Taenia solium taeniasis/cysticercosis (TSTC) is a parasitic zoonotic disease that is endemic in several developing countries, causing serious public health and economic impacts. A cross-sectional study was conducted to assess knowledge, attitudes and practices (KAP) related to porcine cysticercosis (PCC) transmission, prevention and control among smallholder pig farmers in Kongwa and Songwe Districts in Tanzania. A semi-structured questionnaire was administered to 692 smallholder pig farmers from randomly selected households. STATA software version 17 was used to analyse quantitative data, summarize farmers' KAP about PCC and calculate performance scores. Nearly half (42%) of the respondents had little knowledge regarding PCC, only 17% of the respondents had good practices towards prevention/control of PCC and 72% had a positive attitude towards PCC- prevention/control measures. The majority (73%) of smallholder pig farmers admitted deworming their pigs regularly, whereas 76% reported deworming themselves and their family members regularly. Albendazole and ivermectin are the most commonly used medications for deworming people and pigs, respectively. According to the findings, the majority of smallholder pig farmers in Kongwa and Songwe Districts showed a good attitude towards PCC prevention/control measures but had limited knowledge of the PCC life cycle and control. In addition, only one in five farmers was engaged in good practices. The findings revealed further that farmers are engaged in risky behaviours that aid the spread and perpetuation of the T. solium parasite in the study area. It is recommended that farmers should be given proper health education on the T. solium transmission cycle and preventive/control practices to limit PCC transmission.

Taenia solium porcine cysticercosis (PCC) is widespread in many low- and middle-income countries (LMICs) where free-range pig rearing is common and hygienic standards are subpar. A cross-sectional survey was conducted in 42 villages between June and September 2019 (14 in Songwe district, southwest Tanzania, and 28 in Kongwa district, central Tanzania). Using a commercial Ag-ELISA kit (apDia, Belgium), circulating antigens of Taenia spp in pig serum were identified and used to calculate the PCC seroprevalence. The study recruited 692 randomly selected households, sampling one pig per household. The relationship between each risk factor and the seroprevalence of PCC at the household and village levels was analysed using mixed logistic regression models. The findings showed that approximately 28% of the pigs were reared in free-range settings, the proportion of households with latrines across the districts was 92%. Twenty-seven percent of households with latrines had water and soap available for hand washing. Sixty-seven (9.7%) tested positive for PCC based on Ag-ELISA. The overall seroprevalence in Kongwa and Songwe districts was 7.3% and 14.0% respectively. In addition, the overall village Ag-ELISA positivity was 9.3%, with an interquartile range (IQR) of 4.6% – 14.1%. Increasing the age of the pig (OR = 3.13 95% CI = 1.48 – 6.60; p = 0.003), pig originating from outside the household (OR = 0.5 95% CI = 0.25 – 0.99; p = 0.05), and pigs kept in a household that practised deworming (OR = 2.23 95% CI = 1.08 – 4.61; p = 0.03) were important risk factors associated with PCC positivity. Therefore, the high seroprevalence of PCC, up to 14%, calls for rapid and effective control actions such as vaccination and treatment of pigs against PCC, and public health education emphasises on indoor pig rearing, hygienic practices and regular use of latrines. Our findings also point to a potential danger of Taenia. spp infection indicating the possibility of people carrying the adult parasite Taenia solium not only in the rural communities of Kongwa and Songwe districts but also in the urban areas of Tanzania, where pigs from these areas are transported for consumption. To develop effective management measures, further research on taeniasis and cysticercosis in the human population is required.

Porcine cysticercosis (PCC) is a food‐borne zoonotic disease prevalent in resource‐poor rural communities with free‐range pig management systems and low sanitation practices. Various prevention and control strategies have been implemented in Tanzania, with this study highlighting the importance of community‐based health education in controlling the Taenia solium parasite. The study evaluated the effectiveness of community‐based health education using a cocreated health education package (HEP) on the knowledge, attitudes, and practices (KAP) of smallholder farmers, as well as on the prevalence of PCC in Kongwa and Songwe Districts, Tanzania. A cluster‐randomized health education intervention was conducted between June 2019 and December 2021, with pre‐ and postintervention evaluations of PCC prevalence and smallholder farmers’ KAP. A baseline cross‐sectional study was followed by health education training utilizing the HEP, which included brochures, booklets, and posters. The training was provided to trainers (TOT) who, in turn, trained the community. A commercial Ag‐ELISA kit (apDia, Belgium) was used to identify circulating antigens in pig serum and determine the PCC prevalence both before and after the intervention. A total of 692 and 486 respondents participated in face‐to‐face interviews during the baseline and postintervention periods, respectively. Concurrently, 692 and 317 pigs were sampled during these periods. At baseline, the seroprevalence of PCC was 10.2% in the intervention group and 9.1% in the control group. Twelve months following the health education intervention, the study observed significant improvements in knowledge ( β = 1.779, p = 0.004), attitudes ( β = 1.024, p = 0.038), and practices ( β = 0.719, p = 0.023) among participants. Additionally, a reduction in PCC prevalence was observed—3.9% in the intervention group and 0.9% in the control group—though this difference was not statistically significant (OR = 0.70; 95% CI: 0.27–1.83; p = 0.47). The reduction in PCC is a gradual process that likely requires a longer observation period to yield a measurable impact. The limited duration of follow‐up may have constrained the study’s ability to conclusively attribute the observed decline in PCC seroprevalence to the intervention. Evidence suggests that a comprehensive strategy targeting both intermediate and definitive hosts is essential. Therefore, future health education interventions should integrate mass drug administration for pigs and treatment of human taeniosis—an approach that could be effective in disrupting the lifecycle of Taenia solium .