{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:38:34Z","timestamp":1792607914507,"version":"4.5.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008627","name":"Global Affairs Canada","doi-asserted-by":"publisher","award":["P011372"],"award-info":[{"award-number":["P011372"]}],"id":[{"id":"10.13039\/501100008627","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    <jats:italic>Taenia solium<\/jats:italic>\n                    is a zoonotic cestode and the causative agent of human taeniasis\/cysticercosis and porcine cysticercosis. The burden in Rwanda is significant, including death and disability in people and income losses across the pork sector. Despite widespread recognition on the need for multi-sectoral and inclusive\n                    <jats:italic>T. solium<\/jats:italic>\n                    control programming, little is known about water, sanitation and hygiene (WASH) access and gendered disease exposure among rural smallholders involved in the formal and informal pork sectors. This study aimed to characterize gender roles and WASH access in the Nyamagabe District (Southern Province) pork value chain (PVC) to better inform future interventions for disrupting\n                    <jats:italic>T. solium<\/jats:italic>\n                    transmission. We conducted Focus Group Discussions with 23 men and 21 women across five nodes of the PVC (farmers, animal health workers, butchers, vendors, consumers) and interviewed six key informants. Audio-recordings were transcribed verbatim, translated into English and coded as part of inductive thematic analysis. PVC participants identified numerous biosecurity gaps in the Nyamagabe PVC, such as free-range pig production, re-use of human waste, lack of prevention services (deworming, vaccination), informal slaughter, and consumption of infected and\/or undercooked pork. Traditional gender roles were prevalent, with women managing domestic roles related to pig husbandry and men managing roles related to building pens, buying\/selling pigs and slaughtering\/butchering. Water and sanitation facilities were frequently inadequate, causing serious lapses in human and pig hygiene. Participants identified poverty as a major barrier for implementing\n                    <jats:italic>T. solium<\/jats:italic>\n                    control but demonstrated enthusiasm for receiving information and resources to support this goal. Altogether, these findings support the need for One Health programming to reduce the burden of\n                    <jats:italic>T. solium<\/jats:italic>\n                    and other zoonotic diseases in people and pigs in Rwanda. Gendered norms among rural smallholders indicated a need for gender transformative information campaigns targeting specific recipients along the PVC nodes.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0014815","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:52:01Z","timestamp":1792605121000},"page":"e0014815","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cI will not accept to bury my pig\u201d: Taenia solium, WASH, and gender roles in the smallholder pork value chain in Southern Province, Rwanda"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6122-5332","authenticated-orcid":true,"given":"Janna M.","family":"Schurer","sequence":"first","affiliation":[{"name":"Center for One Health, University of Global Health Equity","place":["Butaro, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Zihiga","family":"Uwase","sequence":"additional","affiliation":[{"name":"Center for One Health, University of Global Health Equity","place":["Butaro, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prince","family":"Rwagasore","sequence":"additional","affiliation":[{"name":"Center for One Health, University of Global Health Equity","place":["Butaro, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Veterinarians without Borders Canada","place":["Ottawa, Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anselme","family":"Shyaka","sequence":"additional","affiliation":[{"name":"Center for One Health, University of Global Health Equity","place":["Butaro, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayechalem","family":"Moges","sequence":"additional","affiliation":[{"name":"Center for Gender Equity, University of Global Health Equity","place":["Butaro, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"pntd.0014815.ref001","unstructured":"World Health Organization. Taeniasis\/cysticercosis [Internet]. 2023 [cited 2023 Nov 10]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/taeniasis-cysticercosis"},{"issue":"5","key":"pntd.0014815.ref002","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1111\/j.1528-1167.2009.02401.x","article-title":"Meta-analysis of the association between cysticercosis and epilepsy in Africa","volume":"51","author":"F Quet","year":"2010","journal-title":"Epilepsia"},{"issue":"12","key":"pntd.0014815.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001923","article-title":"World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010","volume":"12","author":"AH Havelaar","year":"2015","journal-title":"PLoS Med"},{"key":"pntd.0014815.ref004","unstructured":"CDC - DPDx - Taeniasis [Internet]. 2024 [cited 2025 Oct 21]. Available from: https:\/\/www.cdc.gov\/dpdx\/taeniasis\/index.html"},{"issue":"10","key":"pntd.0014815.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012598","article-title":"High prevalence of porcine cysticercosis in slaughtered pigs in Rwanda: An abattoir survey","volume":"18","author":"A Shyaka","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"pntd.0014815.ref006","doi-asserted-by":"crossref","first-page":"304","DOI":"10.3347\/PHD.23045","article-title":"Intestinal parasitic infections among children aged 12\u201359 months in Nyamasheke District, Rwanda","volume":"61","author":"E Hakizimana","year":"2023","journal-title":"Parasites Hosts Dis"},{"key":"pntd.0014815.ref007","doi-asserted-by":"crossref","first-page":"645076","DOI":"10.3389\/fvets.2021.645076","article-title":"Evidence for transmission of Taenia solium taeniasis\/cysticercosis in a rural area of Northern Rwanda","volume":"8","author":"L Soto","year":"2021","journal-title":"Front Vet Sci"},{"issue":"11","key":"pntd.0014815.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002558","article-title":"High prevalence of cysticercosis in people with epilepsy in southern Rwanda","volume":"7","author":"R Rottbeck","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0014815.ref009","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/13552074.2013.767495","article-title":"I can do women\u2019s work: Reflections on engaging men as allies in women\u2019s economic empowerment in Rwanda","volume":"21","author":"H Slegh","year":"2013","journal-title":"Gend Dev"},{"key":"pntd.0014815.ref010","doi-asserted-by":"crossref","first-page":"102486","DOI":"10.1016\/j.foodpol.2023.102486","article-title":"Gender roles and masculinities in leveraging milk for household nutrition: Evidence from two districts in Rwanda","volume":"118","author":"C Farnworth","year":"2023","journal-title":"Food Policy"},{"issue":"2","key":"pntd.0014815.ref011","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1080\/09718524.2024.2352300","article-title":"Women\u2019s participation in and benefit from Rift Valley fever livestock vaccine value chain; Current situation and barriers in Nyagatare District, Rwanda","volume":"28","author":"D Majyambere","year":"2024","journal-title":"Gend Technol Dev"},{"key":"pntd.0014815.ref012","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.actatropica.2015.12.021","article-title":"The societal cost of Taenia solium cysticercosis in Tanzania","volume":"165","author":"C Trevisan","year":"2017","journal-title":"Acta Trop"},{"key":"pntd.0014815.ref013","doi-asserted-by":"crossref","first-page":"720553","DOI":"10.3389\/fvets.2021.720553","article-title":"Using a value chain approach to map the pig production system in Rwanda, Its governance, and sanitary risks","volume":"8","author":"A Shyaka","year":"2022","journal-title":"Front Vet Sci"},{"key":"pntd.0014815.ref014","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.actatropica.2016.04.010","article-title":"Control of Taenia solium taeniasis\/cysticercosis: The best way forward for sub-Saharan Africa?","volume":"165","author":"S Gabri\u00ebl","year":"2017","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0014815.ref015","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4314\/rjmhs.v3i1.6","article-title":"Status of water, hygiene and sanitation practices in Southern Rwanda","volume":"3","author":"T Ntakirutimana","year":"2020","journal-title":"RJMHS"},{"key":"pntd.0014815.ref016","volume-title":"The Fifth Rwanda Population and Housing Census, District Profile: Nyamagabe","year":"2023"},{"key":"pntd.0014815.ref017","volume-title":"Neglected Tropical Diseases Strategic Plan 2019-2024","author":"Republic of Rwanda","year":"2019"},{"key":"pntd.0014815.ref018","volume-title":"Rwanda Livestock Masterplan [Internet]","author":"B Shapiro","year":"2017"},{"key":"pntd.0014815.ref019","unstructured":"Ministry of Finance and Economic Planning. Vision 2050 [Internet]. Republic of Rwanda; 2015 [cited 2021 Jun 1]. Available from: https:\/\/www.nirda.gov.rw\/uploads\/tx_dce\/Vision_English_Version_2050_-31_Dec_2020.pdf"},{"key":"pntd.0014815.ref020","volume-title":"Rwanda: Comprehensive food security and vulnerability analysis","author":"L Hjelm","year":"2016"},{"key":"pntd.0014815.ref021","volume-title":"Seventh Integrated Household Living Conditions Survey (EICV7)","year":"2025"},{"key":"pntd.0014815.ref022","unstructured":"Improved sanitation facilities and drinking-water sources [Internet]. Geneva, Switzerland: World Health Organization; 2026 [cited 2026 May 6]. Available from: https:\/\/www.who.int\/data\/nutrition\/nlis\/info\/improved-sanitation-facilities-and-drinking-water-sources"},{"issue":"9","key":"pntd.0014815.ref023","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"BC O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"issue":"5","key":"pntd.0014815.ref024","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s11250-022-03289-2","article-title":"Challenges and opportunities of smallholder pig production systems in Rwanda","volume":"54","author":"C d\u2019Andre Hirwa","year":"2022","journal-title":"Trop Anim Health Prod"},{"key":"pntd.0014815.ref025","first-page":"18","article-title":"An epidemiological survey of the magnitude and local perceptions of porcine cysticercosis by two methods in Nyaruguru district, Rwanda","volume":"14","author":"B Mushonga","year":"2018","journal-title":"Vet Parasitol Reg Stud Reports"},{"key":"pntd.0014815.ref026","doi-asserted-by":"crossref","first-page":"836177","DOI":"10.3389\/fpubh.2022.836177","article-title":"Epidemiology of porcine cysticercosis in Eastern and Southern Africa: Systematic review and meta-analysis","volume":"10","author":"Y Gulelat","year":"2022","journal-title":"Front Public Health"},{"issue":"1","key":"pntd.0014815.ref027","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0001-706X(03)00026-3","article-title":"Improving pig husbandry in tropical resource-poor communities and its potential to reduce risk of porcine cysticercosis","volume":"87","author":"FP Lekule","year":"2003","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0014815.ref028","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/tmi.13703","article-title":"Human health and economic impact of neurocysticercosis in Uganda","volume":"27","author":"F Dupont","year":"2022","journal-title":"Trop Med Int Health"},{"issue":"1","key":"pntd.0014815.ref029","article-title":"Barriers to livestock vaccine use among rural female smallholder farmers of Nyagatare District in Rwanda","volume":"17","author":"L Mukamana","year":"2022","journal-title":"J Rural Community Dev"},{"key":"pntd.0014815.ref030","volume-title":"Women\u2019s empowerment in Rwandan agriculture: A baseline assessment in the context of Rwanda\u2019s gender and youth mainstreaming strategy and the fourth strategic plan for agricultural transformation","author":"G Rosenbach","year":"2023"},{"key":"pntd.0014815.ref031","unstructured":"Implementing Taenia solium control programmes in countries: monitoring and evaluation framework [Internet]. [cited 2025 Nov 4]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240100855"},{"issue":"1","key":"pntd.0014815.ref032","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s40249-021-00823-6","article-title":"Control trial of porcine cysticercosis in Uganda using a combination of the TSOL18 vaccination and oxfendazole","volume":"10","author":"Z Nsadha","year":"2021","journal-title":"Infect Dis Poverty"},{"issue":"10","key":"pntd.0014815.ref033","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0008785","article-title":"TSOL18 vaccine and oxfendazole for control of Taenia solium cysticercosis in pigs: A field trial in endemic areas of Tanzania","volume":"14","author":"ML Kabululu","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014815.ref034","doi-asserted-by":"crossref","first-page":"611166","DOI":"10.3389\/fvets.2021.611166","article-title":"Demand for Taenia solium cysticercosis vaccine: Lessons and insights from the pig production and trading nodes of the Uganda pig value chain","volume":"8","author":"E Ouma","year":"2021","journal-title":"Front Vet Sci"},{"issue":"3","key":"pntd.0014815.ref035","doi-asserted-by":"crossref","first-page":"286","DOI":"10.2166\/washdev.2022.204","article-title":"A one health evaluation of water, sanitation, and hygiene (WASH) services in Butaro Sector, Rwanda","volume":"12","author":"LL Coughlin","year":"2022","journal-title":"J Water Sanit Hyg Dev"},{"key":"pntd.0014815.ref036","unstructured":"Water, sanitation & hygiene in Rwanda: A situation report [Internet]. UNICEF; 2024 [cited 2025 Nov 5]. p. 6. Available from: https:\/\/www.unicef.org\/rwanda\/media\/5381\/file\/UNICEF%20Rwanda.pdf"},{"key":"pntd.0014815.ref037","first-page":"37","article-title":"Capacity building for surveillance and control of Taenia solium\/cysticercosis","volume":"6","author":"K Murrell","year":"2026","journal-title":"FAO Anim Prod Health Proc"},{"issue":"3","key":"pntd.0014815.ref038","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003570","article-title":"Why latrines are not used: Communities\u2019 perceptions and practices regarding latrines in a Taenia solium endemic rural area in eastern Zambia","volume":"9","author":"S Thys","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"pntd.0014815.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0013624","article-title":"Evaluation of a One Health public health program based on minimum inputs to control Taenia solium in Madagascar","volume":"19","author":"DE Andria-Mananjara","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0014815.ref040","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40066-017-0095-7","article-title":"Men and women farmers\u2019 perceptions of adopting improved diets for pigs in Uganda: Decision-making, income allocation, and intra-household strategies that mitigate relative disadvantage","volume":"6","author":"NA Carter","year":"2017","journal-title":"Agric Food Secur"},{"key":"pntd.0014815.ref041","unstructured":"Ministry of Gender and Family Promotion. Revised National Gender Policy: Accelerating the Effectiveness of Gender Mainstreaming and Accountability for National Transformation. 2021."}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:52:11Z","timestamp":1792605131000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014815"}},"subtitle":[],"editor":[{"given":"Feng","family":"Xue","sequence":"first","affiliation":[{"name":"Zhejiang Wanli University","place":["CHINA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014815","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]}}}