Tackling pork tapeworm in humans and pigs in Uganda

The impact of pork tapeworm in Uganda 

Taenia solium (T.solium) infection—also known as pork tapeworm—is widely endemic across sub-Saharan Africa. In humans, the parasite causes neurocysticercosis (NCC), a neglected tropical disease (NTD) caused by larval forms of T. solium lodging in the central nervous system. NCC has been identified as the leading preventable cause of epilepsy in low—and middle-income countries.  

The parasite thrives in areas with unsafe sanitation where the environment is contaminated with T. solium eggs, allowing constant exposure to free-ranging pigs. In Uganda, where widespread free-roaming pigs and low sanitation levels increase the risk of T. solium transmission, the disease results in 170,000 disability-adjusted life years (DALYS) and economic losses exceeding $75 million annually.  

In addition to the health impacts associated with NCC, smallholder pig farmers face a substantial economic burden because pig cysticercosis reduces the value of pork and leads to infected carcasses being discarded. 

Tackling Taenia solium through a One Health approach 

The SUSTAIN-Uganda project will evaluate the impact of integrating human and pig-targeted interventions. A cluster-randomised controlled trial will compare mass drug administration (MDA) of praziquantel in human populations with and without the addition of pig anthelmintic treatment using oxfendazole.  

Interventions across animal and human hosts can improve public health, highlighting the impact of working across sectors. 

Project aim 

The project aims to inform national and international policies on NTDs by generating robust evidence about the effectiveness and economic benefits of integrated control strategies.  

The primary goal is to evaluate the effectiveness of delivering treatment to both humans and pigs, compared to human-only treatment for controlling T. solium in Northern Uganda.  

The project will: 

• Determine the difference in effect through a cluster randomised controlled trial  

• Assess the cost-effectiveness and sustainability of the combined approach through transmission modelling and economic analysis  

• Determine the feasibility and acceptability of such joint One Health interventions for policymakers in the health and agriculture sectors. 

The project findings will contribute to the World Health Organization’s roadmap for NTDs, support Uganda’s Ministry of Health in securing praziquantel donations, and strengthen One Health collaborations between the health and agriculture sectors.  

The SUSTAIN-Uganda project represents a critical step in addressing a neglected health problem in Uganda and advancing One Health solutions for zoonotic diseases.