DURATION OF ALBENDAZOLE THERAPY IN NEUROCYSTICERCOSIS –DOES IT MATTER ??

Abstract

Taenia solium is endemic in India. Poor hygiene and living conditions, allowing pigs access to human faeces, puts people at risk of developing cysticercosis . In endemic countries like India the disease is prevalent in urban, middle-class areas.  Cysticercosis  is a parasitic infection of the larval form of the zoonotic tapeworm, Taenia  solium infection by adult larva in human causes Taeniasis  and  Cysticercosis. Infection of the central nervous system by the larval form is called Neurocysticercosis (NCC). This is the most common parasitic infection of the central nervous system ^1,2 . It is also the leading cause of epilepsy in the developing countries ^1,2,3.Cysticercosis / Taeniasis appears to be serious public and agricultural problem. Epileptic seizure is the most common presentation seen in 70-90% of the cases of NCC ^4,5 .

As NCC has given the burden of epilepsy patient in our country especially in pig farming areas. The pig production is markedly affected due to cysticercosis, resulting in condemnation of live pigs or carcasses at meat inspection and reduction in their commercial value ³ .

Before the advent of neuroimaging facility neurocysticercosis was diagnosed on the basis of clinical features, CT head and search of eggs in stool examination. After the availability of MRI doubtful findings of CT head can be confirmed. On MRI vesicular cyst shows hypodense fluid, non-enhancing to mildly enhancing lesion which is not surrounded by oedema. While the degenerated cyst shows small isodense lesion with ring enhancement on contrast medium and perilesional oedema and calcified cyst ^6,7 .

Standard regimen uses 28-30 days schedule. Some of previous studies shown there is equal effectiveness and efficacy of short-term regimen as compare to the standard therapy of 28 -30 days, but there are conflicting reports in previous study of very short duration of therapy and patients with different stage of lesions. Due to the enormous benefits of short-term regimen as compared to the standard regimen in terms of cost effectiveness, better compliance, less therapy related complication. ithas recently been studied by several workers.

It was decided to conduct this prospective, randomized controlled studycomparing 14 days of albendazole therapy versus 28 days of albendazole therapyin children with neurocysticercosis.