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

Stelzle, D; Makasi, C; Schmidt, V; Trevisan, C; Van Damme, I; Ruether, C; Dorny, P; Magnussen, P; Zulu, G; Mwape, K E; Bottieau, E; Prazeres da Costa, C; Prodjinotho, U F; Carabin, H; Jackson, E; Fleury, A; Gabriël, S; Ngowi, B J; Winkler, A S

doi:10.1007/s15010-023-02021-y

User: Guest

journal article

Title:: Efficacy and safety of antiparasitic therapy for neurocysticercosis in rural Tanzania: a prospective cohort study.
Document type:: Journal Article
Author(s):: Stelzle, D; Makasi, C; Schmidt, V; Trevisan, C; Van Damme, I; Ruether, C; Dorny, P; Magnussen, P; Zulu, G; Mwape, K E; Bottieau, E; Prazeres da Costa, C; Prodjinotho, U F; Carabin, H; Jackson, E; Fleury, A; Gabriël, S; Ngowi, B J; Winkler, A S
Abstract:: 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.
Journal title abbreviation:: Infection
Year:: 2023
Journal volume:: 51
Journal issue:: 4
Pages contribution:: 1127-1139
Fulltext / DOI:: doi:10.1007/s15010-023-02021-y
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/36961623
Print-ISSN:: 0300-8126
TUM Institution:: Institut für Medizinische Mikrobiologie, Immunologie und Hygiene (Prof. Busch); Klinik und Poliklinik für Neurologie (Prof. Hemmer)
BibTeX