MEDAN – For some communities in Simalungun, consuming pork or wild boar dishes mixed with raw liver—a local culinary tradition often served during traditional ceremonies and communal gatherings—is considered a delicacy. However, behind this extreme culinary practice lies a significant health threat. A recent medical study has revealed that the habit of eating raw pork liver has triggered a surge in tapeworm infections (taeniasis) in the region.
An international scientific study titled “A New Focus of Taenia asiatica Taeniasis in North Sumatra, Indonesia: Molecular Confirmation and Prevalence,” published in Parasitology International (2025), successfully identified this new endemic area. The large-scale research, based on genetic tracking, was led by renowned parasitologist Prof. Dr. dr. Dewi Masyithah Darlan, DAP&E, MPH, Sp.ParK from the Faculty of Medicine, Universitas Sumatera Utara (USU), together with an international team of researchers.
A Parasite Detective: Prof. Dewi Masyithah Identifies a New Endemic Area
As the lead investigator, Prof. Dewi Masyithah Darlan focused her research in Raya Kahean District, Simalungun Regency, an area neighboring Silau Kahean District, which had already been identified as an endemic region for Taenia asiatica in 2014. Motivated by reports from local health centers, her team collected and examined hundreds of stool samples from residents.
The findings were striking. Of the 428 residents examined, 21.7% tested positive for tapeworm infections. In several remote villages, including Sorba Dolok and Bah Tonang, infection rates reached 65.4% and 44.3%, respectively. Most cases were found among adult men over the age of 18 who worked as oil palm plantation farmers.
Genetic Evidence Reveals a Hybrid Tapeworm
To confirm the species responsible for the outbreak, Prof. Dewi Masyithah's team analyzed proglottid samples using Multiplex PCR technology. The results confirmed that all samples were positive for Taenia asiatica.
Further genetic analysis of the COX1 and pold genes revealed a unique scientific finding. The Taenia asiatica tapeworms discovered in Simalungun showed very low genetic diversity and appeared to be descendants of an ancient hybridization between Taenia asiatica (Asian pork tapeworm) and Taenia saginata (beef tapeworm). This discovery suggests that transmission has become deeply established within the local ecosystem.
Breaking the Chain of Transmission
Based on field interviews and questionnaires, the researchers identified two major factors sustaining transmission: traditional livestock management and dietary habits. Many residents still allow pigs to roam freely around oil palm plantations, where they can consume human feces containing tapeworm eggs due to open defecation practices. The eggs then develop into cysts (cysticerci) within the pigs’ livers.
When pigs or hunted wild boars are slaughtered, infected liver tissue is often mixed into traditional dishes without being thoroughly cooked and is consumed communally. Once ingested, the cysts develop into adult tapeworms in the human digestive system.
Through this publication, Prof. Dewi Masyithah Darlan urged local authorities to take immediate action by strengthening sanitation education, promoting safer food preparation practices, implementing regular surveillance, and conducting mass treatment programs to eliminate tapeworm carriers and break the cycle of infection.