Lack of knowledge of stakeholders in the pork value chain: considerations for transmission and control of Taenia solium and Toxoplasma gondii in Burundi

BackgroundTaenia solium and Toxoplasma gondii are important foodborne zoonotic parasites that cause substantial health and economic impacts worldwide. In Burundi, there was a lack of data on the knowledge, attitudes, and practices of stakeholders in the pork value chain. To fill this gap, this study aimed to assess the knowledge of stakeholders in the pork value chain regarding T. solium and T. gondii infections and identify health-seeking routes and factors contributing to parasitic transmissions. MethodologyA mixed methods study was conducted in Bujumbura city, Kayanza, and Ngozi provinces from January to April 2023. Quantitative data was collected using questionnaire-based interviews with 386 participants, while qualitative data was gathered through focus group discussions, informal conversations, and observations for 63 participants. R and NVivo software were used for quantitative and qualitative data analyses, respectively. Principal findingsThe majority of the participants had heard about porcine cysticercosis and pork tapeworm, although the transmission and symptoms of these diseases were less known and inaccurately described. Most participants were not aware of human cysticercosis, the link of human cysticercosis associated with epilepsy, and T. gondii infections. Socio-demographic and healthcare factors contributed more to the choice of using traditional medicine, biomedicine, prayers, and staying at home. Furthermore, the short roasting time of pork, misconceptions about eating pork infected with cysts to prevent amoebiasis, and low perception of the consequences of consuming infected pork expose pork consumers to these parasitic infections. Conclusions/SignificanceInadequate knowledge of the causes and symptoms of T. solium and T. gondii infections, along with inadequate practices in treatment-seeking and pork preparation and consumption, can lead to continued transmissions and pose significant barriers to control programmes. Training and public health education following the One Health approach are urgently needed to better tackle these parasitic infections in Burundi. Author summaryThe pork tapeworm Taenia solium and Toxoplasma gondii are important foodborne parasites endemic to Burundi. Humans can get infected with pork tapeworm by consuming pork contaminated with T. solium cysts. Ingesting food or water contaminated with eggs from pork tapeworm carriers can lead to human (neuro)cysticercosis. Also, consuming meat infected with T. gondii cysts or ingesting food and water contaminated with cat faeces can lead to human toxoplasmosis. We designed the mixed methods research to assess the knowledge of stakeholders in the pork value chain regarding these parasitic infections and identify health-seeking routes and factors contributing to parasitic transmissions, to provide valuable insights for effectively implementing disease control measures. Our results illustrate how inadequate knowledge among stakeholders in the pork value chain about the causes and symptoms of these parasitic infections, combined with inadequate practices in treatment-seeking and pork consumption, presents significant barriers to implementing effective control programmes. Based on our results, it is very important to implement control interventions based on the One Health approach to reduce or eliminate the transmission of these parasitic infections in Burundi.