Combating Taenia solium Cysticercosis in Southeast Asia. An Opportunity for Improving Human Health and Livestock Production

Cysticercosis caused by the zoonotic pork tapeworm Taenia solium is emerging as a constraint for the nutritional and economic well-being of small-holder farming communities in many underdeveloped areas of Southeast Asia. It occurs mainly in impoverished regions with inadequate sanitation, poor pig management practices and lack of meat inspection and control. Neurocysticercosis, the most serious form of the disease, is considered the most common parasitic infection of the human nervous system and the most frequent preventable cause of epilepsy in the developing world. Although theoretically easy to control and declared eradicable, T. solium taeniosis/cysticercosis remains a neglected disease. There is a lack of information and awareness of the burden and transmission of the disease at the regional and global level, partially explained by the unavailability of good quality diagnostic tools in field-applicable formats. These factors are further compounded by a lack of validated simple and sustainable intervention packages as part of integrated helminth control programmes. To date, T. solium taeniosis/cysticercosis has not been eliminated from any region by a specific programme in Southeast Asia, and no national control programmes are yet in place except in parts of the People's Republic of China. The presence, distribution, public health importance and economic relevance of cysticercosis need to be better documented in Southeast Asia in order to bring it to the attention of affected communities, decision-makers and funding bodies. A number of proven cost-effective intervention tools for combating cysticercosis appear to be available but need to be field validated. The Regional Network for Asian Schistosomiasis and Other Helminth Zoonoses (RNAS ⁺ ) serves as an important regional 'driving force' for managing research, capacity building, knowledge and stakeholder engagement essential for controlling cysticercosis in the Southeast Asian region while ensuring that research efforts are integrated with regional needs for surveillance and control.