Landscape analysis: control of Taenia solium
This landscape analysis has identified all the current evidence for T. solium control available in the literature published in English. We identify eight key intervention components, being: preventative chemotherapy (through mass drug administration, focus-orientated chemotherapy or identification and treatment of taeniasis cases), health education, improved pig husbandry, improved sanitation, anthelmintic treatment of pigs, vaccination of pigs, improved meat inspection and processing of meat products. Empirical data was available for preventative chemotherapy, health education, anthelmintic treatment of pigs and vaccination of pigs and some combinations thereof.
Valid comparison between control strategies is difficult due especially to short and variable durations of follow-up and differing methods of monitoring between studies. Over the short term, however, there is an indication that disruption of transmission has been achieved through mass drug administration to humans using niclosamide or praziquantel with and without the addition of health education or anthelmintic treatment of pigs. Some reduction in transmission has been reported through the use of health education although it has been difficult to attribute this directly to the interventions used. Oxfendazole administration and vaccination of pigs have both shown efficacy in the treatment and prevention of porcine cysticercosis, although the impact of these strategies on the prevalence of human taeniasis and cysticercosis infections has yet to be quantified.
Due to the paucity of data available it is difficult to make definitive recommendations on control strategies to be used for this parasite. Extrapolation from the evidence available along with modelled projections and the various recommendations of experts available in the literature, however indicates that a combined approach utilizing the treatment of human taeniasis cases (through mass drug administration or selective chemotherapy) combined with the vaccination and treatment of the porcine host would be the ‘best-bet’ for rapid reduction of infection pressure. These core approaches should be supplemented where possible by longer-term sustainable measures such as health education, focusing on the need for improvements in sanitation, pig husbandry and meat inspection.