12.1.1 Beef tapeworm
Taenia saginata infection or beef tapeworm has been known in Ethiopia for many centuries. The disease is locally known as kosso and is related to the cherished tradition of eating raw beef, a common practice in most parts of the country (Figure 12.2). The disease is closely linked to its cure so the traditional taeniacide (agent that kills Taenia) is also known as kosso. Kosso is an Amharic word that describes both infection (beef tapeworm) and the treatment. The name comes from the tree (Hagenia abyssinica) whose flowers are active against tapeworm (Figure 12.3).
The major factors contributing to the continuing existence of beef tapeworm infection in Ethiopia are lack of proper slaughtering practices and eating raw beef. Open defecation also spreads the disease. Open field defecation practices are widespread in rural areas and small urban centres. This means that if a person infected with kosso defecates on open fields, the infected faeces contaminate the environment, especially pastoral lands used for cattle grazing. The cattle then become infected. Once inside the animal, the larval stages of the tapeworm form cysts, also known as cysticerci, in the muscles and some other organs. The contaminated meat containing the cysts will infect people who eat it if it is not thoroughly cooked (see Figure 12.4).
The lack of proper slaughtering facilities and the absence of meat inspection in some slaughterhouses (abattoirs) means that contaminated meat can be sold, and people eat the infected meat. This practice results in a high frequency of tapeworm occurrence.