Efficacy and safety of antiparasitic therapy for neurocysticercosis in rural Tanzania: a prospective cohort study

Autor: D. Stelzle, C. Makasi, V. Schmidt, C. Trevisan, I. Van Damme, C. Ruether, P. Dorny, P. Magnussen, G. Zulu, K. E. Mwape, E. Bottieau, C. Prazeres da Costa, U. F. Prodjinotho, H. Carabin, E. Jackson, A. Fleury, S. Gabriël, B. J. Ngowi, A. S. Winkler
Rok vydání: 2023
Předmět:
Zdroj: Infection.
ISSN: 1439-0973
0300-8126
Popis: 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.
Databáze: OpenAIRE
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