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Optimal control strategies for Taenia solium taeniasis and cysticercosis have not been determined. We conducted a 2-year cluster randomized trial in Peru by assigning 23 villages to 1 of 3 geographically targeted intervention approaches. For ring screening (RS), participants living near pigs with cysticercosis were screened for taeniasis; identified cases were treated with niclosamide. In ring treatment (RT), participants living near pigs with cysticercosis received presumptive treatment with niclosamide. In mass treatment (MT), participants received niclosamide treatment every 6 months regardless of location. In each approach, half the villages received targeted or mass oxfendazole for pigs (6 total study arms). We noted significant reductions in seroincidence among pigs in all approaches (67.1% decrease in RS, 69.3% in RT, 64.7% in MT; p<0.001), despite a smaller proportion of population treated by targeted approaches (RS 1.4%, RT 19.3%, MT 88.5%). Our findings suggest multiple approaches can achieve rapid control of T. solium transmission.

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.

Experimental pigs have been used to study human Taenia solium cysticercosis and neurocysticercosis. Biomarkers such as cardiac troponin I (cTnI) have been used to study various disease states such acute myocardial infarction (AMI) and the effect these diseases have on this molecule. However, no studies have been done to establish the effect of anthelminthic treatment on cTnI in pigs with cysticercosis and the role this biomarker plays with regards to inflammation following treatment. To investigate the effect of anthelminthic treatment on cardiac troponin I (cTnI) levels in pigs naturally infected with cysticercosis. A total of 36 pigs were included in this study and were assigned to either the positive (+ve) or negative (-ve) groups based on cysticercosis infection status as determined by tongue examination and Ag-ELISA (apDIA-Belgium). Pigs in each group were then randomly assigned to either treated or not-treated (control) groups. Treatment was done using oxfendazole (OXF) at effective dose of 30mg/kg orally. Baseline serum samples were collected prior to treatment and thereafter at 24hrs, 48hrs and 72hrs post treatment. This was followed by weekly sampling up to 11 weeks post treatment. Laboratory and statistical analysis of cTnI was done using Ag-ELISA and GraphPad prism software (9.0.0 version) i.e., two-way repeated measures ANOVA, respectively. Carcass dissections were done 12 weeks post treatment, and a correlation analysis was performed to establish the relationship between cTnI concentration and number of cysts in the positive pool of pigs. Both hourly and weekly observations post-treatment revealed a significantly high concentration of cTnI in the infected and treated (IT) group (mean = 0.041 ± 0.002 ng/ml) in comparison to the other treatment and control groups, i.e., infected and not-treated (INT) group (mean = 0.024 ± 0.009 ng/ml) (p = 0.015) as well as the negative groups [not infected and treated (NIT) (mean = 0.016 ± 0.0009 ng/ml) (p = 0.003) and not infected and not treated (NINT) (mean = 0.014 ± 0.006 ng/ml)(p = 0.001)], respectively, throughout the observation period. This study shows that there was a strong relationship between cardiac damage/inflammation and the rise in cTnI concentration following treatment with OXF. Pearson correlation analysis results revealed a strong positive correlation between the number of active cysts and the concentration of cTnI in the INT group. This study shows that OXF treatment of pigs with T. solium cysticercosis results in increased concentration of cTnI possibly due to the cardiac damage/inflammatory response following treatment as the cysts degenerate/calcify. This makes cTnI a very good biomarker for cardiac injury/damage following treatment in pigs with cysticercosis.

Zoonotic infections can be controlled by interceding in the animal host. This report describes elimination of T. solium infection from a region in Peru through intervention in the pig–human cycle; such intervention should diminish complications from cysticercosis in the future. Infection of the human brain by cystic larvae of the pork tapeworm species Taenia solium is the most frequent cause of late-onset seizures and epilepsy in the world. 1 , 2 Transmission is sustained in rural areas through a pig–human cycle in which humans harbor the adult intestinal tapeworm (taeniasis) and pigs carry the cystic larvae in their flesh (cysticercosis). In poor, rural villages, domestic pig husbandry and lack of sanitation allow pigs to become infected by consuming human feces containing tapeworm eggs. In turn, humans acquire taeniasis by consuming pork contaminated with larval cysts or acquire neurocysticercosis through incidental ingestion of . . .

Taenia solium and Toxoplasma gondii are important foodborne zoonotic parasites that cause substantial health and economic impacts worldwide. In Burundi, there was a lack of data on the knowledge, attitudes, and practices of stakeholders in the pork value chain. To fill this gap, this study aimed to assess the knowledge of stakeholders in the pork value chain regarding T. solium and T. gondii infections and identify health-seeking routes and factors contributing to parasitic transmissions. A mixed methods study was conducted in Bujumbura city, Kayanza, and Ngozi provinces from January 10 to April 27, 2023. Quantitative data was collected using questionnaire-based interviews with 386 participants, while qualitative data was gathered from 63 participants through focus group discussions, informal conversations, and observations. The majority of the participants in the quantitative study had heard about porcine cysticercosis (94.8%) and pork tapeworm (90.9%), although the transmission and symptoms of these diseases were less known (>60%) and inaccurately described. Most participants were not aware of human cysticercosis (96.4%), its association with epilepsy (78%), and T. gondii infections (91.2%). There was a low proportion of medical consultations for pork tapeworm (30.1%), epilepsy (36.5%), and toxoplasmosis (7%). The qualitative study supported the findings of the quantitative study, revealing low knowledge among participants and misconceptions about the causes, consequences, and treatment-seeking routes related to T. solium and T. gondii infections. The short roasting time of pork (<15 minutes) and low perception of the consequences of consuming pork infected with cysts exposed pork consumers to these parasitic infections. Inadequate knowledge about these parasitic infections, along with inadequate practices in treatment-seeking and pork preparation and consumption, can contribute to continued transmission and pose significant barriers to control programmes. Training and public health education following the One Health approach are urgently needed to better tackle these parasitic infections in Burundi.

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.

A field trial was conducted in Tanzania to determine the effectiveness of TSOL18 vaccine used concurrently with oxfendazole (OFZ), and of OFZ alone, on T. solium cysticercosis determined by organ and half carcase dissection of slaughter age pigs. This study followed a quasi-experimental group design. Suitable trial sites were randomly allocated to either treatment group T1 (OFZ treatment alone [30mg/kg, Paranthic 10%]) or T2 (TSOL18 [1ml, Cysvax] plus OFZ). Three 4-monthly treatments were administered to eligible pigs. A random selection of pigs were necropsied at baseline and at endline, 2-3.5 months after the final treatment. Additionally, untreated pigs from T1 and T2 areas were necropsied at endline to provide contemporaneous comparisons with T1 and T2 pigs. Baseline prevalence of viable T. solium cysticerci for T1 was 25.5% (Exact 95% CI: 13.9, 40.3; n = 12/47), and for T2 was 12.0% (CI: 6.4, 20.0; n = 12/100). At endline, prevalence was 2.8% for T1 (CI: 0.1, 14.5, n = 1/36) and 0% for T2 (CI: 0, 4.7, n = 0/77). Among untreated pigs, three had viable cysticerci, one from T1 area (12.5%, CI: 0.3, 52.7; n = 1/8) and two from T2 area (5.7%, CI: 0.7, 19.2, n = 2/35). Fisher's exact test showed significant changes in prevalence from baseline to endline in both groups (T1: p = 0.005, T2: p = 0.001). Firth's penalized Maximum Likelihood method suggested the changes were not significant relative to their controls (T1: p = 0.245, T2: p = 0.076). These findings showed a significant reduction in the prevalence of viable cysticerci from baseline to endline after both interventions. However, the changes could not be definitively attributed to the interventions due, in part, to small numbers of control pigs. Concurrent administration of the TSOL18 and OFZ cleared infection among assessed pigs whereas infection remained after treatment with OFZ only. Further studies including larger sample sizes would be required for more definitive conclusions. A One Health approach is recommended for rapid and sustainable impact.

Background Cysticercosis is a zoonotic parasitic disease that poses a serious threat to public health. It is widely distributed and has a high incidence rate in China. Reports of disseminated cysticercosis worldwide are rare. This article presents a case of disseminated cysticercosis in the Guangxi Zhuang Autonomous Region of southwestern China. Case presentation The patient, a 46-year-old male belonging to the Miao ethnic group, hailed from a region in Guangxi Zhuang Autonomous Region known for its high incidence of cysticercosis. He had a habit of consuming raw pork and beef. With a history of recurrent consciousness disturbances and limb convulsions for five years, he presented with headaches and dizziness nine days prior. Comprehensive examinations were conducted on the patient. Ultimately, based on epidemiological history, imaging findings, pathogen testing, and pathological results, he was diagnosed with disseminated cysticercosis. Following anthelmintic treatment, the patient was discharged with clear consciousness, free from headaches, dizziness, nausea, vomiting, and seizures. The patient is currently under follow-up care. Conclusion It is crucial to enhance public awareness, promote health education, and cultivate good hygiene habits, as these are essential measures in reducing the incidence of cysticercosis.