarding the eradicability of T. solium, putting forth further key recommendations to interrupt the parasite life cycle and disease transmission. 8 In southeast Asia (SEA), taeniasis/cysticercosis is moderately endemic and has been identified as one of the major NTDs afflicting the region.…”

Preliminary assessment of the computer‐based Taenia solium educational program ‘The Vicious Worm’ on knowledge uptake in primary school students in rural areas in eastern Zambia

“…Effective T. solium control tools include anthelmintics and pig vaccines, and non-specific measures such as improvements to sanitation and the corralling of pigs. Several studies trialling one or more control strategies in endemic communities successfully reduced disease prevalence and incidence in the short term [4][5][6][7][8][9][10]; however, sustained long-term interruption of parasite transmission has not been achieved to date.…”