Effect of repeated mass drug administration with praziquantel and track and treat of taeniosis cases on the prevalence of taeniosis in Taenia solium endemic rural communities of Tanzania

• School-based MDA with praziquantel in combination with track and treat of taeniosis cases significantly reduced the prevalence of taeniosis.
• Annual MDA was significantly better than biennially MDA.
• In Mbeya Region taeniosis was associated with increasing age and sex (male).
• The study highlights the importance of understanding contributing factors in transmission to better design and implement future control programmes.
• Taenia solium control must adopt a One Health approach if elimination is to be obtained.

This study evaluated the effect of mass drug administration (MDA) with praziquantel administered to school-aged children (SAC) combined with ‘track and treat’ of taeniosis cases in the general population on the copro-antigen (Ag) prevalence of taeniosis. The study was conducted in 14 villages in Mbozi and Mbeya district, Tanzania. SAC made up 34% of the population and received MDA with praziquantel (40 mg/kg) in 2012 (both districts) and in 2013 (Mbozi only). Three cross-sectional population-based surveys were performed in 2012 (R0), 2013 (R1), and 2014 (R2). In each survey approximately 3000 study subjects of all ages were tested for taeniosis using copro-Ag-ELISA. In total 9064 people were tested and copro-Ag-ELISA positive cases were offered treatment 6–8 months after sampling. The copro-Ag prevalence of taeniosis was significantly higher (Χ2-test, p = 0.007) in Mbozi (3.0%) at R0 compared to Mbeya (1.5%). Twelve months after MDA in both districts (R1), the copro-Ag prevalence had dropped significantly in both Mbozi (2.0%, p = 0.024) and in Mbeya (0.3%, p = 0.004), but the significant difference between the districts persisted (Χ2-test, p < 0.001). Ten months after the second round of MDA in Mbozi and 22 month after the first MDA (R2), the copro-Ag prevalence had dropped significantly again in Mbozi (0.8%, p < 0.001), but had slightly increased in Mbeya (0.5%, p = 0.051), with no difference between the two districts (Χ2-test, p = 0.51). The taeniosis cases tracked and treated between round R0 and R2 represented 9% of the projected total number of taeniosis cases within the study area, based on the copro-Ag prevalence and village population data. Among SAC in Mbozi, infection significantly decreased at R1 (p = 0.004, OR 0.12, CI: 0.02–0.41) and R2 (p = 0.001, OR 0.24, CI: 0.09–0.53) when comparing to R0. In Mbeya infection significant decreased at R1 (p = 0.013, OR 0.14, CI: 0.02–0.55), but no difference was found for R2 (p = 0. 089), when comparing to R0 among SAC. This study showed that school-based MDA with praziquantel in combination with ‘track and treat’ of taeniosis cases significantly reduced the copro-Ag prevalence of taeniosis, and that annual MDA was significantly better than single MDA. The persistence of taeniosis cases illustrates that a One Health approach must be emphasized for effective control.

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