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PLoS Negl Trop Dis. 2019 May 20;13(5):e0007336. doi: 10.1371/journal.pntd.0007336. eCollection 2019 May.

Effects of 'The Vicious Worm' educational tool on Taenia solium knowledge retention in Zambian primary school students after one year.

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Department of Biomedical Sciences, One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, St Kitts, West Indies.
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Department of Public Health, Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia.
Institute for Health Research and Society, Université catholique de Louvain, Institute of Health and Society (IRSS), Brussels, Belgium.



Taenia solium is a neglected zoonotic parasite endemic throughout many low-income countries worldwide, including Zambia, where it causes human and pig diseases with high health and socioeconomic burdens. Lack of knowledge is a recognized risk factor, and consequently targeted health educational programs can decrease parasite transmission and disease occurrence in endemic areas. Preliminary assessment of the computer-based education program 'The Vicious Worm' in rural areas of eastern Zambia indicated that it was effective at increasing knowledge of T. solium in primary school students. The aim of this study was to evaluate the impact of 'The Vicious Worm' on knowledge retention by re-assessing the same primary school students one year after the initial education workshops.


Follow-up questionnaires were administered in the original three primary schools in eastern Zambia in 2017, 12 months after the original workshops. In total, 86 pupils participated in the follow-up sessions, representing 87% of the initial workshop respondents. Knowledge of T. solium at 'follow-up' was significantly higher than at the initial 'pre' questionnaire administered during the Vicious Worm workshop that took place one year earlier. While some specifics of the parasite's life cycle were not completely understood, the key messages for disease prevention, such as the importance of hand washing and properly cooking pork, remained well understood by the students, even one year later.


Results of this study indicate that 'The Vicious Worm' may be an effective tool for both short- and long-term T. solium education of rural primary school students in Zambia. Inclusion of educational workshops using 'The Vicious Worm' could be recommended for integrated cysticercosis control/elimination programs in sub-Saharan Africa, particularly if the content is simplified to focus on the key messages for prevention of disease transmission.

Conflict of interest statement

The authors have declared that no competing interests exist.

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