People, pigs and pork tapeworm: One Health in action

The health of people, animals and the environment is closely linked. Many parasites depend on more than one host: a definitive host, where the adult parasite lives, and an intermediate host, where its larval stages develop. Controlling infection in one host alone rarely interrupts transmission.  

Pork tapeworm (Taenia solium), endemic in parts of northern Uganda, is a clear example. Humans are the definitive host, carrying the adult tapeworm in the gut, while pigs act as the intermediate host.  

In this video, Dr. Nicholas Ngwili of the International Livestock Research Institute (ILRI) describes the transmission cycle. The tools to control T. solium already exist, he explains: anthelmintic treatment of people (praziquantel) and pigs (oxfendazole), the TSOL18 pig vaccine, improved sanitation and pig confinement. “But control has not been achieved in most endemic regions,” he says. “Our hypothesis was that probably it’s because the context is not well understood.” 

The team took a multi-sector One Health approach to understanding the local context, bringing together stakeholders from human and animal health, the environment and water in Uganda. They confirmed districts in the north of the country as endemic, which laid the foundations for SUSTAIN-Uganda. SUSTAIN-Uganda is a cluster-randomised controlled trial carried out with partners that will assess the benefits of mass treatment of pigs alongside mass treatment of people, and will also evaluate cost-effectiveness, feasibility and acceptability. 

Planning for scale-up has already begun. At a workshop in early October in Kitgum, Northern Uganda, officials from the four study districts (Kitgum, Agago, Pader and Lamwo) explored how the programme could be expanded after the trial. Together, they designed a questionnaire to gauge how acceptable the programme is, mapped out how it is expected to create impact, and agreed what the trial should measure to judge whether it could work elsewhere in Uganda. Once the results are in, a second workshop will bring national, district and local stakeholders back together to plan the next steps.