Stepwise approach for the control and eventual elimination of Taenia solium as a public health problem.

Authors:
Uffe Christian Braae
Uffe Christian Braae
University of Copenhagen
København | Denmark
Sarah Gabriel
Sarah Gabriel
University of Zambia
Chiara Trevisan
Chiara Trevisan
University of Copenhagen
Denmark
Lian F Thomas
Lian F Thomas
University of Nairobi
Pascal Magnussen
Pascal Magnussen
National Institute for Medical Research
Helena Ngowi
Helena Ngowi
Sokoine University of Agriculture
Maria Vang Johansen
Maria Vang Johansen
University of Copenhagen
Denmark

BMC Infect Dis 2019 Feb 21;19(1):182. Epub 2019 Feb 21.

Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, DK-1870, Frederiksberg, Denmark.

Background: Taenia solium taeniosis/cysticercosis is a public health and agricultural problem, especially in low-income countries, and has been ranked the top foodborne parasitic hazard globally. In 2012, the World Health Organization published a roadmap that called for a validated strategy for T. solium control and elimination by 2015. This goal has not been met, and validated evidence of effective control or elimination in endemic countries is still incomplete. Measuring and evaluating success of control programmes remains difficult, as locally acceptable targets have not been defined as part of the 2012 roadmap nor from other sources, and the performance of tools to measure effect are limited.

Discussion: We believe that an international agreement supported by the tripartite World Health Organization, Food and Agriculture Organization of the United Nations, and World Organisation for Animal Health is needed to facilitate endemic countries in publicising SMART (Specific, Measurable, Achievable/attainable, Relevant, Time-bound) country-level control target goals. These goals should be achievable through locally acceptable adoption of options from within a standardised 'intervention tool-kit', and progress towards these goals should be monitored using standardised and consistent diagnostics. Several intervention tools are available which can contribute to control of T. solium, but the combination of these - the most effective control algorithm - still needs to be identified. In order to mount control efforts and ensure political commitment, stakeholder engagement and funding, we argue that a stepwise approach, as developed for Rabies control, is necessary if control efforts are to be successful and sustainable.

Conclusions: The stepwise approach can provide the framework for the development of realistic control goals of endemic areas, the implementation of intervention algorithms, and the standardised monitoring of the evaluation of the progress towards obtaining the control target goals and eventually elimination.

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http://dx.doi.org/10.1186/s12879-019-3812-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383216PMC
February 2019
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