Spatial and temporal distribution of Taenia solium and its risk factors in Uganda

Abstract

Objectives: The lack of subnational mapping of the zoonotic cestode Taenia solium in endemic countries presents a major challenge to achieving intensified T. solium control milestones, as outlined in the “World Health Organization neglected tropical disease roadmap by 2030”. We conducted a mapping study in Uganda, considered to be endemic, to identify subnational high-risk areas. Methods: T. solium prevalence data, adjusted for diagnostic sensitivity and specificity in a Bayesian framework, were identified through a systematic review. Spatial autocorrelation and interpolation techniques were used to transform demographic and health survey cluster-level sanitation and poverty indicators, overlaid onto a pig density map for Uganda into modelled porcine cysticercosis (PCC) risk maps. Results: A total of 16 articles (n = 11 PCC and n = 5 human cysticercosis (HCC) and/or human taeniasis) were included in the final analysis. The observed HCC prevalence ranged from 0.01% to 6.0% (confidence interval range: 0.004-11.4%), whereas the adjusted PCC ranged from 0.3 to 93.9% (uncertainty interval range: 0-99.8%). There was substantial variation in the modelled PCC risk factors and prevalence across Uganda and over time. Conclusion: The high PCC prevalence and moderate HCC exposure estimates indicate the need for urgent implementation of T. solium control efforts in Uganda.

Keywords

• Taenia solium
• Risk factor mapping
• Spatial statistics
• One Health
• Zoonotic diseases
• Neglected tropical diseases