The pig tapeworm is the leading cause of preventable epilepsy worldwide. Adult tapeworms live in the human small intestine, acquired by eating larval cysts in undercooked pork. However, tapeworm eggs can also develop into cysts in humans, and if cysts develop in the brain, they can cause neurocysticercosis, with epilepsy being the most important symptom. The prevalence of epilepsy is high in low and middle-income countries, and around a third of epilepsy cases in endemic areas are thought to be due to tapeworm infection, where poor sanitation enables exposure of pigs and people to infective eggs in human faeces. The burden of disease is particularly high in sub-Saharan Africa and is likely to increase as pig production and pork consumption is increasing rapidly.  A number of methods have recently become available to control pig tapeworm infection, including drugs to treat pigs and people, and a newly developed vaccine that protects pigs from infection. There is now a need to study how best to use these methods to sustainably control infection in African countries.

We are studying the importance of cysticercosis in Rwanda for human health and agricultural production.  The overall aim is to develop a national plan for disease control. Our objectives are to collect data on pig production methods and economics, to estimate the prevalence of infection in pork entering the food chain and in pigs and humans across the country, and to determine the risk factors for infection in humans and pigs. We will then use these results, and inputs from important stakeholders, to develop a national country strategy.