**5. Comprehensive prevention and control**

#### **5.1 From the porcine aspect**

Comprehensive prevention and control encompasses chemotherapy for taeniid tapeworm carriers, cysticercosis patients and pigs in the community, as well as government initiatives for food safety laws, and meat inspections and regulations [16, 21]. Since 1970s, there have been surveillance and intervention measures for cysticercosis/ taeniasis in endemic areas across the country through government health education and promotion programs [16]. Government and international funds have consistently

supported the community-based investigations of cysticercosis and taeniasis in order to advance disease control efforts. In China, health education and promotion have proven to be effective in the control of *T. solium* taeniasis/cysticercosis [20, 21, 49].

Great efforts have been made in the last few decades to develop effective vaccines and novel chemotherapeutic agents for the purpose of immunizing pigs and preventing *T. solium* transmission between humans and pigs, and continue in progress [50]. In recent field trials, a vaccine for porcine cysticercosis (TSOL18) has been shown to be highly effective against naturally acquired infection with *T. solium* in pigs [6]. In the recent years, evidence of active elimination of *T. solium* transmission with the use of the porcine cysticercosis vaccine TSOL18 in combination with a single dose of oxfendazole treatment of pigs has been obtained from endemic areas of Cameroon [51]. Indeed, it has the potential to be an excellent tool in the fight against cysticercosis.

Mass treatment of taeniasis is a cost-effective control strategy in the endemic areas [52]. Oxfendazole has been shown to be an effective drug for curing pigs by eliminating the cysts and providing resistance to further infection. Educating farmers about the importance of resource management strategy to minimize such kind of infections will encourage them to invest more money on pig farms [53, 54].

Interventions focused on pigs will not only control the sources of taeniasis transmission but may also potentially ameliorate the economic value of the pigs. Preventing *T. solium* infection and treating cysticercosis in pigs obviously benefit the farmers financially and may lead to increased compliance with other control activities such as community-based screening, therapy, and health education [55].

#### **5.2 From the human aspect**

Poor hygiene, inadequate sanitation, the use of untreated or partially treated human waste in agriculture, improper food handling, lack of knowledge about the risk of infection while visiting endemic countries, and the consumption of raw or undercooked pork, particularly in/from regions where pigs are raised in poor conditions, all contribute to the spread of human taeniasis/cysticercosis [31, 33, 37, 38]. Moreover, person-to-person transmission should not be ignored [56, 57].

Enhancing sanitation and health education to improve sanitary and food hygiene practices, interventions consisting of human chemotherapy with better diagnostic tools for taeniasis, and porcine chemotherapy and immunization should all be included in the prevention and control of *Taenia* pp. infections and cysticercosis [58]. Co-infection of multiple helminthes and other parasites is very common in cysticercosis-endemic regions and countries. In order to develop effective integrated parasite control programs, health systems and services must consider the presence of various parasites [3]. According to the available data, implementation of a single approach to *T. solium* control is insufficient. Thus, an integrated approach is required to ensure long-term prevention and control.

#### **5.3 From the ecological aspect**

In the past few decades, significant efforts have been made and are still being realized to eliminate human cysticercosis. Among these efforts are health promotions, meat inspection, chemotherapy, and combined comprehensive measures, which no doubt are the primary control measures for the diseases [21]. However, some additional factors such as modification in pig farming practices and the development of modern toilets that could affect human and pig *T. solium* taeniasis/cysticercosis

Taenia solium *Taeniasis and Cysticercosis Prevalence and Control Practice in China DOI: http://dx.doi.org/10.5772/intechopen.110628*

have also been identified. These preventive measures could significantly hinder the *T. solium* transmission route. Although these two factors were often mentioned in the previous articles [59–61], the fundamental significance for reducing human cysticercosis by minimizing disease transmission was not adequately addressed. The spread of *T. solium* taeniasis and cysticercosis is noticeably being gradually reduced along with the shift in pig farming practices from small-scale to large-scale intensive farms as well as the revolution made in the use of sanitary toilets by humans.

However, *T. solium* taeniasis and cysticercosis are still prevalent in some lowsocioeconomic areas of China, particularly in rural communities in Sichuan, Yunnan, and Guangxi provinces, where pigs are reared in substandard management conditions, and the consumption of raw or undercooked pork is a traditional feeding habit [28, 31, 37, 58]. Therefore, in order to completely eliminate cysticercosis, promotion of health and education, meat inspection, and chemotherapy are warranted and must be continued in the days to come.
