Human cysticercosis in Southeastern Côte d’Ivoire: Seroprevalence and risk factors in two rural departments

Cysticercosis is a parasitic disease caused by Taenia solium, primarily transmitted via fecal-oral route. It is a public health concern because it contributes to increasing morbidity of epilepsy. Its true prevalence remains largely unknown in Côte d'Ivoire. This study aimed to estimate the seroprevalence of cysticercosis in rural southeastern Côte d'Ivoire and identify risk factors. Two cross-sectional cluster sample surveys were conducted in villages in the departments of Dabou and Agboville. Data on socio-demographic, neurological history, knowledge about taeniasis/cysticercosis complex and hygiene behaviors' were collected. A blood sample was collected for serological analysis to detect anti-cysticercosis immunoglobulin G antibodies by ELISA and EITB. The Stata survey command was used for statistical analysis. Qualitative variables were compared using the Chi2 test. A multivariate logistic regression was used to model cysticercosis seropositivity. Cysticercosis seroprevalence was estimated at 9.65% (95%CI: 4.83-18.34%) and 13.11% (95%CI: 9.55-17.74%) in Dabou and Agboville respectively. In Dabou, seropositivity was determined by area of residence and previous knowledge of cysticercosis. The rural population in the Toupah sub-prefecture was more likely to be seropositive (adjusted Odds Ratio [aOR]: 3.53, 95%CI: 1.09-11.44). In Agboville, older adults were 2.74 times more likely to be seropositive than youth at age under 16. Educated individuals (aOR: 0.63, 95%CI: 0.43-0.95), those of muslim faith (aOR: 0.56, 95%CI: 0.34-0.92) and those who reported washing raw vegetables before consumption (aOR: 0.45, 95%CI: 0.22-0.92) had a lower risk. This initial study confirms the circulation of Taenia solium and the endemicity of cysticercosis in these rural regions of south-eastern Côte d'Ivoire, area that supply pigs to markets in Abidjan. Insufficient hygiene practices put communities at high risk of fecal-oral transmission. These findings showed public health issue of cysticercosis in rural areas of Côte d'Ivoire, suggesting that targeted interventions should be considered to reduce transmission and associated neurological problems.