Global Force-of-Infection Trends for Human Taenia solium Taeniasis/Cysticercosis

Infection by Taenia solium poses a major burden across endemic countries. The World Health Organization (WHO) 2021–2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified T. solium control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab- seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab- seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in T. solium transmission rates indicate the need for setting- specific intervention strategies to achieve the WHO goals. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement MAD, PW, CW, ZMC and MGB acknowledge funding from the Medical Research Council (MRC) Centre for Global Infectious Disease Analysis (reference MR/R015600/1), jointly funded by the UK MRC and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement and is also part of the European and Developing Countries Clinical Trials Partnership (EDCTP2) programme supported by the European Union. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All age-(sero)prevalence data are available in the following data repository: . Original data for two datasets available (under the Creative Commons Attribution License; CC BY 4.0) from the International Livestock Research Institute open-access repository () referenced in Holt et al. (2016) and University of Liverpool open-access repository () referenced in Fevre et al. (2017). Previously Published Datasets: Ecosystem approaches to the better management of zoonotic emerging infectious diseases in the Southeast Asia region: Holt HR, Inthavong P, Khamlome B, Blaszak K, Keokamphe C, Somoulay V, Phongmany A, Burr PA, Graham K, Allen J, Donnelly B, Blacksell SD, Unger F, Grace D, Alonso S, Gilbert J, 2016, , ILRI Data Portal; An integrated study of human and animal infectious disease in the Lake Victoria Crescent small-holder crop-livestock production system, Kenya: Fevre EM, de Glanville WA, Thomas LF, Cook EAJ, Kariuki S, Wamae CN, 2017, ), DataCat: The Research Data Catalogue I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All age-(sero)prevalence data are available in the following data repository: . Original data for two datasets available (under the Creative Commons Attribution License; CC BY 4.0) from the International Livestock Research Institute open-access repository () referenced in Holt et al. (2016) and University of Liverpool open-access repository () referenced in Fevre et al. (2017).