**5. Education model**

214 Novel Aspects on Epilepsy

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

Pig rearing in Sub Saharan East Africa has been increasing by 10% per year over the past decade and in Uganda pork production increased by ten times between 1985 and 2005. Many people living in rural areas of East Africa depend for their livelihood on smallholder pig farming. The advantage of keeping pigs over cattle or sheep are that pigs grow faster and have more offspring in a short time period, eat leftover food, and are very easy to sell (Lekule & Kyvsgaard 2003; Mutua *et al*. 2010). Smallholder farmers typically live in extended family compounds on an average of one to two acres of land (Kagira *et al* 2010; Mutua *et al*. 2010). Some family members may not use a latrine because of cultural norms or they may not have a functional latrine in the family compound (Githigia et al., 2005; Mutua et al., 2007). When one or more family members does not use the latrine, the life cycle of *T. solium* is enhanced because pigs gain access to human stool. Smallholder farmers who live in poverty grow their own food and therefore have insufficient land for other livestock. Therefore, *T. solium* tends to be a problem of the poorest of the poor. If there is a competition between the food resources between people and pigs, the pigs are kept in the traditional manner in a mixture of free range and tethered management style, largely because the inputs are much lower than under intensive management (Kagira *et al*. 2010; Lekule & Kyvsgaard 2003). Pigs are purchased when the family has some extra money to buy a weaned piglet. Then the pigs are kept to bank small amounts of money, for income generation, and to source money in a hurry when there is a family emergency such as medical needs, school fees, or for food between harvest seasons

In areas where *T. solium* is endemic, eradication is only possible by eliminating the reservoirs of the parasite. However, it is difficult to find live infected pigs because the test that is used, an examination of tongue for evidence of cysts, has a very low sensitivity of approximately 50%. Therefore, the only method of keeping infected pigs from the food chain is to ensure that all pigs are inspected by a government official after slaughter. In many developing countries the inspection system is poor and often people in the villages use home slaughter after which they sell meat from the family's farm (Roman et al., 2000).

One study indicates that community behavioural and environmental practices must be modified to prevent continued transmission of cysticercosis and taeniasis (Sarti et al., 1992). This is perhaps best accomplished through education. Researchers have found that education in conjunction with community involvement reduces opportunities for transmission of *T. solium* in the human-pig cycle Sarti et al., 1997. A successful long-term change will only occur if the intervention program is associated with community participation and health education programs (Sarti et al., 1997; Cao et al., 1997; Sanchez et

cycle (Mafojane et al., 2003; Phiri et al., 2003).

**3. Situation in Sub Saharan East Africa** 

(Kagira *et al*. 2010; Lekule & Kyvsgaard 2003; Mutua *et al*. 2010).

**4. Education** 

al., 1999; Carrique-Mas et al., 2001).

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