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. 2020 Jul;67 Suppl 2(Suppl 2):69-81.
doi: 10.1111/tbed.13214. Epub 2019 Jun 24.

Perceptions and acceptability of piloted Taenia solium control and elimination interventions in two endemic communities in eastern Zambia

Emma Clare Hobbs  1   2   3 , Kabemba Evans Mwape  4 , Andrew M Phiri  4 , Moses Mambwe  5 , Richard Mambo  5 , Séverine Thys  2 , Gideon Zulu  5 , Mwelwa Chembensofu  4 , Chiara Trevisan  2 , Inge Van Damme  3 , Isaac Khozozo Phiri  4 , Brecht Devleesschauwer  3   6 , Jennifer Ketzis  1 , Pierre Dorny  2   3 , Arve Lee Willingham  1 , Sarah Gabriël  3
Affiliations

Perceptions and acceptability of piloted Taenia solium control and elimination interventions in two endemic communities in eastern Zambia

Emma Clare Hobbs et al. Transbound Emerg Dis. 2020 Jul.

Abstract

Infections with Taenia solium cause significant public health and economic losses worldwide. Despite effective control tools, long-term sustained control/elimination of the parasite has not been demonstrated to date. Success of intervention programs is dependent on their acceptability to local communities. Focus group discussions (FGDs) and questionnaires (QS) were conducted in two study communities in eastern Zambia to assess local perceptions and acceptance of two piloted intervention strategies: one targeting pigs only ('control' study arm), and one integrated human- and pig-based ('elimination') strategy. QS (n = 227) captured data regarding participation in project activities, knowledge and perceptions of T. solium and of the interventional drugs used in the study. FGDs (n = 18) discussed perceived advantages and disadvantages of the interventions and of the project's delivery and value. QS data revealed 67% of respondents participated in at least one educational activity, and 80% correctly identified at least one disease targeted by the education. All elimination study arm respondents (n = 113) had taken the human treatment, and 98% intended to do so next time. Most (70%) indicated willingness to pay for future treatments (median 0.20 USD per dose). Of pig-owning respondents, 11/12 (92%) had allowed their pigs to be treated/vaccinated and all intended to do so again next time. Four pig owners indicated willingness to pay 0.10-0.50 USD per dose of treatment or vaccine. FGD feedback revealed positive perceptions of interventions; people reported improved health in themselves and their pigs, and fewer cysticerci in pork. Latrine use, hand washing, meat inspection and proper cooking of pork had reportedly increased since the program's inception. Preliminary assessment indicates that the piloted intervention methods are generally acceptable to the communities. The reported willingness of many respondents to pay for the medications would contribute to the feasibility of long-term, government-led T. solium intervention programs in future.

Keywords: Taenia solium; communicable disease control; focus groups; parasites; public health; surveys and questionnaires.

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Conflict of interest statement

The study received financial support from the Institute of Tropical Medicine, Antwerp (https://www.itg.be) via the Flemish Department of Science, Economy and Innovation (EWI, https://www.ewi-vlaanderen.be/) and via the Belgian Development Cooperation (DGD, https://diplomatie.belgium.be/en/dgd) in the framework of the collaboration between the Institute of Tropical Medicine in Antwerp, Belgium, and the University of Pretoria, South Africa. Ross University School of Veterinary Medicine provided PhD funding (RUSVM, https://veterinary.rossu.edu/). Praziquantel used in the study was generously donated by the World Health Organisation (WHO, http://www.who.int/). This publication is also based on research funded in part by the Bill & Melinda Gates Foundation and the UK Government through GALVmed (https://www.galvmed.org/; study number ZAF/SUI/15/060). The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation or the UK Government. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors declare no conflict of interests exist.

Figures

Figure 1
Figure 1
Schematic representation of the CYSTISTOP project activities during the period described in this study. Ed: human health education; FGDs: focus group discussions; QS: questionnaires
Figure 2
Figure 2
Participation of questionnaire respondents in CYSTISTOP educational activities in the two intervention study arms
See this image and copyright information in PMC

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