Current management of cystic echinococcosis: a survey of specialist practice.
نویسندگان
چکیده
BACKGROUND Cystic echinococcosis (CE) is a significant public health problem worldwide. However, there remains a dearth of evidence guiding treatment in various stages of CE. The 2010 World Health Organization (WHO) Informal Working Group on Echinococcosis (WHO IWGE) guidance is thus based on expert consensus rather than a good evidence base. This study aims to describe the way clinicians worldwide manage CE and to establish whether clinicians follow WHO IWGE guidance. METHODS Using the online surveying tool SurveyMonkey, a questionnaire was produced detailing 5 clinical cases. Clinicians treating CE were identified and asked how to manage each case through tick-box and short-answer questions. RESULTS The results showed great variation in practice worldwide. There are practices in common use that are known to be ineffectual, including puncture, aspiration, injection, reaspiration procedures on WHO type 2 cysts, or outdated, including interrupted, rather than continuous, courses of albendazole. A number of unsafe practices were identified such as using scolicidal agents in cysts communicating with the biliary tree and short-course medical therapy for disseminated disease. Most clinicians do not follow the WHO IWGE guidance, but the reasons for this are unclear. CONCLUSIONS Management of CE varies greatly worldwide. There are key areas of CE for which there is no evidence on which to base guidelines, and randomized controlled trials are needed together with a well-designed international registry to collect data. Further work is required to establish why clinicians do not follow the IWGE guidance, together with better dissemination of future guidance.
منابع مشابه
HLA –DRB1*, DQB1* Alleles In Hydatid Patients By Molecular Typing
Mosayebi M1, Dalimi Asl A2, Moazeni M3, Mosayebi Gh4 1. Ph.D Student, Department of Parasitology, Faculty of medicine, Tarbiat Modarres University 2. Professor, Department of Parasitology, Faculty of medicine, Tarbiat Modarres University 3. Professor, Department of Immunology, Faculty of medicine, Tarbiat Modarres University 4. Assistant professor, Department of Immunology, Faculty of medici...
متن کاملHuman Cystic Echinococcosis in Lorestan province, Southwest Iran: A retrospective epidemiological study of surgical cases during a 10 years period (2005-2014)
The aim of this study was to determine the prevalence of hydatidosis in Lorestan province during a 10 year period (2005-2014). We surveyed medical records of infected patients with hydatid cyst who had been operated in referral hospitals of Lorestan province, Iran. Several parameters were analyzed including age, gender, place of residency, hospitalization time, and the location of cysts. Cystic...
متن کاملHuman Cystic Echinococcosis in Lorestan province, Southwest Iran: A retrospective epidemiological study of surgical cases during a 10 years period (2005-2014)
The aim of this study was to determine the prevalence of hydatidosis in Lorestan province during a 10 year period (2005-2014). We surveyed medical records of infected patients with hydatid cyst who had been operated in referral hospitals of Lorestan province, Iran. Several parameters were analyzed including age, gender, place of residency, hospitalization time, and the location of cysts. Cystic...
متن کاملHuman Cystic Echinococcosis: Old Problems and New Perspectives
Cystic echinococcosis (CE) is a widespread chronic endemic helminthic disease caused by infection with metacestodes of the tapeworm Echinococcus granulosus. CE affects humans and has a worldwide prevalence of approximately six million. In this review, we discuss current findings in diagnosis and clinical management of CE and new concepts relating to E. granulosus molecules that directly modulat...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
دوره 60 5 شماره
صفحات -
تاریخ انتشار 2015