Ramiandrasoa, Noromanana Sylvia, Ravoniarimbinina, Pascaline, Solofoniaina, Armand Rafalimanantsoa, Andrianjafy Rakotomanga, Iharilanto Patricia, Andrianarisoa, Samuel Hermas, Molia, Sophie, Fahrion, Anna Sophie, Donadeu, Meritxell, Rajaonatahina, Davidra, Ramiandrasoa, Noromanana, Id, Ravoniarimbinina, Solofoniaina, Armand, Patricia, Iharilanto, Rakotomangaid, Andrianjafy, Andrianarisoa, Samuel, Moliaid, Sophie, Labouche, Anne-Marie, Sophie, Anna, 5¤, Fahrion, Donadeuid, Meritxell, Abela-Ridder, Bernadette, Rajaonatahinaid, Davidra, Ministère de la Santé Publique [Antananarivo, Madagascar], Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Animal, Santé, Territoires, Risques et Ecosystèmes (UMR ASTRE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département Systèmes Biologiques (Cirad-BIOS), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), Faculty of Veterinary and Agricultural Science [Melbourne], University of Melbourne, Initiative for Neglected Animal Diseases (INAND), and Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA)
Taenia solium is endemic in Madagascar and presents a significant burden on the population and the health system. The parasite cycles through humans who host the adult tapeworm, and pigs that host the larval stages. Accidental infection of humans may occur with the larval stages which encyst in the nervous central system causing neurocysticercosis, a major cause of seizure disorders and a public health problem. One of the interventions to facilitate the control of the disease is mass drug administration (MDA) of the human population with taeniacide. Here we describe a pilot project conducted in Antanifotsy district of Madagascar from 2015 to 2017 where three annual rounds of MDA (praziquantel, 10mg/Kg) were undertaken in 52 villages. Changes in the prevalence of taeniasis were assessed before, during and after the treatments. A total of 221,308 treatments were given to all eligible people above 5 years of age representing a 95% coverage of the targeted population. No major adverse effects were notified related to the implementation of the MDA. The prevalence of taeniasis was measured using Kato-Katz and copro-antigen techniques. Analyses undertaken combining the results of the Kato-Katz with copro-antigen, or using the Kato-Katz results alone, showed that there was a significant reduction in taeniasis 4 months after the last MDA, but 12 months later (16 months after the last MDA) the taeniasis prevalence had returned to its original levels. Results of the pilot project emphasize the need of a multi-sectorial One-Health approach for the sustained control of T. solium., Author summary The parasite Taenia solium causes neurocysticercosis in humans in its larval stage and is the main cause of seizure disorders in poor communities that keep pigs (the intermediate host). Diagnosis and treatment of neurocysticercosis remains beyond the reach of the general population in Madagascar. Prevention is therefore the most suitable strategy for combating this disease. Mass drug administration (MDA) is used to treat communities for several parasitic diseases such as schistosomiasis. Infection with the T. solium tapeworm in people can be treated with MDA using praziquantel. Here, we conducted a pilot project in Madagascar, giving over 220,000 treatments to people in 52 villages once per year, for 3 consecutive years. The effects on taeniasis seemed to be encouraging when assessed 4 months after finishing the treatment, but 16 months later, the parasite’s prevalence had returned to its original level. MDA was effective in providing temporary control of taeniasis, but parasite transmission was not interrupted. With respect to T. solium, this highlights the need of incorporating other interventions such as vaccination and medication in pigs, improved pig husbandry and meat inspection to tackle the whole cycle of the parasite.