Case Report: Disseminated Cysticercosis due to Intentional Ingestion of Parasitic Worm Eggs for Weight Loss.

A 20-year-old female resident of Beijing intended to consume the eggs of the parasitic worm, Taenia saginata, for weight loss; however, she apparently inadvertently ingested Taenia solium (pork tapeworm) eggs, which resulted in disseminated cysticercosis. Cysticerci developed in the brain, tongue, muscles, liver, peritoneum, and subcutaneous tissues. She was administered oral albendazole and praziquantel. After four 10-day courses of treatment, most of the cysts disappeared and she recovered. After 3 years, the patient remains in good health.

Histopathological Survey on Sarcocystis Species Infection in Slaughtered Cattle of Zabol-Iran

Objective: Sarcocystosis is an important zoonotic protozoal disease with worldwide distribution and wide range of hosts. The aim of the present study was to determine the intensity of Sarcocystis spp. infection and to show histopathological features of their cystic lesions in slaughtered cattle of Zabol- Iran. Methods: From April to September 2018, 500 tissue samples from esophagus, heart, diaphragm, tongue and masticatory muscles were prepared from 100 slaughtered cattle. All samples were fixed in 10% neutral buffered formalin and routine tissue processing protocol was performed. Results: The microscopic results showed that 92.2% of specimens had thin-walled cysts of S. cruzi and 14% had thick-walled Sarcocystis (S. hirsuta and S. hominis) but macrocyst was only observed in one cattle. The positivity rate of thin walled cysts was 58.8% for heart, 13.9% for masticatory muscles, 10.2% for tongue, 9.3% for esophagus and 7.8% for diaphragm. The positivity rate of thick walled cysts was 32.8% for esophagus, 28.6% for tongue, 22.9% for heart, 15.7% for masticatory muscles and 0% for diaphragm, which could represent either S. hominis or S. hirsuta. The most infected tissue was heart and the least infected tissue was diaphragm. Thin walled cysts (S. cruzi) were mostly found in heart and were less found in diaphragm. However, thick-walled cysts (S. hirsuta and S. hominis) were mostly detected in esophagus. No thick-walled cysts were found in diaphragm muscle. Conclusion: A high positivity rate of sarcocystosis in slaughtered cattle in Zabol abattoir revealed heavily environmental contamination of Sistan region by this important parasitic disease.

Sarcocystis morae (Apicomplexa) in Fallow Deer (Dama dama) from Spain: Ultrastructure and New Host Record.

Members of the genus Sarcocystis are frequently found infecting members of the family Cervidae. Although Sarcocystis species are generally host specific for their intermediate hosts, species in cervids appear to be less host specific. Here, we report fallow deer (Dama dama) as a new host for Sarcocystis morae, originally described from the red deer (Cervus elaphus). Tongues of 69 legally hunted animals in Spain were tested for sarcocysts, and the species were characterized by light microscopy, ultrastructurally and molecularly. Sarcocysts were identified in 66.7% of D. dama. Sarcocysts had thin (<2 µm thick) cyst wall with hair-like villar protrusions bifurcated at their tips resembling type 8a. Genetic sequences obtained for 18S rRNA and COI reached 99.6-100% and 97.9-98.7% similarity, respectively, to those of S. morae from the red deer. The present study provides new data concerning lower level of host specificity within Sarcocystis genus for cervids.

A comparison of Taenia solium and Taenia hydatigena infection in pigs using serological diagnosis and post-mortem inspection methods in Benoué division, North Cameroon.

The metacestodes of Taenia solium and Taenia hydatigena are the cause of cysticercosis in pigs. T. solium is also responsible of the taeniosis/neurocysticercosis complex in humans, constituting a main cause of epilepsy cases across endemic countries. T. hydatigena is non-zoonotic, but its occurrence in pigs contributes significantly to false positive reactions should genus-species serological methods be used for diagnosis of T. solium porcine cysticercosis. T. hydatigena is often considered not common in pigs in Africa compared to T. solium. On the basis of the evidence that these two cestodes coexist in Cameroon, we examined the viscera of 305 pigs for the identification of the metacestodes of T. hydatigena in Bénoué division, North Region of Cameroon. Tongue, masticatory muscles and heart were sliced for the identification of T. solium cysticerci (TMH dissection test). Twenty seven (8.85%) and 16 (5.24%) pigs were found infected with the metacestodes of T. solium and T. hydatigena, respectively. The difference between the two rates of infection was not statistically significant (P > 0.05). Serum samples were also collected for the evaluation of an inhibition ELISA (i-ELISA) specific to antibodies anti- T. solium or anti-T. hydatigena cysticerci. After incubation of these sera with cyst fluid of T. solium, T. hydatigena, T. multiceps multiceps, T. multiceps gaigeri and T. saginata to eliminate cross-reactions among cestodes parasites, the i-ELISA indicated that 26.56% and 28.52% slaughtered pigs had predominant specific antibodies to cyst fluid of T. solium and T. hydatigena, respectively. Combination of TMH dissection test, i-ELISA and a standard indirect ELISA in a Bayesian simulation approach revealed a true prevalence of 19.27% (0.7-49.27, CI 95%) and 24.85% (5.17-48.34, CI 95%) of porcine cysticercosis due to T. solium and T. hydatigena, respectively. These results indicated that T. hydatigena is as prevalent as T. solium in pigs in the North of Cameroon.

Sarcocystis bertrami in skeletal muscles of donkeys (Equus africanus asinus) from Southern Italy.

Among the protozoa of the genus Sarcocystis (Apicomplexa; Sarcocystidae), Sarcocystis bertrami (syn. Sarcocystis fayeri) is an obligate intracellular parasite of donkeys and horses with worldwide distribution. Here, we report the detection of S. bertrami in naturally infected donkeys from southern Italy and describe their structure by light microscopy (LM) and transmission electron microscopy (TEM). Protozoal cysts were detected both morphologically and molecularly in skeletal muscles of 28.57% (40/140) donkeys. Mature cysts of S. bertrami were found in skeletal muscle measuring 31-102 µm long and 19-83 µm wide with radially striated thick cyst wall. The high prevalence of infected donkeys suggests that dogs, the definitive hosts of S. bertrami, are contaminating environment with environmentally resistant sporocysts. Considering the increased consumption of raw donkey meat results also suggest a potential risk for human health.

Isolation of viable Toxoplasma gondii from organs and Brazilian commercial meat cuts of experimentally infected pigs.

The present study evaluated the distribution and viability of Toxoplasma gondii tissue cysts in the organs and Brazilian commercial cuts of experimentally infected pigs. The pigs were infected with 3 × 103 oocysts of the T. gondii isolate TgCkBr57 (Type BrII). Mouse bioassays were performed on the brain, retina, tongue, diaphragm, and heart as well as the following muscle cuts: loin (longissimus), coppa (longissimus, spinalis dorsi, rhomboideus), tenderloin (psoas major), outside flat (biceps femoris), topside (semimembranosus), and top sirloin (gluteus medius). Toxoplasma gondii was isolated from the coppa, heart, diaphragm, and tongue of three pigs; from the tenderloin, outside flat, and brain of two pigs; and from the top sirloin and loin of one pig. Thus, the viability of T. gondii cysts was observed in all of the organs and cuts evaluated (except for the topside and retina), demonstrating the broad distribution of this parasite in pig organs and commercial meat cuts, and the importance of this species as a source of human infection.

Nematode capilaridae in the tongue of Cerdocyon thous of free life in Brazil / Nematoide capilaridae na língua de Cerdocyon thous de vida livre no Brasil

Abstract Studies of helminths in road-killed wild animals are still uncommon but may provide promising results since they can identify the parasites in juvenile and adult hosts and meet the recommendations of current discussions on bioethics that prioritize alternative methods for the use of animals. This study evaluated three Cerdocyon thous individuals that were donated after dying from being run over. Two of them had small nematode adults in the epithelial and connective tissues of the tongue. The diagnosis was based on the presence of eggs, observed in histological sections, and morphological characteristics of the nematodes in the tongue. Morphologically, this nematode has a body with transverse grooves, simple mouth opening and no lips, esophagus and stichosome with stichocytes and bacillary bands along the body, which is characteristic morphology of the family Capilariidae and genus Capillaria . The presence of this nematode in the tongue of C. thous is an extremely important fact that contributes to what is known about the biodiversity of zoonotic parasites in wild canid populations. However, an explanation for these findings remains unclear because, until now, this has not been observed in the biological cycle of the species.

Resumo O estudo de helmintos de animais selvagens vitimados por atropelamento, ainda é uma prática pouco comum, porém pode ser promissor, uma vez que permite a identificação de helmintos a partir de hospedeiros juvenis e adultos, e atendem às atuais discussões em bioética, as quais priorizam métodos alternativos para o uso de animais. Foram avaliados 3 exemplares de Cerdocyon thous provenientes de doação pós-óbito por atropelamento. Dois deles apresentaram pequenos nematoides adultos inseridos nos tecidos epitelial e conjuntivo da língua. O diagnóstico foi baseado na análise de cortes histológicos que evidenciaram a presença de ovos no interior do nematoide e nas características morfológicas gerais do mesmo. Morfologicamente estes nematoides apresentavam corpo com estrias transversais, abertura bucal simples e lábios ausentes, esôfago trichuroiude com a presença de esticócitos e bandas bacilares ao longo do corpo, característica morfologicamente sugestiva da família Capillariidae e do gênero Capillaria . A presença de nematoides inseridos na língua de C. thous é um fato de extrema importância para o conhecimento da biodiversidade de parasitos zoonóticos circulantes presentes em populações selvagens de canídeos. Porém, permanece obscura a explicação para tais achados, uma vez que tal evento não foi observado no ciclo biológico das espécies até o momento.

Pathological and molecular identification of porcine cysticercosis in Maharashtra, India.

Porcine cysticercosis, caused by metacestodes of Taenia solium is an important emerging zoonotic disease with public health and economic significance. Pigs acquire the disease through consumption of Taenia solium eggs excreted by human tapeworm carriers. The present study was conducted to investigate the prevalence of porcine cysticercosis in Nagpur and Mumbai region of Maharashtra, India by P/M examination of carcasses followed by histopathology of affected organs in infected animals and molecular identification of cysts for confirmation. Out of 1000 pigs examined during slaughter, three pigs were found to be heavily affected with T. solium cysts giving a prevalence of 0.3%. Histological section of brain in infected animals revealed marked vascular congestion of meninges, mild neuronal degeneration, perivascular cuffing and gliosis while the liver showed the infiltration of mononuclear cell, predominantly eosinophils throughout the parenchyma. Some degree of calcification was observed in the cysts lodged in liver while calcification was not evident in case of cysts lodged in brain, tongue, diaphragm and skeletal muscle. Molecular identification by PCR using two sets of oligonucleotide primers against LSU rRNA gene and Mt-Cox1 gene of T. solium confirms the cysts to be that of T. solium. The molecular diagnostics methods have been considered for validation in conjunction with P/M inspections, parasitological and histopathological examinations. The study confirms the presence of porcine cysticercosis in the two regions and demands proper sanitary measures to minimize the risk of infection from zoonoses and food safety point of view.

An epidemiological survey of the magnitude and local perceptions of porcine cysticercosis by two methods in Nyaruguru district, Rwanda.

This study investigated the magnitude of porcine cysticercosis (PC), its risk factors, economic effects and the perceptions of 80 pig farmers from Nyabimata (n = 38) and Muganza (n = 42) and 20 registered butchers in the Nyaruguru district of Rwanda. January to December 2013 slaughter records from Kamirabagenzi market were also analysed for PC diagnoses based on the tongue test and meat inspection. During this period, the responding farmers' records showed a tongue test-based PC magnitude (3.9%, n = 984) which was lower than the collective tongue test-based PC magnitude of 9.2% (n = 1720) at Kamirabagenzi (p < .05). The overall magnitude of PC based on routine meat inspection diagnosis at Kamirabagenzi was 4%. The overall magnitude of PC for respondents using Free-range production systems (7.9%) was significantly greater than for those in Semi-intensive (2.1%) and Intensive production systems (1.5%) (p < .05). Though most farmers (90%) knew that PC is zoonotic, only 22.5% of the farmers opted for treatment of PC-infected pigs and 52.5% were willing to seek veterinary inspection while the rest (25%) opted to circumvent veterinary inspection (P > .05). Most butchers (70%) indicated they would circumvent veterinary inspection and continue to slaughter PC-positive animals whilst the rest (30%) indicated they would resell PC positive animals to defray costs (P < .05). The low sensitivity and specificity of methods used for PC detection in the study, implies that this may just be the tip of an iceberg and the actual magnitude is most likely to be much higher. In conclusion, PC is endemic in the Nyaruguru district of Rwanda with a high proportion of positive animals. The condition has public health implications and is worsening the economic plight of the impoverished Nyaruguru community.

Pampas fox (Lycalopex gymnocercus) new intermediate host of Sarcocystis svanai (Apicomplexa: Sarcocystidae).

Several Sarcocystis spp. have carnivores as definitive host and sarcocysts are common in muscles of herbivores (intermediate host). However, sarcocysts have been found in muscles of wild and domestic carnivores suggesting they are intermediate host for some Sarcocystis spp. Here, we report mature sarcocysts in the muscles of Pampas fox (Lycalopex gymnocercus). A total of 36 free-living foxes were analyzed. Different skeletal muscles were assessed by microscopic and molecular methods. Cysts and/or DNA of Sarcocystis sp. were detected in 61.1% (22/36) foxes. Histopathology revealed the presence of sarcocysts in 52.8% (19/36) foxes. The tongue and masseter were the muscles more frequently infected. Of all the samples processed by homogenization of pooled muscles of each animal, 45.4% (10/22) evidenced muscle cysts and 68.2% (15/22) resulted positives by PCR. Individual cysts obtained from the ten positive samples in direct microscopic examination were all positive by PCR. Five amplicons from individual cysts from different samples were selected for sequencing together with four PCR products obtained from the pooled muscles. All nine sequences shared a high identity among them (99.8-100%) and showed the highest identity by BLAST (99%) with a S. svanai sequence (KM362428) from a North American dog. By transmission electron microscopy, the sarcocyst wall was thin (<1µm), had minute undulations, with tiny evaginations and without evident villar protrusions. The cyst wall type is referred as "type 1". Sarcocystis svanai infects L. gymnocercus with a high prevalence and the presence of mature sarcocysts suggests the role of the Pampas fox as natural intermediate host. The definitive host of S. svanai remains unknown.

Nodular granulomatous glossitis as the sole clinical sign in canine leishmaniosis.

A 5.5-year-old, intact male Rottweiler dog was admitted with a history of multifocal nodular tongue lesions which progressively deteriorated during the previous year. Physical examination revealed several reddish nodules with central depression on the surface of the tongue in an otherwise healthy dog. Clinicopathologic abnormalities included eosinophilia and hyperproteinemia. Lingual nodule cytopathology, histopathology, and immunohistochemistry revealed Leishmania spp. amastigotes and a severe granulomatous glossitis. The dog was also seroreactive to L infantum antigens by an indirect immunofluorescence assay. Clinical reevaluation 3 months after the institution of treatment with allopurinol and miltefosine indicated that the nodular lesions had completely regressed. In endemic areas, lingual nodular lesions may rarely be the sole clinical sign of canine leishmaniosis. Standard medical treatment may provide an excellent prognosis.

Presence of Toxoplasma gondii in Pork Intended for Human Consumption in Tropical Southern Mexico.

BACKGROUND: Toxoplasmosis is caused by the protozoon Toxoplasma gondii, which is one of the most widespread parasites that infect animals and humans worldwide. One of the main routes of infection for humans is through the consumption of infected meat containing bradyzoites in tissue cysts. Pork is one of the foremost meat types associated with outbreaks of acute toxoplasmosis in humans. MATERIALS AND METHODS: Sixty blood samples were collected from finished pigs at slaughter and their sera was evaluated by an indirect-IgG ELISA. Matched muscle samples were obtained from the tongue and loin. Whole blood and tissue samples were evaluated to search for T. gondii DNA using a nested-polymerase chain reaction. RESULTS: Seroprevalence of T. gondii was 96.6% (58/60) of sampled pigs. Meanwhile, T. gondii DNA was present in 23.21% of tongue tissue samples (13/56), 7% of loin tissues (4/57), and 0% in blood samples (0/44), respectively. Two pigs were serologically indeterminate. CONCLUSION: This is the first report of the presence of T. gondii DNA in tissue samples obtained from finalized pigs. Results from the present study suggest a high exposure to T. gondii in pigs intended for human consumption from the tropical region of Mexico. Thus, the consumption of some undercooked pork meat meals typical from the southern region of Mexico could represent a significant risk for acquiring infection for the human population.

Lingual palpation for porcine cysticercosis: a rapid epidemiological tool for estimating prevalence and community risk in Africa.

OBJECTIVE: To assess the association between the prevalence of tongue cyst-positive and antigen-positive pigs across different settings in Africa, to evaluate whether examining pigs for cysts could be used as a rapid surveillance tool for identifying geographical areas with a higher probability of high transmission of cysticercosis. METHODS: Published data were collated from 26 study sites across Africa that reported the prevalence of porcine cysticercosis by both lingual and serological examinations. The study sites were located in 10 countries across Africa. RESULTS: Seroprevalence rates ranged from 4% to 41%. Despite the varied study sites, the relationship between the two variables was highly consistent and suggests identification of tongue cysts may be useful for cysticercosis surveillance. We found that all areas with more than 10% of pigs having cysts in their tongues had at least 30% seroprevalence (PPV of 100%), although this cut-off is less reliable at predicting that an area is of low transmission (NPV of 84%). CONCLUSION: Assessing the prevalence of tongue cyst-positive pigs is a potential rapid epidemiological tool for identifying areas at high risk of cysticercosis, although further refinement and validation is required using standardised data sets.

Occurrence of porcine cysticercosis in free-ranging pigs delivered to slaughter points in Arapai, Soroti district, Uganda.

Poverty, hunger and the need for production of pigs with meagre or zero inputs have made most farmers release their pigs to range freely, thus creating a pig-human cycle that maintains Taenia solium, the pig tapeworm and cause of porcine cysticercosis, in the ecosystem. A preliminary study was designed to establish the prevalence of porcine cysticercosis by postmortem examination of the tongue and carcass of free-range pigs from February to April 2014 in Arapai subcounty, Soroti district, eastern Uganda. The tongue of each pig was extended and examined before deep incisions were made and the cut surfaces were examined. The rest of the carcasses were examined for cysts. Out of 178 pigs examined, 32 were qualitatively positive for porcine cysticercosis, representing a prevalence of 18.0%. This high prevalence represents a marked risk to the communities in the study area of neurocysticercosis, a debilitating parasitic zoonosis. Proper human waste disposal by use of pit latrines, confinement of free-range pigs and treatment with albendazole and oxfendazole are recommended.

An experimental Toxoplasma gondii dose response challenge model to study therapeutic or vaccine efficacy in cats.

High numbers of Toxoplasma gondii oocysts in the environment are a risk factor to humans. The environmental contamination might be reduced by vaccinating the definitive host, cats. An experimental challenge model is necessary to quantitatively assess the efficacy of a vaccine or drug treatment. Previous studies have indicated that bradyzoites are highly infectious for cats. To infect cats, tissue cysts were isolated from the brains of mice infected with oocysts of T. gondii M4 strain, and bradyzoites were released by pepsin digestion. Free bradyzoites were counted and graded doses (1000, 100, 50, 10), and 250 intact tissue cysts were inoculated orally into three cats each. Oocysts shed by these five groups of cats were collected from faeces by flotation techniques, counted microscopically and estimated by real time PCR. Additionally, the number of T. gondii in heart, tongue and brains were estimated, and serology for anti T. gondii antibodies was performed. A Beta-Poisson dose-response model was used to estimate the infectivity of single bradyzoites and linear regression was used to determine the relation between inoculated dose and numbers of oocyst shed. We found that real time PCR was more sensitive than microscopic detection of oocysts, and oocysts were detected by PCR in faeces of cats fed 10 bradyzoites but by microscopic examination. Real time PCR may only detect fragments of T. gondii DNA without the presence of oocysts in low doses. Prevalence of tissue cysts of T. gondii in tongue, heart and brains, and anti T. gondii antibody concentrations were all found to depend on the inoculated bradyzoite dose. The combination of the experimental challenge model and the dose response analysis provides a suitable reference for quantifying the potential reduction in human health risk due to a treatment of domestic cats by vaccination or by therapeutic drug application.

Tungiasis presenting as a soft tissue oral lesion.

BACKGROUND: The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation. CASE PRESENTATION: An adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital's Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections. CONCLUSION: Lingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals.

Ring-screening to control endemic transmission of Taenia solium.

BACKGROUND: Taenia solium is a major cause of preventable epilepsy in developing nations. Screening and treatment of human intestinal stage infection (taeniasis) within high-risk foci may reduce transmission and prevent epilepsy by limiting human exposure to infective eggs. We piloted a ring-strategy that involves screening and treatment for taeniasis among households located nearby pigs heavily-infected with the larval stage (cysticercosis). These pigs mark areas of increased transmission and can be identified by tongue examination. METHODOLOGY: We selected two villages in northern Peru for a controlled prospective interventional cohort pilot study. In the intervention village (1,058 residents) we examined the tongues of all pigs every 4 months for nodules characteristic of cysticercosis. We then screened all residents living within 100-meters of any tongue-positive pig using enzyme-linked immunosorbent assay to detect Taenia antigens in stool. Residents with taeniasis were treated with niclosamide. In both the intervention and control (753 residents) we measured incidence of exposure by sampling the pig population every 4 months for serum antibodies against cysticercosis using enzyme-linked immunoelectrotransfer blot. PRINCIPAL FINDINGS: Baseline seroincidence among pigs born during the study was 22.6 cases per 100 pigs per-month (95% confidence interval [CI] 17.0-30.0) in the intervention and 18.1 (95% CI 12.7-25.9) in the control. After one year we observed a 41% reduction in seroincidence in the intervention village compared to baseline (incidence rate ratio 0.59, 95% CI 0.41-0.87) while the seroincidence in the control village remained unchanged. At study end, the prevalence of taeniasis was nearly 4 times lower in the intervention than in the control (prevalence ratio 0.28, 95% CI 0.08-0.91). CONCLUSIONS/SIGNIFICANCE: Ring-screening reduced transmission of T. solium in this pilot study and may provide an effective and practical approach for regions where resources are limited. However, this strategy requires validation in larger populations over a greater period of time.

Isolated cysticercosis of tongue: a case report.

Cysticercosis of the tongue is a rare disease caused by infestation with the larval stage of the pork tapeworm (Taenia solium) in which man acts as a secondary host rather than a primary host. Most of these lesions are asymptomatic. The patient usually reports to the physician with the complaint of swelling. The solitary swelling in the tongue of this young 12-year-old girl was not suspected clinically for cysticercosis. Fine needle aspiration cytology, used for pre-operative diagnosis, suggested the possibility of cysticercosis. Detailed medical evaluation was carried out which ruled out neural cysticercosis and other extraneural lesions. The complete removal of the lesion was achieved by simple excision. The histopathological examination confirmed the diagnosis of lingual cysticercosis.

Prevalence of porcine cysticercosis and associated risk factors in smallholder pig production systems in Mbeya region, southern highlands of Tanzania.

Porcine cysticercosis (PC) caused by the larval stage of a zoonotic tapeworm Taenia solium, is known to pose serious economic losses and public health risk among smallholder pig production communities. The present study was conducted to determine prevalence and associated risk factors for PC in smallholder pig production systems in Mbeya region, the major pig rearing region of Tanzania. A cross-sectional survey employing a random sample of 300 pig keepers from 30 villages of Mbozi and Mbeya Rural districts, Mbeya region were used to evaluate pig production systems and practices. Concurrently, 600 male and female pigs of different age categories were randomly selected and examined for PC using lingual examination method and antigen enzyme-linked immunosorbent assay (Ag-ELISA). The overall pig level PC prevalence in Mbozi district was 11.7% (95% CI=8.5-15.8%) and 32% (95% CI: 27-37.5%) based on lingual examination and Ag-ELISA, respectively. In Mbeya Rural district, the prevalences were 6% (95% CI: 3.8-9.3%) and 30.7% (95% CI: 25.8-36.1%) by lingual examination and Ag-ELISA, respectively. In Mbozi district 46% of the households were found infected (one or more infected pigs) and the corresponding figure was 45% for Mbeya Rural district. The agreement between lingual examination and Ag-ELISA was poor (κ<0.40). There were no significant differences in the prevalence of PC in different sex categories of pigs. Significant risk factors associated with PC prevalence were free roaming of pigs (OR=2.1; 95% CI=1.3-3.6; p=0.006), past experience of porcine cysticercosis in the household (OR=2.6; 95% CI=1.5-4.8; p=0.002), increased age of pig (OR=1.9; 95% CI=1.2-3.0), slatted raised floor in pig pen (OR=8.4; 95% CI=1.0-70.0), in-house origin of the pig (OR=1.6; 95% CI=1.1-2.5) and sourcing of water from rivers (OR=3.1; 95% CI=1.6-6.3; p<0.001) and ponds (OR=5.0; 95% CI=1.2-21.7; p=0.031). This study has clearly revealed a high sero-prevalence of PC in the study area, which imposes a major economical and public health burden to the smallholder pig farmers. The study also points to a number of important risk factors in smallholder pig management that may be addressed (e.g. confinement, quality of pens and water sources) in future interventions and educational campaigns for control of T. solium.