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Abstract

Abstract Background In sub-Saharan Africa, studies have examined stakeholder knowledge, attitudes, and practices in the pig value chain alongside porcine cysticercosis occurrence. However, cross-border pig traders' understanding of, and responses to, the Taenia solium complex remain understudied. This gap can limit understanding of other factors facilitating parasite spread and hamper effective control strategies in endemic areas. This research assessed stakeholder knowledge, attitudes, and practices in the cross-border pig food chain between Zambia (a southern African country and pig exporter) and the Democratic Republic of Congo (a central African country, pig importer and consumer) regarding T. solium . Method From September 2023 to January 2025, this study employed semi-structured interviews with 70 Congolese stakeholders and observations across Kasenga, Kasumbalesa, Kipushi, Sakania (border), and Lubumbashi. The 41-question survey evaluated sociodemographics, knowledge, attitudes, practices, and economic impacts of porcine cysticercosis, while observations examined how stakeholders handled infected carcasses. Results Most participants were male (6:4 ratio), aged 14–60 years (average: 35 ± 10), with 2 months to 35 years of experience. They included live pig traders, buyers/sellers, slaughterers, slaughterer-sellers, and pork grill vendors. Taenia solium complex knowledge scores ranged from 2.5 to 19.5 out of 24 (median: 9), indicating moderate understanding of its zoonotic aspects; porcine cysticercosis knowledge varied from insufficient to good. Human taeniasis and cysticercosis scores ranged from 0 to 5 out of 6 (median: 0), with 57.1% (40/70) scoring zero. Attitude and risk-practice scores ranged from 1 to 6.5 out of 9, reflecting low to very high public health risks, including importing and distributing infected pigs. Professional experience was associated with porcine cysticercosis knowledge scores and the disease's zoonotic dimension. Attitude and practice scores did not differ by gender, age, profession, workplace, or experience. Inconsistent pig sanitary control across the food chain (Zambian sources, DRC borders) allowed infected carcasses to reach consumers' plates in Haut-Katanga. Conclusion The reported knowledge gaps and risky practices indicate that infected pigs from Zambia could be reaching consumers in the DRC. This poses a public health risk and underscores the importance of coordinated “One Health” strategies that target, collaborate, and engage stakeholders to achieve effective parasite control.