Challenges for control of taeniasis/cysticercosis in Indonesia.

Taeniasis/cysticercosis has been reported from several provinces of Indonesia: Papua (=former Irian Jaya), Bali, North Sumatra, East Nusa Tenggara, South East Sulawesi, Lampung, North Sulawesi, Jakarta, West Kalimantan, and East Java. The highest level of endemicity of taeniasis/cysticercosis has been found in Papua. Recent surveys in Jayawijaya District of Papua in 2000 and 2001 showed that 5 of 58 local people (8.6%) harbored the adult tapeworm, Taenia solium, whereas 44 of 96 people (45.8%), 50 of 71 pigs (70.4%), and 7 of 64 local dogs (10.9%) were seropositive for T. solium cysticercosis. Current surveys in Bali and Samosir District, North Sumatra during 2002-2005 revealed that Taenia saginata taeniasis has increased in incidence whereas T. solium cysticercosis is now rather rare compared to one-two decades ago in Bali. Taenia asiatica taeniasis is still common in Samosir District. Data from other provinces of Indonesia are very limited or unavailable. Control of these diseases is not a priority in the health or veterinary services, neither at central or local government levels. However, limited efforts toward control of the diseases have been implemented such as training of health personnel, community education on disease prevention, and provision of anthelminthics. A working group for control of the disease in Indonesia and an international collaboration have been established among Ministry of Health, Indonesia; University of Indonesia; and Asahikawa Medical College, Asahikawa, Japan since 1996. Future goals include implementation of active case finding (active surveillance) and treatment of tapeworm carriers, sustainable public health education, establishment of a system to check the quality of beef/pork and determine the distribution of infected animals and strengthening of laboratory capacity. Efforts to motivate provinces and districts should be implemented in developing the strategic plan to control of the disease. Given the considerable differences in cultures, religions, levels of education, socio-economic levels, daily habits and behaviour etc., control programmes must be adapted to the local situations.