Review Article Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives
Am. J. Trop. Med. Hyg., 79(3), 2008, pp. 301–311 Copyright © 2008 by The American Society of Tropical Medicine and Hygiene Review Article Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives Thomas Junghanss, Antonio Menezes da Silva, John Horton, Peter L. Chiodini, and Enrico Brunetti* Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom;Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy Abstract. Clinical management of cystic echinococcosis (CE) has evolved over decades without adequate evaluation of important features such as efficacy, effectiveness, rate of adverse reactions, relapse rate, and cost. CE occurs in health care environments as different as Europe/North America and resource-poor countries of the South and the East. This creates setting-specific problems in the management of patients. Furthermore, studies carried out in either of the two fundamentally different environments lack external validity, i.e., results obtained in one setting may be different from those in the other and practices that can work in one may not be applicable to the other. In this paper, we review the current management procedures of CE with particular emphasis on the evidence base and setting-specific problems. INTRODUCTION dures of CE with particular emphasis on the evidence base and setting-specific problems. Cystic echinococcosis (CE) is among the most neglected parasitic diseases. Development of new drugs and other treat- MATERIALS AND METHODS ment modalities receives very little attention, if any, and is Papers covering the subject were obtained by a Medline slow.1,2 Clinical management procedures have evolved over search of the literature published in English on this subject.
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