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Published in: BMC Infectious Diseases 1/2022

01-12-2022 | Epilepsy | Research article

Knowledge, attitudes and practices related to Taenia solium cysticercosis and taeniasis in Tanzania

Authors: Chacha Nyangi, Dominik Stelzle, Ernatus M. Mkupasi, Helena A. Ngowi, Ayubu J. Churi, Veronika Schmidt, Christopher Mahonge, Andrea S. Winkler

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

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

Appendix
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Literature
1.
go back to reference World Health Organization (WHO). Assembling a framework for intensified control of taeniasis and neurocysticercosis caused by Taenia solium: Report of an informal consultation. World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland; 2015. World Health Organization (WHO). Assembling a framework for intensified control of taeniasis and neurocysticercosis caused by Taenia solium: Report of an informal consultation. World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland; 2015.
2.
go back to reference FAO and WHO. Multicriteria-Based Ranking for Risk Management of Food-Borne Parasites. Rome: Italy; 2014. FAO and WHO. Multicriteria-Based Ranking for Risk Management of Food-Borne Parasites. Rome: Italy; 2014.
3.
go back to reference Murrell K, Dorny P, Flisser A, Geerts S, Kyvsgaard N, McManus D, et al., editors. WHO/FAO/OIE Guidelines for the surveillance, prevention and control of taeniosis/cysticercosis. Paris: World Health Organisation for Animal Health (OIE), 2005. OIE, 12, rue de Prony, 75017 Paris, France; 2005. Murrell K, Dorny P, Flisser A, Geerts S, Kyvsgaard N, McManus D, et al., editors. WHO/FAO/OIE Guidelines for the surveillance, prevention and control of taeniosis/cysticercosis. Paris: World Health Organisation for Animal Health (OIE), 2005. OIE, 12, rue de Prony, 75017 Paris, France; 2005.
4.
go back to reference Okello A, Thomas L. Human taeniasis: Current insights into prevention and management strategies in endemic countries. Risk Manag Healthc Policy. 2017;10:107–16.CrossRef Okello A, Thomas L. Human taeniasis: Current insights into prevention and management strategies in endemic countries. Risk Manag Healthc Policy. 2017;10:107–16.CrossRef
5.
go back to reference Mwanjali G, Kihamia C, Kakoko DVC, Lekule F, Ngowi H, Johansen MV, et al. Prevalence and risk factors associated with human Taenia Solium infections in Mbozi District, Mbeya Region, Tanzania. PLoS Negl Trop Dis. 2013;7(3):e2102.CrossRef Mwanjali G, Kihamia C, Kakoko DVC, Lekule F, Ngowi H, Johansen MV, et al. Prevalence and risk factors associated with human Taenia Solium infections in Mbozi District, Mbeya Region, Tanzania. PLoS Negl Trop Dis. 2013;7(3):e2102.CrossRef
6.
go back to reference Ngowi HA, Carabin H, Kassuku AA, Mlozi MRS, Mlangwa JED, Willingham AL. A health-education intervention trial to reduce porcine cysticercosis in Mbulu District Tanzania. Prev Vet Med. 2008;85(1–2):52–67.CrossRef Ngowi HA, Carabin H, Kassuku AA, Mlozi MRS, Mlangwa JED, Willingham AL. A health-education intervention trial to reduce porcine cysticercosis in Mbulu District Tanzania. Prev Vet Med. 2008;85(1–2):52–67.CrossRef
7.
go back to reference Gabriël S, Dorny P, Mwape KE, Trevisan C, Braae UC, Magnussen P, et al. Control of Taenia solium taeniasis/cysticercosis: the best way forward for sub-Saharan Africa? Acta Trop. 2017;165:252–60.CrossRef Gabriël S, Dorny P, Mwape KE, Trevisan C, Braae UC, Magnussen P, et al. Control of Taenia solium taeniasis/cysticercosis: the best way forward for sub-Saharan Africa? Acta Trop. 2017;165:252–60.CrossRef
8.
go back to reference Braae UC, Saarnak CFL, Mukaratirwa S, Devleesschauwer B, Magnussen P, Johansen MV. Taenia solium taeniosis/cysticercosis and the co-distribution with schistosomiasis in Africa. Parasit Vectors. 2015;8(1):1–14.CrossRef Braae UC, Saarnak CFL, Mukaratirwa S, Devleesschauwer B, Magnussen P, Johansen MV. Taenia solium taeniosis/cysticercosis and the co-distribution with schistosomiasis in Africa. Parasit Vectors. 2015;8(1):1–14.CrossRef
9.
go back to reference Komba EVG, Kimbi EC, Ngowi HA, Kimera SI, Mlangwa JE, Lekule FP, et al. Prevalence of porcine cysticercosis and associated risk factors in smallholder pig production systems in Mbeya region, southern highlands of Tanzania. Vet Parasitol. 2013;198(3–4):284–91.CrossRef Komba EVG, Kimbi EC, Ngowi HA, Kimera SI, Mlangwa JE, Lekule FP, et al. Prevalence of porcine cysticercosis and associated risk factors in smallholder pig production systems in Mbeya region, southern highlands of Tanzania. Vet Parasitol. 2013;198(3–4):284–91.CrossRef
10.
go back to reference Kavishe MDB, Mkupasi EM, Komba EVG, Ngowi HA. Prevalence and risk factors associated with porcine cysticercosis transmission in Babati district, Tanzania. Livest Res Rural Dev. 2017;29(1):13. Kavishe MDB, Mkupasi EM, Komba EVG, Ngowi HA. Prevalence and risk factors associated with porcine cysticercosis transmission in Babati district, Tanzania. Livest Res Rural Dev. 2017;29(1):13.
11.
go back to reference Hunter E, Burton K, Iqbal A, Birchall D, Jackson M, Rogathe J, et al. Cysticercosis and epilepsy in rural Tanzania: a community-based case-control and imaging study. Trop Med Int Heal. 2015;20(9):1171–9.CrossRef Hunter E, Burton K, Iqbal A, Birchall D, Jackson M, Rogathe J, et al. Cysticercosis and epilepsy in rural Tanzania: a community-based case-control and imaging study. Trop Med Int Heal. 2015;20(9):1171–9.CrossRef
12.
go back to reference Winkler AS, Willingham AL, Sikasunge CS, Schmutzhard E. Epilepsy and neurocysticercosis in sub-Saharan Africa. Wien Klin Wochenschr. 2009;121(SUPPL. 3):3–12.CrossRef Winkler AS, Willingham AL, Sikasunge CS, Schmutzhard E. Epilepsy and neurocysticercosis in sub-Saharan Africa. Wien Klin Wochenschr. 2009;121(SUPPL. 3):3–12.CrossRef
13.
go back to reference Winkler AS. Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management. Pathog Glob Health. 2012;106(5):261–74.CrossRef Winkler AS. Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management. Pathog Glob Health. 2012;106(5):261–74.CrossRef
14.
go back to reference Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, Qian YJ, Rainwater E, et al. A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis. 2010;4(11):e870.CrossRef Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, Qian YJ, Rainwater E, et al. A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis. 2010;4(11):e870.CrossRef
15.
go back to reference Trevisan C, Devleesschauwer B, Schmidt V, Winkler AS, Harrison W, Johansen MV. The societal cost of Taenia solium cysticercosis in Tanzania. Acta Trop. 2017;165:141–54.CrossRef Trevisan C, Devleesschauwer B, Schmidt V, Winkler AS, Harrison W, Johansen MV. The societal cost of Taenia solium cysticercosis in Tanzania. Acta Trop. 2017;165:141–54.CrossRef
16.
go back to reference World Health Organization WHO. A guide to developing knowledge, attitude and practice surveys. Geneva: World Health Organization; 2008. World Health Organization WHO. A guide to developing knowledge, attitude and practice surveys. Geneva: World Health Organization; 2008.
17.
go back to reference Chacha M, Yohana C, Nkwengulila G. Indigenous knowledge, practices, beliefs and social impacts of porcine cysticercosis and epilepsy in Iringa Rural. Int J Infect Dis. 2014;178:2894. Chacha M, Yohana C, Nkwengulila G. Indigenous knowledge, practices, beliefs and social impacts of porcine cysticercosis and epilepsy in Iringa Rural. Int J Infect Dis. 2014;178:2894.
18.
go back to reference Mwidunda S, Carabin H, Matuja W, Winkler A, Ngowi H. A school based cluster randomised health education intervention trial for improving knowledge and attitudes related to Taenia solium cysticercosis and taeniasis in Mbulu district, northern Tanzania. PLoS ONE. 2015;10(2):1–17.CrossRef Mwidunda S, Carabin H, Matuja W, Winkler A, Ngowi H. A school based cluster randomised health education intervention trial for improving knowledge and attitudes related to Taenia solium cysticercosis and taeniasis in Mbulu district, northern Tanzania. PLoS ONE. 2015;10(2):1–17.CrossRef
19.
go back to reference Ngowi HA, Mkupasi EM, Lekule FP, Willingham IL, Thamsborg SM. Impact of farmer education on their knowledge, attitudes, and practices in southern Tanzania: a case for Taenia solium control. Impact of farmer education on their knowledge, attitudes, and pr. Livest Res Rural Dev. 2011;23(1):1–8. Ngowi HA, Mkupasi EM, Lekule FP, Willingham IL, Thamsborg SM. Impact of farmer education on their knowledge, attitudes, and practices in southern Tanzania: a case for Taenia solium control. Impact of farmer education on their knowledge, attitudes, and pr. Livest Res Rural Dev. 2011;23(1):1–8.
20.
go back to reference Ngowi HA, Mlangwa JED, Mlozi MRS, Tolma EL, Kassuku AA, Carabin H, et al. Implementation and evaluation of a health-promotion strategy for control of Taenia solium infections in northern Tanzania. Int J Heal Promot Educ. 2009;47(1):24–34.CrossRef Ngowi HA, Mlangwa JED, Mlozi MRS, Tolma EL, Kassuku AA, Carabin H, et al. Implementation and evaluation of a health-promotion strategy for control of Taenia solium infections in northern Tanzania. Int J Heal Promot Educ. 2009;47(1):24–34.CrossRef
21.
go back to reference Ertel RL, Braae UC, Ngowi HA, Johansen MV. Assessment of a computer-based Taenia solium health education tool ‘The Vicious Worm’ on knowledge uptake among professionals and their attitudes towards the program. Acta Trop. 2015;6:240–5. Ertel RL, Braae UC, Ngowi HA, Johansen MV. Assessment of a computer-based Taenia solium health education tool ‘The Vicious Worm’ on knowledge uptake among professionals and their attitudes towards the program. Acta Trop. 2015;6:240–5.
22.
go back to reference Mwang’onde BJ, Nkwengulila G, Chacha M. The risk factors for human cysticercosis in Mbulu District Tanzania. Onderstepoort J Vet Res. 2014;81(2):1–5. Mwang’onde BJ, Nkwengulila G, Chacha M. The risk factors for human cysticercosis in Mbulu District Tanzania. Onderstepoort J Vet Res. 2014;81(2):1–5.
23.
go back to reference Mwang’onde BJ, Chacha MJ, Nkwengulila G. The status and health burden of neurocysticercosis in Mbulu district, northern Tanzania. BMC Res Notes. 2018;11(1):1–5.CrossRef Mwang’onde BJ, Chacha MJ, Nkwengulila G. The status and health burden of neurocysticercosis in Mbulu district, northern Tanzania. BMC Res Notes. 2018;11(1):1–5.CrossRef
24.
go back to reference Ngowi HA, Kassuku AA, Maeda GEM, Boa ME, Carabin H, Willingham AL. Risk factors for the prevalence of porcine cysticercosis in Mbulu District Tanzania. Vet Parasitol. 2004;120(4):275–83.CrossRef Ngowi HA, Kassuku AA, Maeda GEM, Boa ME, Carabin H, Willingham AL. Risk factors for the prevalence of porcine cysticercosis in Mbulu District Tanzania. Vet Parasitol. 2004;120(4):275–83.CrossRef
25.
go back to reference Shonyela SM, Mkupasi EM, Sikalizyo SC, Kabemba EM, Ngowi HA, Phiri I. An epidemiological survey of porcine cysticercosis in Nyasa District, Ruvuma Region. Tanzania Parasite Epidemiol Control. 2017;2(4):35–41.CrossRef Shonyela SM, Mkupasi EM, Sikalizyo SC, Kabemba EM, Ngowi HA, Phiri I. An epidemiological survey of porcine cysticercosis in Nyasa District, Ruvuma Region. Tanzania Parasite Epidemiol Control. 2017;2(4):35–41.CrossRef
26.
go back to reference Boa ME, Mahundi EA, Kassuku AA, Willingham AL, Kyvsgaard NC. Epidemiological survey of swine cysticercosis using ante-mortem and post-mortem examination tests in the southern highlands of Tanzania. Vet Parasitol. 2006;139(1–3):249–55.CrossRef Boa ME, Mahundi EA, Kassuku AA, Willingham AL, Kyvsgaard NC. Epidemiological survey of swine cysticercosis using ante-mortem and post-mortem examination tests in the southern highlands of Tanzania. Vet Parasitol. 2006;139(1–3):249–55.CrossRef
27.
go back to reference Fisher AA, Laing JE, Stoeckel JE, Townsend J. Handbook for family planning operations research design. 2nd edn., New York, New York, USA. 1991; p. 43. Fisher AA, Laing JE, Stoeckel JE, Townsend J. Handbook for family planning operations research design. 2nd edn., New York, New York, USA. 1991; p. 43.
29.
go back to reference Ngowi HA, Tolma EL, Kassuku AA, Mlozi MRS, Mlangwa JED, Carabin H, et al. Using the PRECEDE model to plan a health promotion strategy for control of Taenia solium infections in northern Tanzania. Int J Heal Promot Educ. 2007;45(2):41–8.CrossRef Ngowi HA, Tolma EL, Kassuku AA, Mlozi MRS, Mlangwa JED, Carabin H, et al. Using the PRECEDE model to plan a health promotion strategy for control of Taenia solium infections in northern Tanzania. Int J Heal Promot Educ. 2007;45(2):41–8.CrossRef
30.
go back to reference Winkler AS, Blocher J, Auer H, Gotwald T, Matuja W, Schmutzhard E. Epilepsy and neurocysticercosis in rural Tanzania—an imaging study. Epilepsia. 2009;50(5):987–93.CrossRef Winkler AS, Blocher J, Auer H, Gotwald T, Matuja W, Schmutzhard E. Epilepsy and neurocysticercosis in rural Tanzania—an imaging study. Epilepsia. 2009;50(5):987–93.CrossRef
31.
go back to reference Alexander AM, Mohan VR, Muliyil J, Dorny P, Rajshekhar V. Changes in knowledge and practices related to taeniasis/cysticercosis after health education in a south Indian community. Int Health. 2012;4(3):164–9.CrossRef Alexander AM, Mohan VR, Muliyil J, Dorny P, Rajshekhar V. Changes in knowledge and practices related to taeniasis/cysticercosis after health education in a south Indian community. Int Health. 2012;4(3):164–9.CrossRef
32.
go back to reference Sarti E, Flisser A, Schantz PM, Gleizer M, Loya M, Plancarte A, et al. Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico. Am J Trop Med Hyg. 1997;56(2):127–32.CrossRef Sarti E, Flisser A, Schantz PM, Gleizer M, Loya M, Plancarte A, et al. Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico. Am J Trop Med Hyg. 1997;56(2):127–32.CrossRef
33.
go back to reference World Health Organisation WHO. Ending the neglect to attain the sustainable development goals—a road map for neglected tropical diseases: 2021–2030. Geneva: World Health Organisation; 2021. World Health Organisation WHO. Ending the neglect to attain the sustainable development goals—a road map for neglected tropical diseases: 2021–2030. Geneva: World Health Organisation; 2021.
34.
go back to reference Carabin H, Millogo A, Ngowi HA, Bauer C, Dermauw V, Koné AC, et al. Effectiveness of a community-based educational programme in reducing the cumulative incidence and prevalence of human Taenia solium cysticercosis in Burkina Faso in 2011–14 (EFECAB): a cluster-randomised controlled trial. Lancet Glob Health. 2018;6(4):e411–25.CrossRef Carabin H, Millogo A, Ngowi HA, Bauer C, Dermauw V, Koné AC, et al. Effectiveness of a community-based educational programme in reducing the cumulative incidence and prevalence of human Taenia solium cysticercosis in Burkina Faso in 2011–14 (EFECAB): a cluster-randomised controlled trial. Lancet Glob Health. 2018;6(4):e411–25.CrossRef
35.
go back to reference Gabriël S, Mwape KE, Hobbs EC, Devleesschauwer B, Van Damme I, Zulu G, et al. Potential elimination of active Taenia solium transmission in Africa. New Engl J Med. 2020;383(4):1–3.CrossRef Gabriël S, Mwape KE, Hobbs EC, Devleesschauwer B, Van Damme I, Zulu G, et al. Potential elimination of active Taenia solium transmission in Africa. New Engl J Med. 2020;383(4):1–3.CrossRef
Metadata
Title
Knowledge, attitudes and practices related to Taenia solium cysticercosis and taeniasis in Tanzania
Authors
Chacha Nyangi
Dominik Stelzle
Ernatus M. Mkupasi
Helena A. Ngowi
Ayubu J. Churi
Veronika Schmidt
Christopher Mahonge
Andrea S. Winkler
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Epilepsy
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07408-0

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