Taenia saginata taeniosis/cysticercosis risk factors: Applying Pareto principles to model more efficient control and prevention strategies in Botswana

Most available data on Taenia saginata taeniosis/cysticercosis risk factors in Botswana neither associate risk factors with Batswana’s lifestyle nor rank risk factors’ contribution to observed prevalence. This disconnect undermines usability of data for bovine cysticercosis control. This study identified bovine cysticercosis risk factors and quantitatively ranked risk factors’ contributions to observed prevalence. Visual observation and interviews using Likert scale-formatted questionnaire was employed in collecting primary data from beef industry’s stakeholders (149). Fourteen (14) out of eighteen (18) risk factors jointly predicted bovine cysticercosis prevalence (p <0.05), but the only factor of ‘beef sold at non-licensed premises’ predicted prevalence individually. Top 20% important risk factors were absence or distant pit latrines in farms (p <0.05; MD=1.288; CI: 1.15-1.43), proximity to uncontrolled human defecate (p <0.05; MD=1.184; CI=1.03-1.34), access to contaminated pasture (p <0.05; mean=4.13; MD=1.131), and failure to deworm herd boys (p <0.05; mean=4.10; MD= 1.097). Current prevention strategies in Botswana emphasizes proper disposal of human defecate. However, this study showed that minimizing butchers buying and slaughtering animals without proper ante-mortem and post-mortem examination would yield more efficient result. By adopting Pareto principle, this study modeled that controlling these top 20% important risk factors instead of targeting a repertoire of risk factors would result in 80% prevalence drop. Respondents showed greater consensus on risk factors with high odds to cause bovine cysticercosis. This consensus provides platform for driving attitudinal change, since risk factors were lifestyle-related. Associating people’s lifestyle with risk factors of this zoonosis while targeting top 20% risk factors yields more efficient control outcomes.