Taenia solium cysticercosis in Africa:: an under-recognised problem

Data collected during the last decade show that T solium cysticercosis in pigs and man is more widely distributed in sub-Saharan Africa than assumed. In West Africa nation-wide surveys have been carried out on a representative sample of the population of two countries. In Benin and Togo prevalence figures for cysticercosis were reported of 1.3 and 2.4 %, respectively. In some regions of Nigeria the prevalence of porcine cysticercosis and human taeniasis are quite high (20.5 and 8.6% respectively) and epilepsy is also very common, suggesting that cysticercosis is most probably involved, From other West-African countries only case reports are available. In East and Central Africa large scale surveys on human cysticercosis have not been carried out, except in Cameroon. West Cameroon is an endemic region with prevalences of 0.8 to 2.4 % in man and up to 25 % in pigs, although recent figures show a decreasing trend. Rwanda, Burundi and the Democratic Republic of Congo are known to be (hyper)-endemic for cysticercosis with prevalence figures exceeding 25 % in pigs in several regions and many case reports of human cysticercosis. However, figures from large scale surveys in man are lacking. Recently, high infection rates in pigs have also been reported in some regions of Tanzania and Zambia. In South Africa several rural regions are known to be endemic for cysticercosis. In Transkei and Kwazulu prevalence figures up to 5.5 % were reported in school children, Finally, cysticercosis is also (hyper)-endemic on the islands Madagascar and Reunion. There is an urgent need for more comprehensive surveys on T solium cysticercosis in pigs and man in order to estimate the real impact of this zoonosis in Africa.