The role of cooking practices in the transmission of the foodborne parasite Taenia solium: A qualitative study in an endemic area of Southern Tanzania

Abstract

The pork tapeworm Taenia solium is a zoonotic food-borne parasite endemic in many developing countries causing human cysticercosis and taeniosis as well as porcine cysticercosis. It mainly affects the health of rural smallholder pig farmers and their communities, resulting in lower health status, reduced pork quality, and economic loss due to condemnation of pigs or low pricing of pork. This qualitative study aimed to identify key food related practices linked to consumption of pork at village level, of importance for transmission of taeniosis. We used an interpretivist-constructivist paradigm in a multiple case study of exploratory qualitative research design. Data was acquired through guided and probing interviews with 64 pork cooks, and 14 direct observations in four villages in a T. solium endemic area of Mbeya Region in the Southern Highlands of Tanzania. The study showed that the informants were members of communities of practice through their pork cooking practices, one community of practice for the restaurant cooks and one for the home cooks, learning, sharing, and distributing their cooking skills. Furthermore, the analysis showed that the pork cooks generally had some awareness of there being something undesirable in raw pork, but they had very diverse understandings of what it was, or of its potential harm. Major potential transmission points were identified in restaurants and in home kitchens. It appears that the pork cooks act according to socio-cultural and economic factors guiding them in their actions, including pressure from customers in restaurants, the family values of tradition in the home kitchens, and the culturally guided risk perception and appraisal. These practices might generate potential transmission points. Future research on interventions aimed at preventing the spread of T. solium taeniosis should recognise the importance of tradition and culture in risky food practices.

Fig 1. The (simplified) life cycle of Taenia solium, modified from [7].

T. solium eggs are shed by infected humans and passed on to humans or pigs through ingestion of faecal matter, causing (neuro)cysticercosis. If infected pork is consumed, humans can develop taeniosis, thus completing the cycle.

Fig 2. The flow of the CoP.

The entry of newcomers in the communities of practice (CoPs), learning by engagement and interaction. The newcomers continue their path into the centre of the CoP, becoming old-timers at the practice (modified from [28]).

Fig 3. A restaurant workstation in Factory Village showing the three types of pork for sale in the restaurant.

On the right on the plate, plantains are seen alongside the dipped pork. On the left, the restaurant female cook is cutting the ready-to-serve pork and plantains on the wooden table where also the raw pork is located (in front).

Fig 4. The influx of new practices in an existing Community of Practice (CoP).