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The Cochrane Database of Systematic... Jul 2007Anthelminthic drugs may shrink brain cysts in neurocysticercosis, but can also cause severe adverse effects. (Review)
Review
BACKGROUND
Anthelminthic drugs may shrink brain cysts in neurocysticercosis, but can also cause severe adverse effects.
OBJECTIVES
The objective of this review was to assess the effects of drug treatment in human neurocysticercosis in relation to survival, cyst persistence, subsequent seizures and hydrocephalus.
SEARCH STRATEGY
We searched the Cochrane Infectious Diseases Group specialized trials register (September 2002), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2002), MEDLINE (1966 to September 2002), EMBASE (1980 to August 2002), LILACS (September 2002). We contacted researchers and experts in the field, and pharmaceutical companies.
SELECTION CRITERIA
Randomised or quasi-randomised trials comparing a cysticidal drug with a placebo or a control group receiving symptomatic therapy, in patients with neurocystercosis.
DATA COLLECTION AND ANALYSIS
Assessment of trial quality and data extraction was done independently by two reviewers.
MAIN RESULTS
Four studies involving 305 people met the inclusion criteria. None reported on withdrawal of anticonvulsant therapy, headache relief, disability or death as outcomes. A difference just approaching significance was detected between cysticidal therapy and placebo in relation to cyst persistence up to six months (relative risk 0.83, 95% confidence interval 0.70 to 0.99). Two trials reported on seizures after one to two years follow-up and found no difference (relative risk 0.95, 95% 0.59 to 1.51). There was no difference detected for hydrocephalus (relative risk 2.19, 95% confidence interval 0.29 to 16.55).
AUTHORS' CONCLUSIONS
There is insufficient evidence to assess whether cysticidal therapy in neurocysticerosis is associated with beneficial effects.
Topics: Albendazole; Anticestodal Agents; Brain Diseases; Humans; Neurocysticercosis; Praziquantel; Trichlorfon
PubMed: 17636621
DOI: 10.1002/14651858.CD000215.pub2 -
Parasitology Research Aug 2016Cystic echinococcosis (CE) is a widespread zoonosis caused by the species complex Echinococcus granulosus. Albendazole (ABZ)-the first-line anthelminthic drug for...
Cystic echinococcosis (CE) is a widespread zoonosis caused by the species complex Echinococcus granulosus. Albendazole (ABZ)-the first-line anthelminthic drug for medical treatment of CE-is metabolized in vivo to the active derivative ABZ-sulphoxide (ABZ-SO). Target-site ABZ-SO concentrations in the hydatid cyst mediate the anthelminthic effect in CE. Primary outcome of this systematic review of individual patient data was the intra-cystic ABZ-SO concentration stratified by cyst size, location, calcification status and use of praziquantel. Studies reporting intra-cystic ABZ-SO concentrations in humans were identified by a systematic search. A pooled analysis of individual patient data was performed to assess intra-cystic concentrations. Pharmacokinetic data of 121 individual cysts were analysed. There was no correlation between plasma and intra-cystic ABZ-SO concentrations (rho = -0.03, p = 0.76). Intra-cystic drug concentrations were also not associated with sex and treatment duration. Use of praziquantel in combination with ABZ was associated with higher plasma (median 540 vs. 240 μg/L; p = 0.04) but not intra-cystic ABZ-SO concentrations (median 220 vs. 199 μg/L; p = 0.36). Relative drug concentrations in hepatic cysts were higher than in other cysts (0.8 vs. 0.4; p = 0.05). Intra-cystic concentrations were higher in calcified than non-calcified cysts (median 897 vs. 245 μg/L; p = 0.03). There was a trend towards higher intra-cystic concentrations in smaller sized cysts (β = -17.2 μg/L/cm; 95th CI, -35.9 to 1.6; p = 0.07). This study demonstrates that mean intra-cystic drug concentrations are similar to plasma concentrations on a population level. However, in individual patients plasma concentrations are not directly predictive for intra-cystic concentrations. The use of booster drugs was not associated with higher intra-cystic ABZ-SO concentrations in this analysis.
Topics: Albendazole; Animals; Anthelmintics; Cysts; Echinococcosis; Echinococcus granulosus; Humans; Praziquantel
PubMed: 27085708
DOI: 10.1007/s00436-016-5054-x -
Expert Review of Anti-infective Therapy Jul 2013Preventive chemotherapy campaigns against schistosomiasis have progressively scaled-up during the last decade, administering single standard dose praziquantel... (Review)
Review
Preventive chemotherapy campaigns against schistosomiasis have progressively scaled-up during the last decade, administering single standard dose praziquantel (40 mg/kg) treatments to millions of African children. Steps taken in securing international advocacy and national level implementation are traced to highlight an international treatment platform set for further expansion, including surveillance of schistosomiasis, school-level targeting with better on-site drug administration and annual reporting of programmatic indicators (i.e., treatment coverage), potentially in real-time. Several shortcomings in need of resolution are identified and efficacy of praziquantel is assessed by a systematic review. If WHO predictions in reduction of schistosomiasis are to be realized, careful international harmonization and tailoring of national resources are required. Maintaining an effective drug distribution system and regularly checking drug efficacy are paramount.
Topics: Africa; Anthelmintics; Child; Disease Eradication; Epidemiological Monitoring; Humans; Praziquantel; Schistosomiasis; Treatment Outcome
PubMed: 23879611
DOI: 10.1586/14787210.2013.811931 -
Travel Medicine and Infectious Disease 2020Schistosoma japonicum is endemic in the Philippines, China, and Indonesia, and is the third-most common schistosoma species. The infection can be asymptomatic for years...
BACKGROUND
Schistosoma japonicum is endemic in the Philippines, China, and Indonesia, and is the third-most common schistosoma species. The infection can be asymptomatic for years but, if left untreated, can lead to irreversible complications.
METHOD
We report the results of a systematic review of the literature on imported S. japonicum infection and describe two previously unpublished cases diagnosed in Filipino migrants in Italy.
RESULTS
Twenty-five imported cases of S. japonicum schistosomiasis were retrieved. All patients but one were migrants. Most subjects acquired the infection in Philippines (n = 18, 72%). Median age at diagnosis was 46 years. Median period of residence in non-endemic countries before diagnosis was 14.5 years. Cases of prevalent hepatosplenic involvement were 10 (40%), those with prevalent intestinal involvement were 10 (40%), whereas five (20%) had overlapping manifestations. Ten patients suffered from cirrhosis; two underwent liver transplantation. Three patients presented with acute abdomen due to intestinal complications, leading to explorative laparotomy. In all cases, but one, the diagnosis was based on a histological examination of biopsy specimen, revealing S. japonicum ova. Seventeen patients were treated with praziquantel, and in three of them, possible treatment failures occurred.
CONCLUSIONS
S. japonicum infection is uncommonly reported in non-endemic areas, but is probably underestimated because of a low threshold awareness of clinicians and unavailability of specific diagnostic tools. Viable S. japonicum adults may persist for decades, indicating that migrants or travellers previously exposed in areas with high-risk areas can harbour viable worms and deserve treatment.
Topics: Adult; Animals; Humans; Italy; Philippines; Schistosoma japonicum; Schistosomiasis japonica; Transients and Migrants
PubMed: 31561021
DOI: 10.1016/j.tmaid.2019.101496 -
Infectious Diseases of Poverty Apr 2023Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world. This disease is responsible for many socio-economic...
BACKGROUND
Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world. This disease is responsible for many socio-economic and public health issues. The aim of this study was to investigate the impact of the disease on morbidity and to describe demographic and socioeconomic factors in relation to the status of children with urogenital schistosomiasis in Mali.
METHODS
We conducted a cross-sectional study in November 2021 of 971 children aged 6 to 14 years selected at random from six schools in three districts in the Kayes Region of Mali. Demographic and socioeconomic data were collected on survey forms. Clinical data were collected following a medical consultation. Hematuria was systematically searched for through the use of strips. The search for Schistosoma haematobium eggs in urine was done via the filtration method. The urinary tract was examined by ultrasound. Associations between each of these variables and disease infection were tested using multivariate logistic regression.
RESULTS
The overall prevalence of urinary schistosomiasis detected was 50.2%. The average intensity of infection was 36 eggs/10 ml of urine. The associated risk factors for urogenital schistosomiasis showed that children who bathed, used the river/pond as a domestic water source, and who habitually urinated in the river/pond were more affected (P < 0.05). Children with farming parents were most affected (P = 0.032). The collection of clinical signs revealed that boys had more pollakiuria (58.6%) and dysuria (46.4%) than girls. Ultrasound data showed that focal lesion rates were recorded in all villages with the lowest rate in Diakalel (56.1%). Ultrasound and parasitological findings showed that irregularity and thickening were strongly associated with urinary schistosomiasis (P < 0.0001).
CONCLUSIONS
Schistosoma haematobium infection was still endemic in the study site despite more than a decade of mass treatment with praziquantel. However, the high percentage of symptoms associated with high intensity reinforces the idea that further studies in terms of schistosomiasis-related morbidity are still needed.
Topics: Male; Female; Animals; Humans; Child; Schistosomiasis haematobia; Mali; Cross-Sectional Studies; Schistosoma haematobium; Prevalence; Risk Factors; Schools
PubMed: 37081494
DOI: 10.1186/s40249-023-01071-6 -
Pathogens (Basel, Switzerland) Jun 2024Schistosome egg deposition in pregnant women may affect the placenta of infected mothers and cause placental schistosomiasis (PS). Histopathological examination of... (Review)
Review
BACKGROUND
Schistosome egg deposition in pregnant women may affect the placenta of infected mothers and cause placental schistosomiasis (PS). Histopathological examination of placental tissue is an inadequate detection method due to low sensitivity. So far, there has not been any systematic review on PS.
METHODS
We conducted a systematic literature search on PubMed, EMBASE, and Medline and included all publications that reported microscopically confirmed cases of PS, as well as the relevant secondary literature found in the citations of the primarily included publications.
RESULTS
Out of 113 abstracts screened we found a total of 8 publications describing PS with a total of 92 cases describing egg deposition of dead and/or viable eggs and worms of and in placental tissue. One cross-sectional study investigating the prevalence of PS and its association with adverse birth outcomes, found 22% of placentas to be infested using a maceration technique but only <1% using histologic examination. Additionally, no direct link to deleterious pregnancy outcomes could be shown.
CONCLUSIONS
PS is a highly unattended and underdiagnosed condition in endemic populations, due to a lack of awareness as well as low sensitivity of histopathological examinations. However, PS may play an important role in mediating or reinforcing adverse birth outcomes (ABO) such as fetal growth restriction (FGR) in maternal schistosomiasis, possibly by placental inflammation.
PubMed: 38921768
DOI: 10.3390/pathogens13060470 -
PLoS Neglected Tropical Diseases Jan 2021Schistosomiasis affects nearly 220 million people worldwide, mainly in Sub-Saharan Africa (SSA). Preventive chemotherapy (PC) treatment, through regular mass-drug...
BACKGROUND
Schistosomiasis affects nearly 220 million people worldwide, mainly in Sub-Saharan Africa (SSA). Preventive chemotherapy (PC) treatment, through regular mass-drug administration (MDA) of Praziquantel tablets remains the control measure of choice by Ministries of Health. Current guidelines recommend that 75% of school-aged children receive treatment. Many programmes, however, struggle to achieve this target. Given the risk of high reinfection rates, attaining sustained high levels of treatment coverage is essential. This study provides a comprehensive review of the barriers and facilitators operating at different levels of analysis, from the individual to the policy level, conditioning the uptake of PC for schistosomiasis in SSA.
METHODOLOGY/PRINCIPAL FINDINGS
A systematic literature search was conducted in several databases for publications released between January 2002 and 2019 that examined factors conditioning the uptake of Praziquantel in the context of MDA campaigns in SSA. A total of 2,258 unique abstracts were identified, of which 65 were selected for full text review and 30 met all eligibility criteria. Joanna Briggs Institute's Critical Appraisal and the Mixed-Methods Assessment tools were used to assess the strength of the evidence. This review was registered with PROSPERO (CRD42017058525). A meta-synthesis approach was used. Results indicated publication bias, with the literature focusing on East African rural settings and evidence at the individual and programmatic levels. The main influencing factors identified included material wellbeing, drug properties, knowledge and attitudes towards schistosomiasis and MDAs, fears of side effects, gender values, community and health systems support, alongside programme design features, like training, sensitisation, and provision of incentives for drug-distributors. The effect of these factors on determining Praziquantel uptake were explored in detail.
CONCLUSIONS/SIGNIFICANCE
Multiple determinants of treatment uptake were found in each level of analysis examined. Some of them interact with each other, thus affecting outcomes directly and indirectly. The promotion of context-based transdisciplinary research on the complex dynamics of treatment uptake is not only desirable, but essential, to design effective strategies to attain high levels of treatment coverage.
Topics: Africa South of the Sahara; Animals; Anthelmintics; Chemoprevention; Health Knowledge, Attitudes, Practice; Humans; Mass Drug Administration; Praziquantel; Schistosoma; Schistosomiasis
PubMed: 33465076
DOI: 10.1371/journal.pntd.0009017 -
BMJ (Clinical Research Ed.) May 2007To evaluate the effect of routine administration of intestinal anthelmintic drugs on haemoglobin. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the effect of routine administration of intestinal anthelmintic drugs on haemoglobin.
DESIGN
Systematic review of randomised controlled trials.
DATA SOURCES
Electronic databases and hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences.
STUDY SELECTION
Included studies were randomised or quasi-randomised controlled trials using an intestinal anthelmintic agent in the intervention group, in which haemoglobin was evaluated as an outcome measure. Trials in which treatment for schistosoma (praziquantel) was given exclusively to the intervention group were excluded.
RESULTS
The search identified 14 eligible randomised controlled trials. Data were available for 7829 subjects, of whom 4107 received an anthelmintic drug and 3722 received placebo. The pooled weighted mean difference (random effect model) of the change in haemoglobin was 1.71 (95% confidence interval 0.70 to 2.73) g/l (P<0.001; test for heterogeneity: Cochran Q=51.17, P<0.001; I(2)=61% (37% to 76%)). With the World Health Organization's recommended haemoglobin cut-offs of 120 g/l in adults and 110 g/l in children, the average estimated reduction in prevalence of anaemia ranged from 1.1% to 12.4% in adults and from 4.4% to 21.0% in children. The estimated reductions in the prevalence of anaemia increased with lower haemoglobin cut-offs used to define anaemia.
CONCLUSIONS
Routine administration of intestinal anthelmintic agents results in a marginal increase in haemoglobin (1.71 g/l), which could translate on a public health scale into a small (5% to 10%) reduction in the prevalence of anaemia in populations with a relatively high prevalence of intestinal helminthiasis.
Topics: Anthelmintics; Helminthiasis; Hemoglobins; Humans; Intestinal Diseases, Parasitic; Randomized Controlled Trials as Topic
PubMed: 17434954
DOI: 10.1136/bmj.39150.510475.AE -
International Journal of Public Health Nov 2015Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential...
OBJECTIVES
Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested.
METHODS
PubMed published literature was reviewed based on the MOOSE guidelines. All publications on MGS were included regardless of publication year and study design. Furthermore, all publications were searched for information on possible HIV association.
RESULTS
The 40 identified publications related to MGS were dominated by case reports and observational studies. No randomized clinical trials have been conducted to date, and very scant information related to possible associations with HIV transmission was presented.
CONCLUSIONS
Clinical, randomized studies and epidemiological studies covering the possible association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition.
SYSTEMATIC REVIEW REGISTRATION NUMBER
CRD42015016252.
Topics: Adult; Animals; Endemic Diseases; HIV Infections; HIV-1; Humans; Male; Praziquantel; Risk Factors; Schistosoma haematobium; Schistosomiasis haematobia; Schistosomicides; Sexually Transmitted Diseases; Virus Shedding
PubMed: 26298443
DOI: 10.1007/s00038-015-0714-7 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Oct 2018To investigate the changes of brain CT imaging in patients with cerebral cysticercosis during the period of anti-cysticercus chemotherapy.
OBJECTIVE
To investigate the changes of brain CT imaging in patients with cerebral cysticercosis during the period of anti-cysticercus chemotherapy.
METHODS
A total of 380 inpatients that were conformed to the practical diagnostic criteria of cerebral cysticercosis were enrolled in this study in the Third Affiliated Hospital of Shandong Academy of Medical Sciences from May 2010 to May 2015. All the patients were given anti-cysticercus chemotherapy (albendazole and praziquantel). All the patients received brain CT scan, and of which 210 received enhanced scan. The data of CT imaging were systematically reviewed.
RESULTS
Before the treatment, the CT images of the patients showed single or multiple small cystic (s) with low density and small nodule-like cephalomere with high density. The re-examinations of CT showed that there were 81.58% (310/380) of the patients whose low density foci were completely absorbed, there were 16.32% (62/380) of the patients whose foci were mostly absorbed, and there were 2.11% (8/380) of the patients whose foci were calcified. Along with the prolongation of treatment time, the side effects were gradually reduced, and in the third course of treatment, the foci were absorbed or calcified in most of the patients.
CONCLUSIONS
CT examination can diagnose the lesion site, range and classification of cerebral cysticercosis, and can evaluate the effect of the therapy according to the changes of CT imaging during the period of anti-cysticercus chemotherapy.
Topics: Albendazole; Animals; Brain; Cysticercus; Humans; Neurocysticercosis; Tomography, X-Ray Computed
PubMed: 30567023
DOI: 10.16250/j.32.1374.2018016