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We report a case of autochthonous Taenia saginata infection in Timor-Leste. Screening of 1,121 schoolchildren revealed a 0.4% prevalence of human taeniasis. Genetic analysis of the mitochondrial cox1 gene identified group A lineage. Our findings fill a considerable geographic data gap and highlight the need for integrated One Health control strategies.

Taenia solium cysticercosis/taeniasis disease complex is a multifaceted neglected tropical zoonosis. Previous reviews on T. solium cysticercosis/taeniasis risk factors have been limited by geographic region and/or host, making it difficult to understand the complex web of causes underlying infection at the various stages of its life cycle. Our objective was to elucidate the causal mechanisms involved in the transmission of T. solium to all hosts through a systematic review of the literature. We conducted a systematic literature search about the epidemiology of T. solium infection published before May 2020 (OpenScience protocol https://doi.org/10.17605/OSF.IO/U64K3). We searched PubMed, Web of Science, and CABAbstracts, and reference lists of systematic reviews identified in our searches for relevant studies meeting the inclusion criteria: i) describing a risk factor-outcome association related to T. solium infection, and ii) published in English, French, Spanish, or Portuguese. Qualitative or quantitative epidemiologic associations were extracted and evaluated according to a modified version of the Quality Assessment Tool for Quantitative Studies. Our review is reported according the PRISMA guidelines. We extracted 876 associations from 159 studies. Risk factors of human cysticercosis are well-studied, while taeniasis is least-studied (10% of associations). The evidence suggests that male gender is a risk factor for human cysticercosis while female sex is a risk factor for porcine cysticercosis. The direction of association did not differ according to the quality of the studies across most studied risk factors. Our rigorous systematic review is the first to consider risk factors of human and porcine T. solium disease simultaneously, allowing a synthesis of information from both hosts in order to elucidate causal mechanisms for risk factors of cysticercosis. Our work also highlights areas of T. solium epidemiology which are understudied, such as the causal mechanisms of taeniasis.

Taenia solium is responsible for a substantial global disease burden in pig-raising and pork-consuming regions of the developing world. The study assessed the reported spatial pattern of Taenia solium taeniosis and cysticercosis (TSTC) in Kenya, with the focus on risk mapping of TSTC in Busia County. The study employed a mixed approach, incorporating routinely collected data and open-source resources. A literature review and collection of pig population data were used to map the TSTC and pig population distribution at the national level. In Busia County, the retrospective study retrieved reports on porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) from hospitals and meat inspection records. The cross-sectional study assessed risk behaviors associated with TSTC in Busia County. The TSTC reports and proportions of porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) were aggregated at the county and sub-county levels and visualized using QGIS. In addition, the World Health Organization's (WHO's) T. solium mapping tool was employed for risk mapping T. solium in Busia County. The pig population data showed a linear growth trend, with a higher population reported in Central and Western Kenya. A systematic search of the literature yielded a total of fourteen research reports, with the reported cases ranging from 1.8% to 49.9% for porcine cysticercosis, 1.6% to 31.1% for human cysticercosis, and 0.18% to 19.9% for T. solium taeniosis, respectively. The retrospective data showed cases of porcine cysticercosis and epilepsy (as a proxy indicator of neurocysticercosis) in all sub-counties of Busia. The WHO risk mapping tool categorized Bunyala, Teso South, Nambale, and Butula sub-counties as high-risk areas. The questionnaire survey highlighted semi-confinement as the predominant pig husbandry practice (61.1%), with 32% of pigs having access to sewage, and there was poor community awareness about TSTC in Busia County. The study indicated the presence of TSTC transmission in Western Kenya and identified Busia County as a high-risk area based on multiple layers of evidence. This mixed approach utilized readily available data to generate new evidence that could support sustainable One Health strategies for interrupting the T. solium transmission cycle.

Background Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. Methods We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. Results Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata , although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002–7.82%. Conclusions Detection and reporting of taeniosis in western Europe should be improved. The existence of T. solium tapeworm carriers, of suspected autochthonous cases of human cysticercosis and the lack of confirmation of porcine cysticercosis cases deserve further attention. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniosis and human cysticercosis should be notifiable and surveillance in animals should be improved.

Cysticercosis in humans caused by the parasite Taenia solium is one of the World Health Organization’s Neglected Tropical Diseases. The parasite is transmitted between the human host and pigs. Efforts to prevent the disease have relied mainly on treatment of people with anthelmintics. However, to date, there is no practical and effective control method that has been delivered as a public health program. Here we describe a large-scale, minimum inputs T. solium control program implemented as a public health program in Madagascar. Initially all pigs were vaccinated for porcine cysticercosis and medicated with oxfendazole, after which only young piglets and pigs imported into the program area were targeted for interventions. After piglet interventions were in place and on-going, a single mass drug administration (MDA) was delivered to the human population with a taeniacide. The outcomes were assessed one year after the human treatment, by comparing pre-and post-intervention levels of porcine cysticercosis caused by T. solium and human T. solium taeniasis. Over a twenty-two-month period, 96,735 pig vaccinations and oxfendazole medications were delivered and during the MDA, 117,216 people received taeniacide. Ninety percent of the pig population were receiving vaccination and medication at the end of the intervention period. Coverage of the eligible human population by the MDA was 62.5%. Prior to the intervention 30.8% of slaughter-age pigs had viable T. solium infection, reduced to 8% after the program. Human taeniasis was found to be 1.25% prior to the MDA and 0.6% one year after the MDA. The program successfully demonstrated effective control of T. solium transmission to pigs using minimum inputs and delivered as a public health program. Sustained control and expansion of the program could potentially lead to the elimination of the disease being a public health problem in Madagascar.

This study presents the first detection of Taenia omissa metacestodes in guanaco ( Lama guanicoe ) within the Chilean Patagonia, marking the southernmost record of natural infection in an intermediate host on the continent. Taenia omissa was found in the continental part of the Magallanes region where the top predators are pumas ( Puma concolor ). Conversely, all metacestodes found in guanacos collected from Tierra del Fuego Island, where no pumas exist, were identified solely as Echinococcus granulosus sensu stricto . Additionally, this research highlights a tissue preference of T. omissa for liver, contrasting with E. granulosus , which predominantly affects the lungs in guanacos. We also report the infection of T . pisiformis in 1 guanaco. Our findings emphasize the need for accurate identification of metacestodes during meat inspection in an area where T. omissa and E. granulosus overlap. This research also contributes to increase the knowledge of parasite–host dynamics in wildlife and underscores the importance of considering broader spectrum intermediate hosts in the epidemiology of parasitic infections.

Background Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungwe in Tanzania. Data on KAP were collected through questionnaire-based interviews and household infrastructure observations. Results Knowledge about porcine cysticercosis was good, particularly among pig keepers across the districts. Many participants had heard about the pork tapeworm ( T. solium taeniasis), and the knowledge about signs/symptoms and treatment was fair, but the means of transmission and prevention measures were often unknown. Whilst most participants were familiar with epilepsy, no one knew anything about human cysticercosis and the link between cysticercosis and epileptic seizures. A similar trend is reflected through the attitudes toward the low risk perception of cysticercosis infection. Not surprisingly, the risk perception of the infection with the pork tapeworm was low too. Many participants reported not washing their hands before eating or after using the toilet which highlights potential risks for the development of human cysticercosis. Albeit nearly every participant reported using the toilet always, household observations revealed that toilets were either lacking or had no complete walls. Generally, household observations revealed a discrepancy between questionnaire answers on the one hand and the availability of toilet and handwashing facilities and the confinement of pigs on the other hand. Conclusion This study demonstrates knowledge gaps and adverse practices which may hinder and/or slow down the control/elimination of T. solium in endemic countries. The study results are also useful for appropriate designing of TSCT health interventions that need to be planned carefully, taking into account the local context and designing TSCT in partnership with the local communities from the beginning to the end applying a One Health approach to allow the possible sustained and best impacts. Graphical Abstract

Taeniasis and cysticercosis are parasitic infections caused by Taenia spp., mainly transmitted through the consumption of undercooked pork. Prevention requires increasing knowledge and awareness, improving meat inspection and hygiene, and promoting safe food handling and sanitation. The aim of this study was to evaluate the knowledge and practice (KP) of residents in Pak Chong District, Nakhon Ratchasima, Thailand, regarding taeniasis and cysticercosis. A cross-sectional study was conducted in Pak Chong District, Nakhon Ratchasima, Thailand, and its 11 subdistrict municipalities. Study participants were selected using a stratified random sampling design. A validated questionnaire (Cronbach's alpha = 0.70) was used to collect socio-demographic information and assess knowledge and practices related to taeniasis and cysticercosis. Descriptive statistics and multiple linear regression were used for the analysis. Of the 360 survey respondents, 65.0% (n = 234) were women, 82.2% (n = 296) were aged under 60 years, 99.2% (n = 357) identified as Buddhist, 87.5% (n = 315) had less than a bachelor's degree education level, 54.2% (n = 195) had monthly family income ≥10,000 Thai baht, 10.6% (n = 38) were unemployed, and 26.1% (n = 93) lived in a town municipality. The survey revealed that 98.3% (n = 354) of participants were categorized as having less accurate knowledge and 83.6% (n = 301) were classified as more frequently engaging in correct prevention practices. Our study revealed that pig farmers (1.7%) occasionally permitted the pigs to forage freely. The results of multiple linear regression analysis revealed that knowledge scores were positively associated with household income ≥10,000 Thai baht (βadj = 1.50, 95% confidence interval [CI] 0.65 to 2.36). Practice scores were negatively associated with age over 60 years (βadj = -1.77, 95% CI -3.14 to -0.40) and living in a subdistrict municipality (βadj = -2.58, 95% CI -3.77 to -1.39). There was no association between KP regarding taeniasis and cysticercosis in the population of Pak Chong. Overall, participants' knowledge was lacking. Public education interventions are recommended to improve knowledge among residents with low socioeconomic status. These findings can inform the development of targeted interventions and educational programs in Pak Chong District, especially among elderly people in subdistrict municipalities, to improve practices for the prevention and control of these parasitic infections.

Cysticercosis is caused by the invasion of human or pig tissues by the metacestode larval stage of Taenia solium. In Europe, the disease was endemic in the past but the autochthonous natural life cycle of the parasite is currently completed very rarely. Recently, imported cases have increased in parallel to the increased number of migrations and international travels. The lack of specific surveillance systems for cysticercosis leads to underestimation of the epidemiological and clinical impacts. To review the available data on epidemiology and management of cysticercosis in Europe. A review of literature on human cysticercosis and T. solium taeniasis in Europe published between 1990-2011 was conducted. Out of 846 cysticercosis cases described in the literature, 522 cases were autochthonous and 324 cases were imported. The majority (70.1%) of the autochthonous cases were diagnosed in Portugal from 1983 and 1994. Imported cases of which 242 (74.7%) diagnosed in migrants and 57 (17.6%) in European travellers, showed an increasing trend. Most of imported cases were acquired in Latin America (69.8% of migrants and 44.0% of travellers). The majority of imported cases were diagnosed in Spain (47.5%), France (16.7%) and Italy (8.3%). One third of neurosurgical procedures were performed because the suspected diagnosis was cerebral neoplasm. Sixty eight autochthonous and 5 imported T. solium taeniasis cases were reported. Cysticercosis remains a challenge for European care providers, since they are often poorly aware of this infection and have little familiarity in managing this disease. Cysticercosis should be included among mandatory reportable diseases, in order to improve the accuracy of epidemiological information. European health care providers might benefit from a transfer of knowledge from colleagues working in endemic areas and the development of shared diagnostic and therapeutic processes would have impact on the quality of the European health systems.

The pork tapeworm, Taenia solium , is the cause of a preventable zoonotic disease, cysticercosis, affecting both pigs and humans. Continued endemic transmission of T . solium is a major contributor of epilepsy and other neurologic morbidity, and the source of important economic losses, in many rural areas of developing countries. Simulation modelling can play an important role in aiding the design and evaluation of strategies to control or even eliminate transmission of the parasite. In this paper, we present a new agent based model of local-scale T . solium transmission and a new, non-local, approach to the model calibration to fit model outputs to observed human taeniasis and pig cysticercosis prevalence simultaneously for several endemic villages. The model fully describes all relevant aspects of T . solium transmission, including the processes of pig and human infection, the spatial distribution of human and pig populations, the production of pork for human consumption, and the movement of humans and pigs in and out in several endemic villages of the northwest of Peru. Despite the high level of uncertainty associated with the empirical measurements of epidemiological data associated with T . solium , the non-local calibrated model parametrization reproduces the observed prevalences with an acceptable precision. It does so not only for the villages used to calibrate the model, but also for villages not included in the calibration process. This important finding demonstrates that the model, including its calibrated parametrization, can be successfully transferred within an endemic region. This will enable future studies to inform the design and optimization of T . solium control interventions in villages where the calibration may be prevented by the limited amount of empirical data, expanding the possible applications to a wider range of settings compared to previous models.