# Implementation of ring strategy for community-engaged control of neurocysticercosis

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2021 · $502,823

## Abstract

PROJECT SUMMARY
Neurocysticercosis (NCC) is a common neurologic disease and a leading cause of preventable epilepsy in
Asia, Africa, and Latin America. It is caused by central nervous infection with Taenia solium (the pork
tapeworm). While there has been considerable recent progress in developing interventions to control
transmission, programmatic adoption of these strategies has lagged far behind. There is an urgent need for
sound implementation research to ensure that the most effective and practical strategies can be adopted. Over
the past 7 years we developed, optimized, and tested a targeted approach known as ring treatment that takes
advantage of the strong spatial clustering between human and pig hosts of this zoonotic disease. Surveillance
and detection of pig infection (cysticercosis), which is visible in meat at time of slaughter and in the tongues of
live pigs, leads to treatment for taeniasis (human intestinal infection) in nearby homes. This strategy provides a
simple and practical method for surveillance leading to efficient treatment of those humans at highest risk of
being infected with taeniasis. In a head-to-head cluster randomized trial over 2 years, ring treatment achieved
the same robust level of reduced parasite transmission as mass treatment (69.3% vs. 64.7% reduction,
respectively) but did so using only a small fraction of the drug (1791 vs. 11,186 doses). However, a number of
barriers exist that must still be solved for ring treatment to adopted a control program.
In this 5-year project, we use the Consolidated Framework for Implementation Research (CFIR) to develop an
adoptable approach for ring treatment as a control program for T. solium. We first use formative evaluation with
stakeholders to develop intervention protocols, then refine these protocols through a pilot study with iterative
evaluation. We then evaluate ring treatment implementation as a government run and community-engaged
program in a 3 year trial, following the cRE-AIM framework (cost, reach, adoption, implementation, and
maintenance). We also evaluate the utility and effectiveness of integrating a new urine screening assay for
cysticercosis in ring treatment intervention. Finally, we provide a series of didactic and applied implementation
research training opportunities for trainees to advance capacity for implementation research in Peru.

## Key facts

- **NIH application ID:** 10229455
- **Project number:** 5R01NS080645-08
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Javier A Bustos
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $502,823
- **Award type:** 5
- **Project period:** 2013-12-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10229455

## Citation

> US National Institutes of Health, RePORTER application 10229455, Implementation of ring strategy for community-engaged control of neurocysticercosis (5R01NS080645-08). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10229455. Licensed CC0.

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