Pig production has increased significantly in the Eastern and Southern Africa (ESA)
region during the past decade, especially in rural, resource-poor, smallholder communities.
Concurrent with the increase in smallholder pig keeping and pork consumption, there
have been increasing reports of porcine cysticercosis in the ESA region. This article
reviews the findings concerning the presence and impact of porcine cysticercosis in
seven of the ESA countries. Most of the reported findings are based on surveys utilising
lingual palpation and post-mortem examination, however, some also used serological
assays. In Tanzania, community-based studies on porcine cysticercosis indicate a prevalence
of 17.4% in the northern highlands district of Mbulu and a prevalence range of 5.1-16.9%
in the southern highlands. In Kenya recent surveys in the southwestern part of the
country where smallholder pig keeping is popular indicate that 10-14% of pigs are
positive for cysticercosis by lingual examination. Uganda has the most pigs in Eastern
Africa, most of which are kept under smallholder conditions. Preliminary surveys in
1998 and 1999 at slaughterhouses in Kampala indicated a prevalence of porcine cysticercosis
between 0.12 and 1.2%, however, a rural survey in northern Uganda in 1999 indicated
34-45% of pigs slaughtered in selected villages were infected. Additionally, a new
survey of 297 pigs slaughtered in Kampala in 2002 indicated that pigs from the central
region of the country were negative for cysticercosis while 33.7% of the pigs coming
from the rural Lira district in the north were positive. Interestingly 8 piglet foetuses
removed from an infected slaughtered sow coming from Lira district were all found
to harbour cysts of T. solium providing evidence of congenital transmission of porcine
cysticercosis. In Mozambique, abattoir records indicate that porcine cysticercosis
is present in all provinces of the country. A serological survey on pigs in rural
Tete Province found 15% of pigs positive. In Zimbabwe, a retrospective study in official
abattoirs around the country from 1994 to 2001 reported a mean prevalence of 0.34%
which is in contrast to a post-mortem survey in 1999, which showed that the prevalence
of porcine cysticercosis in rural west Zimbabwe where smallholder pig keeping is popular
was 28.6%. In Zambia, abattoir records reported porcine cysticercosis in six of the
nine provinces. Routine meat inspection of 1316 pigs at a slaughter slab in Lusaka
showed that 20.6% of the pigs had cysticercosis whereas serological testing of 874
pigs at the same abattoir indicated that 56.6% were found to have circulating antigens
of Taenia solium. Field surveys based on lingual palpation in Southern and Eastern
Provinces of Zambia revealed prevalences of 8.2-28.4 and 5.2%, respectively. South
Africa has the largest number of pigs in Southern Africa and cysticercosis has been
recognised as a problem in the country for many decades. There is strong evidence
supporting the high prevalence of neurocysticercosis infecting humans from resource-poor
areas of the country where pigs are being raised under smallholder conditions. In
spite of this community-based surveys on porcine cysticercosis have never been conducted
in South Africa and the last slaughterhouse survey was conducted nearly 40 years ago.
The prevalences of porcine cysticercosis found in these ESA countries rank among the
highest in the world and the disease is emerging as an important constraint for the
nutritional and economic well being of resource-poor smallholder farming communities.
The current findings suggest the widespread presence of human tapeworm carriers and
thus a high risk of human cysticercosis in both rural areas and urban centres in the
ESA region. More research is required in the region to assess the extent and public
health and economic impact of T. solium infection in order to determine whether and
what prevention and control efforts are needed.