Using the PRECEDE model to plan a health promotion strategy for control of Taenia solium infections in northern Tanzania

Taenia solium is a zoonotic parasite that may cause serious illnesses in humans, primarily manifested with epileptic seizures. In this article we describe the application of a sound planning model, the PRECEDE model, in order to develop a health promotion strategy for the control of T. solium infections in Mbulu District, northern Tanzania, where the parasite is highly prevalent. During the epidemiological assessment T. solium was identified as a parasite of public health importance in the area. The social assessment revealed that porcine cysticercosis caused by T. solium was indeed an important problem for the smallholder pig farmers. Behavioural and environmental assessment revealed various factors that facilitated the transmission of T. solium in the area, including free ranging pigs, not using pit latrines, eating infected pork and drinking unboiled water. Poor knowledge on the parasite mode of transmission and public health impact and perceived barriers to adoption of better pig management practices were among factors that predisposed people to the behaviours that facilitated the transmission of the parasite. Finally, public extension services in the community were inadequate. Using the PRECEDE model we were able to identify the foci of our intervention based on the principles of importance and changeability. In conclusion, the PRECEDE model is a useful model in the development of public health interventions in the area toward the prevention of infectious diseases.