**2. Life cycle of the** *Taenia solium* **parasite**

*T. solium,* called the pork tapeworm, has people as its definitive host. The adult tapeworm grows in the intestine of the infected person, shedding proglotids which are mature segments of the worm. These proglotids, that contain approximately 50,000 eggs, are shed each day in the stool of the infected person. Pigs, as the intermediate host, are infected by *Cysticercus cellulosae*. When a pig ingests the eggs that have been shed in the stool of the human, the egg crosses the intestinal wall. Next, the egg enters the blood stream and migrates to the muscle tissue. There the egg develops into a larval cyst. The tapeworm is transmitted to another person when this second person eats infected, undercooked pork. However, people can also act as an intermediate host. If a person ingests a tapeworm egg, it crosses from the intestine to the blood stream and preferentially migrates to nervous tissue. There it develops into a larval cyst. Epilepsy is caused by the space occupying lesions of the cysts in the brain of the infected person. This form of the disease is called neurocysticercosis (Serpa et al., 2007).

Epilepsy is a devastating clinical problem in rural areas where there is little education, high rates of poverty, and poor access to health care. People suffering from epilepsy are often misunderstood, ostracised, and limited in their participation in society. The family members

Educating People Participating in the Pig

number of positive pigs in the food chain.

**5. Education model** 

**5.1 Farmer education** 

**5.2 Government staff education** 

Industry to Reduce Epilepsy due to Taenia Solium 215

Education of farmers, butchers and government extension workers is likely the best method to prevent the lifecycle of *T. solium*. The government workers should include public health, adult education, veterinary and livestock specialist and social workers who are responsible for facilitating farmer groups. Ideally the education will also include key community leaders such as teachers, village elders and village chiefs (or the equivalent depending on the societal structure) whose opinion will be valued. It is important that the education includes the pig butchers as well because they are often responsible for slaughtering the pigs and selling raw and cooked pork. The farmers are in the most opportune position to interrupt the life cycle of the parasite by keeping the pig tied and away from human stool and the pig butchers and government veterinary inspectors can identify infected pigs to reduce the

Although there are many education models that are likely successful, one such model that was used in Western Kenya will be described in this chapter (Wohlgemut et al., 2010). Regardless

This four-part study included baseline data collection using individual farmer interviews followed by a workshop. Approximately half of any group of farmers is expected to attend one-day workshops. The farmers included in the data collection were randomly chosen within each selected village whereas the workshops were open to all pig farmers, village elders and village chiefs who wished to attend. Two subsequent farm visits followed the workshop, each 5 months apart. During these farm visits, a questionnaire was completed followed by one-on-one training. Farmers were asked if they attended the workshop and if not, they were given the education about the lifecycle of *T. solium* and prevention of the disease in people and in pigs. All farmers were encouraged to ask questions about *T. solium*, pig management or disease. The farmer was not limited in the number of questions they could ask or the time the researchers spent answering questions. During each visit, the farmer was interviewed in their native tongue by a local person who was hired by the research team and trained to conduct the interview. These research assistants translated for the English speaking researchers who were experts in pig production and disease. Phase 3 of the program was to provide a 2nd set of workshops for the farmers two years after the first farm visit. The workshop was based on the research results obtained during the longitudinal project and provided an opportunity to discuss *T. solium*. The final phase was to return to the community four years after the start of the study, which was two years after the phase 3. During this phase the researchers conducted one-on-one interviews to determine what behaviours the farmers adopted in response to the education (Wohlgemut et al., 2010).

A Training of the Trainers model was used in this project. The advantage of this model is that the government staff are taught the material that the researchers hope to spread to the entire community. The education program is longer term and more widespread because the staff can continue to disseminate the information for years after the project has ended. It is also important that the staff are given the same information that the farmers receive. Finally, the staff are able to converse with the farmers in their own local language. The researchers

of the education model used, the long-term success of the program must be evaluated.

experience shame and may choose to keep the person suffering from epilepsy confined to the home. Often the affected person will not receive a proper diagnosis or appropriate medication. Epilepsy left unmedicated may advance significantly to increase the frequency and severity of seizures and may result in secondary trauma such as severe lacerations or burns. The eradication of the epilepsy due to this parasite requires the disruption of its life cycle (Mafojane et al., 2003; Phiri et al., 2003).
