Efficacy and safety of antiparasitic therapy for neurocysticercosis in rural Tanzania: a prospective cohort study
Purpose Neurocysticercosis is common in regions endemic for Taenia solium. Active-stage neurocysticercosis can be treated with antiparasitic medication, but so far no study on efficacy and safety has been conducted in Africa. Methods We conducted a prospective cohort study on treatment of neurocysticercosis in Tanzania between August 2018 and January 2022. Patients were initially treated with albendazole (15 mg/kg/d) for 10 days and followed up for 6 months. Additionally in July 2021, all participants who then still had cysts were offered a combination therapy consisting of albendazole (15 mg/kg/d) and praziquantel (50 mg/kg/d). Antiparasitic treatment was accompanied by corticosteroid medication and anti-seizure medication if the patient had experienced epileptic seizures before treatment. Results Sixty-three patients were recruited for this study, of whom 17 had a complete follow-up after albendazole monotherapy. These patients had a total of 138 cysts at baseline, of which 58 (42%) had disappeared or calcified by the end of follow-up. The median cyst reduction was 40% (interquartile range 11–63%). Frequency of epileptic seizures reduced considerably (p < 0.001). Three patients had all active cysts resolved or calcified and of the remaining 14, eight received the combination therapy which resolved 63 of 66 cysts (95%). Adverse events were infrequent and mild to moderate during both treatment cycles. Conclusion Cyst resolution was unsatisfactory with albendazole monotherapy but was very high when it was followed by a combination of albendazole and praziquantel..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
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| Enthalten in: |
Infection - 51(2023), 4 vom: 24. März, Seite 1127-1139 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Stelzle, D. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Albendazole |
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| Anmerkungen: |
© The Author(s) 2023 |
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| doi: |
10.1007/s15010-023-02021-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2144518424 |
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| 245 | 1 | 0 | |a Efficacy and safety of antiparasitic therapy for neurocysticercosis in rural Tanzania: a prospective cohort study |
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| 520 | |a Purpose Neurocysticercosis is common in regions endemic for Taenia solium. Active-stage neurocysticercosis can be treated with antiparasitic medication, but so far no study on efficacy and safety has been conducted in Africa. Methods We conducted a prospective cohort study on treatment of neurocysticercosis in Tanzania between August 2018 and January 2022. Patients were initially treated with albendazole (15 mg/kg/d) for 10 days and followed up for 6 months. Additionally in July 2021, all participants who then still had cysts were offered a combination therapy consisting of albendazole (15 mg/kg/d) and praziquantel (50 mg/kg/d). Antiparasitic treatment was accompanied by corticosteroid medication and anti-seizure medication if the patient had experienced epileptic seizures before treatment. Results Sixty-three patients were recruited for this study, of whom 17 had a complete follow-up after albendazole monotherapy. These patients had a total of 138 cysts at baseline, of which 58 (42%) had disappeared or calcified by the end of follow-up. The median cyst reduction was 40% (interquartile range 11–63%). Frequency of epileptic seizures reduced considerably (p < 0.001). Three patients had all active cysts resolved or calcified and of the remaining 14, eight received the combination therapy which resolved 63 of 66 cysts (95%). Adverse events were infrequent and mild to moderate during both treatment cycles. Conclusion Cyst resolution was unsatisfactory with albendazole monotherapy but was very high when it was followed by a combination of albendazole and praziquantel. | ||
| 650 | 4 | |a Neurocysticercosis | |
| 650 | 4 | |a Neglected tropical diseases | |
| 650 | 4 | |a Antiparasitic medication | |
| 650 | 4 | |a Albendazole | |
| 650 | 4 | |a Praziquantel | |
| 700 | 1 | |a Makasi, C. |0 (orcid)0000-0002-2484-617X |4 aut | |
| 700 | 1 | |a Schmidt, V. |4 aut | |
| 700 | 1 | |a Trevisan, C. |4 aut | |
| 700 | 1 | |a Van Damme, I. |0 (orcid)0000-0003-2488-1132 |4 aut | |
| 700 | 1 | |a Ruether, C. |4 aut | |
| 700 | 1 | |a Dorny, P. |4 aut | |
| 700 | 1 | |a Magnussen, P. |4 aut | |
| 700 | 1 | |a Zulu, G. |4 aut | |
| 700 | 1 | |a Mwape, K. E. |4 aut | |
| 700 | 1 | |a Bottieau, E. |4 aut | |
| 700 | 1 | |a Prazeres da Costa, C. |4 aut | |
| 700 | 1 | |a Prodjinotho, U. F. |4 aut | |
| 700 | 1 | |a Carabin, H. |4 aut | |
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| 700 | 1 | |a Ngowi, B. J. |4 aut | |
| 700 | 1 | |a Winkler, A. S. |0 (orcid)0000-0003-3131-6983 |4 aut | |
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