CC BY
5
Original articles Оригинальные статьи
Russian Journal of Infection and Immunity = Infektsiya i immunitet Инфекция и иммунитет
2022, vol. 12, no. 6, pp. 1143-1148 2022, Т. 12, № 6, с. 1143-1148
THE EFFICACY AND SAFETY OF THREE 30-DAY COURSES OF ALBENDAZOLE IN PATIENTS WITH NEUROCYSTICERCOSIS
C.T. Sinha, T.T. Thangb, T.D. Thangc, C.B. Loid, L.T. Anhe
a Vinh Medical University, Nghe An, Vietnam b Nghe An Eye Hospital, Nghe An, Vietnam c Thai Thuong Hoang Hospital, Nghe An, Vietnam
dNational Institute of Malaria, Parasitology and Entomology, Ha Noi, Vietnam e Vietnam Military Medical University, Ha Noi, Vietnam
Abstract. Albendazole is one of the drugs indicated for the treatment of neurocysticercosis. However, data on the treatment outcome of a long course of this drug is scarce. This study aims to investigate the efficacy and safety of three 30-day courses of albendazole in patients with neurocysticercosis. Materials and methods. The diagnosis of neurocysticercosis was based on epidemiological, clinical and laboratory criteria as guided by the Vietnamese Ministry of Health. Sixty patients with a mean age of 50.17+10.03 years old, with 86.7% (95% CI: 77.8-95.5%) men, were involved in this study. Patients received three 30-day courses of albendazole with an intermittence of 20 days. Additional treatment included steroids, anticonvulsants or analgesics. Based on brain magnetic resonance imaging 6 months after the therapy, the efficacy was classified as cure (viable cysts not discernible), improvement (50% or more cysts disappeared or calcified) or inefficacy (changes in less than 50% of the cysts). The safety was determined based on the changes of biochemical parameters after each treatment course. Results. The most common clinical presentations were headache (90.0%, 95% CI: 82.2-97.8) and/ or seizure (68.3%, 95% CI: 56.2-70.4), followed by other symptoms such as fainting, memory loss, and limb numbness. Active cysts were discovered in all cases and located mainly in the parenchymal region. After therapy, the rates of cure, improvement or inefficacy were 43.3% (95% CI: 30.4-56.2%), 51.7% (95% CI: 38.7-64.7%) and 5.0% (95% CI: 0-10.7%), respectively. Liver enzymes were slightly higher compared to those before therapy and mostly returned to normal ranges after drug interruption. Alanine aminotransferase levels before the 3rd course were higher than values before the first and second courses. No abnormalities in blood urea or creatinine after therapy were reported. Conclusion. Three 30-day cycles of albendazole appear to have good efficacy and tolerability in patients with neurocysticercosis.
Key words: neurocysticercosis, efficacy, safety, albendazole, long course.
ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ ТРЕХ 30-ДНЕВНЫХ КУРСОВ АЛЬБЕНДАЗОЛА У БОЛЬНЫХ НЕЙРОЦИСТИЦЕРКОЗОМ
Шинь Ц.Т.1, Тханг Ч.Т.2, Тханг Т.Д.3, Лой К.Б.4, Ань Л.Ч.5
1 Медицинский университет Винь, Нгеан, Вьетнам 2Глазная больница Нге Aн, Нгеан, Вьетнам 3Больница Тхай Тхыонг Хоанг, Нгеан, Вьетнам
4Национальный институт малярии, паразитологии и энтомологии, Ханой, Вьетнам 5Вьетнамский военно-медицинский университет, Ханой, Вьетнам
Резюме. Альбендазол является одним из препаратов, показанных для лечения нейроцистицеркоза, однако данные об исходе лечения длительным курсом этого препарата немногочисленны. Настоящее исследование
Адрес для переписки:
Ле Чан Ань
160 Фунг Хунг, Ха Донг, Ханой, Вьетнам, Вьетнамский военно-медицинский университет. Тел.: +84 98 3289514. E-mail: anh_lt@vmmu.edu.vn
Для цитирования:
Шинь Ц.Т., Тханг Ч.Т., Тханг Т.Д., Лой К.Б., Ань Л.Ч. Эффективность и безопасность трех 30-дневных курсов альбендазола у больных нейроцистицеркозом // Инфекция и иммунитет. 2022. Т. 12, № 6. С. 1143-1148. Со1: 10.15789/2220-7619-ТЕА-1910
© БтИ С.Т. е! а1., 2022
Contacts:
Le Tran An h
160 Phung Hung, Ha Dong, Ha Noi, Vietnam,
Vietnam Military Medical University.
Phone: +84 98 3289514. E-mail: anh_lt@vmmu.edu.vn
Citation:
Sinh C.T., Thang T.T., Thang T.D., Loi C.B., Anh L.T. The efficacy and safety of three 30-day courses of albendazole in patients with neurocysticercosis // Russian Journal of Infection and Immunity = Infektsiya i immunitet, 2022, vol. 12, no. 6, pp. 1143-1148. doi: 10.15789/2220-7619-TEA-1910
DOI: http://dx.doi.org/10.15789/2220-7619-TEA-1910
направлено на изучение эффективности и безопасности трех 30-дневных курсов альбендазола у пациентов с нейроцистицеркозом. Материалы и методы. Диагноз нейроцистицеркоза был основан на эпидемиологических, клинических и лабораторных критериях в соответствии с рекомендациями Министерства здравоохранения Вьетнама. В исследование вошли 60 пациентов мужского пола, средний возраст которых составил 50,17+10,03 года, из них 86,7% являлись лицами мужского пола (95% ДИ: 77,8—95,5%). Пациенты получали три 30-дневных курса альбендазола с перерывом в 20 дней. Дополнительное лечение включало стероиды, про-тивосудорожные препараты или анальгетики. На основании магнитно-резонансной томографии головного мозга через 6 месяцев после терапии эффективность классифицировали как излечение (жизнеспособные кисты не были различимы), улучшение (исчезновение или кальцификация 50% и более кист) или неэффективность (изменения были зарегистрированы менее чем в 50% кист). Безопасность определяли по изменению биохимических показателей после каждого курса лечения. Результаты. Наиболее частыми клиническими проявлениями были головная боль (90,0%, 95% ДИ: 82,2-97,8), судороги (68,3%, 95% ДИ: 56,2-70,4), за которыми следовали такие симптомы как обморок, потеря памяти, онемение конечностей. Активные кисты были обнаружены во всех случаях и располагались преимущественно в паренхиме головоного мозга. После терапии частота излечения, улучшения и неэффективности составила 43,3% (95% ДИ: 30,4-56,2%), 51,7% (95% ДИ: 38,7-64,7%) и 5,0% (95% ДИ: 0-10,7%) соответственно. Показатели печеночных ферментов в сыворотке крови печени были несколько выше по сравнению с таковыми до терапии и в большинстве случаев возвращались к нормальным значениям после прекращения приема препарата. Уровень аланинаминотрансферазы перед 3-м курсом был выше, чем до первого и второго курсов. Отклонений в показателях мочевины и креатинина в крови после терапии не зарегистрировано. Выводы. Три 30-дневных цикла альбендазола характеризуются хорошей эффективностью и переносимостью у пациентов с нейроцистицеркозом.
Ключевые слова: нейроцистицеркоз, эффективность, безопасность, альбендазол, длительный курс.
Introduction
Cysticercosis is a disease caused by the larval stages (cysticercus) of the pork tapeworm (Taenia solium). The disease is endemic in most low- and middle-income countries and also reported in industrial countries [24]. The clinical manifestations of the disease depend on the number, location, as well as response of the body human to these cysticerci [9]. Neurocysticercosis (NCC) is the most common form of the disease and responsible for significant morbidity. Neurocysticercosis is the cause of 30% of all epilepsy cases worldwide in addition to other neurological symptoms including chronic headaches, focal neurologic deficits, intracra-nial hypertension, and cognitive decline [25].
Treatment of NCC is mostly symptomatic. Nevertheless, antiparasitic drugs for the destruction of cysts are important [6]. Between the two anthelmintics most commonly used, albendazole may be superior to praziquantel because of its better penetration into the central nervous system, lower cost, and lesser interaction with other drugs [19]. Several studies have investigated the efficacy of albendazole, and a dose of 15 mg/kg/day has generally been accepted [2, 3, 10, 11, 12]. However, there is still considerable disagreement concerning the length of therapy. Most studies have relied on a one to four-week course, with observed cyst disappearance in 25% to 37% of case [2, 3, 10, 11, 12]. Due to the low efficacy of this regime, a longer duration (more than one 4-week course) might be an appropriate approach, but there is little information on the treatment outcome of this prolonged regime [17]. This study aims to investigate the efficacy and safety of three 30-day courses of albendazole in patients with NCC.
Materials and methods
Ethical consideration. This research is part of thesis work for the fulfilment of Doctor of Philosophy in Health Studies. It obtained clearance from the ethics committee of the Vietnam National Institute of Malariology, Parasitology and Entomology (NIMPE). Written or verbal consent was obtained from all the patients or their legal representatives.
Study design. This prospective study was carried out at the Specialized Parasitic Clinic, NIMPE during January 2017 and December 2020. All patients visiting the clinic with clinical symptoms/signs suspected of NCC were screened for the infection. Criteria for inclusion were subjects more than five years old and diagnosed with NCC, with willingness to complete antiparasitic therapy and follow-up examination after treatment. Criteria for exclusion were pregnant women, subjects exhibiting acute diseases or concurrent parasitic diseases, or having a known history of allergy to benzimidazole.
After informed consent was obtained, a detailed history of symptoms, duration and progression of the disease, in addition to sociodemographic data, was recorded. A careful systemic and neurologic examination was done, followed by laboratory investigations. Blood examination included blood cell counts and standard tests of biochemistry. Serum enzyme-linked immunosorbent assay (ELISA) for certain infections common in Vietnam (cysticercosis, fascioliasis, strongyloidiasis, gna-thostomiasis, toxocariasis, amebiasis) was performed using reagents from Cortez Diagnostics Inc. (USA) following manufacturer instructions. Brain magnetic resonance imaging (MRI) was
used to determine the number and stages of cysts. Stool samples were collected and examined for intestinal helminths or protozoans.
The treatment. Patients with vesicular, colloidal, or granular cysts on MRI received three 30-day courses of albendazole at a daily dose of 15 mg/kg of body weight. The intermittence between the courses was 20 days. Before taking albendazole, patients received praziquantel 20 mg/kg to treat adult worms [22]. Additional treatment included steroids to decrease inflammation and anticonvulsant or analgesic drugs as needed.
Follow-up. Clinical assessment was performed at the start of and during therapy. Blood samples were taken at the beginning and the end of all three courses. Brain MRI was performed 6 months after completion of therapy to assess treatment outcome.
Definition. As guided by the Vietnamese Ministry of Health, diagnosis of cysticercosis was based on epidemiological, clinical, and laboratory criteria based on well-known ones [4, 5]. Epidemiologic criteria include ingestion of raw vegetables or living in endemic areas. Suggestive manifestations of NCC are late-onset seizures, focal neurologic deficits, in-tracranial hypertension, chronic headaches, or cognitive decline. Laboratory criteria are: (1) positive biopsy results of cysts; (2) pathognomonic lesions on computed tomography (CT) or MRI (cysts with "hole-with-dot" appearance); (3) parasites discovered by funduscopic examination; and (4) a positive result by serum ELISA [22]. On MRI, location of cysts was grouped into cortex/subcortex, hemisphere, subarachnoid, or intraventricular. Based on stage, they were classified as viable (vesicular, colloidal, granular) or dead (calcified) cysts [7, 26]. Treatment outcome was classified based on the resolution of cystic lesions as follows: complete resolution/cure wherein viable cysts were not discernible on MRI; partial resolution/improvement wherein 50% or more cysts disappeared or calcified; or no resolution/inefficacy wherein changes were reported in less than 50% of the cysts. Reference ranges were: 1—35 U/L for aspartate aminotransferase (AST) and alanine aminotransferase (ALT); 1.8— 7.1 mmol/L for urea; and 44—97 p,mol/L (female) and 53—106 p,mol/L (male) for creatinine [23]. Mild elevation was designated as liver enzyme levels less than five times the upper limit of the normal value. Greater than 15 times the upper limit was designated as severe elevation.
Statistical analysis. Data analysis was performed with SPSS 16.0 (SPSS-IBM Company). Categorical variables were expressed as case number (n) and percentages, while numerical variables were expressed as mean and standard deviation (±SD). A paired sample t-test was used to determine the mean difference of continuous variables at different time points. P-values less than 0.05 were considered statistically significant.
Results
Sixty patients aged between 28—68 years participated in the study. The male to female ratio was 6.5/1. All patients met the epidemiologic criteria due to a history of eating raw vegetables in addition to living in north and central Vietnam where active transmission of taeniasis and cysticercosis has been reported. The most common clinical presentations were headache and/or seizure, followed by other symptoms such as fainting, memory loss, or limb numbness. Only one patient had a history of defecating proglottides or subcutaneous cysts. On brain MRI, cysts were located in different locations, but mainly in the parenchymal region (cerebral hemisphere (83.3%), cortical/subcortical region (41.7%), or cerebellum (10.0%). Multiple cysts (> 2) were discovered in 48/50 (96%) cases in the hemisphere, 14/25 (56%) cases in cortical/subcortical regions, and 3/6 (50%) cases in the cerebellum. In the intraventricular or subarach-noid region, only a single cyst was discovered. Vesicular cysts occurred in 60 (100%) cases, and calcified cysts in one case (cerebellum). Elevation of AST occurred in 19 (31.7%) patients and of ALT in 24 (40.0%) patients. Average liver enzyme levels were slightly higher than normal reference, whereas the levels of urea and creati-nine were within the normal ranges (Table 1).
Table 1. Baseline patient characteristics (n = 60)
Variable n % (95% CI)
Age (years, X±SD) 50.17±10.03
Gender Female 8 13.3 (4.8-22.2)
Male 52 86.7 (77.8-95.5)
Occupation Farmer 39 65.5 (52.6-77.4)
Other jobs 21 35.5 (22.6-47.4)
Headache 54 90.0 (82.2-97.8)
Seizure 41 68.3 (56.2-70.4)
Memory loss 23 19.2 (12.3-34.4)
Fainting 17 28.3 (16.6-40.1)
Manifestation Limb numbness 12 20.0 (9.6-30.4)
Vomiting, nausea 9 15.0 (5.7-24.3)
Balance disorders 6 10.0(2.2-17.8)
Muscle weakness 6 10.0(2.2-17.8)
Blurred vision 2 3.3 (0.1-8.0)
Hemisphere 50 83.3 (73.6-93.0)
Cortical/ subcortical 25 41.7 (28.8-54.4)
Cyst site* Cerebellum 6 10.0(2.2-17.8)
Ventricles 1 1.7 (0-0.5)
Subarachnoid spaces 1 1.7 (0-0.5)
AST (U/L, X±SD) 38.16±27.45
Biochemical parameters ALT (U/L, X±SD) 35.87±19.07
Urea (mmol/L, X±SD) 5.43±1.03
Creatinine (mmol/L, X±SD) 80.30±14.12
Note. *Same patients with cysts at different sites.
Table 2. Efficacy of antiparasitic treatment (n = 60)
n % (95% CI)
Cure 26 43.3 (30.4-56.2)
Improvement 31 51.7 (38.7-64.7)
Inefficacy 3 5.0(0-10.7)
After antiparasitic therapy, almost all (95.0%) patients had radiological improvement, but a complete resolution was reported in less than half of the participants (43.3%). There were two patients with no cystic resolution, and one patient showed an increase in the number of cysts six months after treatment (Table 2). Clinical examination showed that 23/41 (56.1%) patients with seizures were completely cured, and 25/54 (46.3%) patients having headaches recovered. Of the patients with loss of memory or fainting, the rates of complete recovery were (6/14) 42.9% and (11/17) 64.7%, respectively.
Table 3 shows changes in biochemical parameters after treatment. The levels of liver enzymes after treatment were all above the normal ranges and significantly higher compared to those before the antiparasitic course. The percentages of patients with increased AST after the 1st, 2nd and 3rd course were 66.7%, 75% and 85% respectively. There were 50 (83.3%), 55 (91.7%), and 49 (81.7%) cases having elevated ALT levels after the first, second, and third course. Most of them had mild or moderate elevation; only one patient had a severe elevation of liver enzymes. After drug interruption, liver enzyme levels mostly returned to normal ranges equivalent to pretreatments levels. However, ALT levels before the 3rd course were higher than the baseline as well as the normal range. Urea and creatinine concentrations were within normal limits at all examinations. The only exception was that urea concentration after the 2nd and 3rd course increased slightly compared to levels before the course but was within normal ranges. During therapy, some patients developed headaches, vomiting, or exacerbation of seizures.
Discussion
This study was carried out to investigate the efficacy and safety of a prolonged regime of albenda-zole in patients with NCC. Our results suggest that three 30-day cycles of albendazole have good efficacy against NCC. Most of the patients (95%) had radiological improvement, and a complete clearance of cysts on MRI was reported in 43.3% of cases. Clinical examination showed that about half of the patients had improvement, but these results were not included in the efficacy evaluation. Clinical evaluation has been considered inappropriate because some symptoms, such as seizures, can present long after cyst clearance [7, 9]. The complete resolution rate in our patients (43.3%) was slightly higher than that in previous observations (reporting cure rates ranging from 25% to 37%) [2, 3, 10, 11]. This difference in the efficacy could be due to the longer duration of therapy (90 days) in our study compared to previously cited studies (7—28 days) [2, 3, 10, 11]. Some authors have reported that a long duration of albendazole may have no additional benefit compared to the short ones [15, 20]. Nevertheless, Garcia et al. (1997) noted a significant difference in the number of cysts persisting at day 360 among patients taking a short (7-day) and long (14-day) schedule of albendazole [8]. An overly-short duration (one week) may not change the natural course of NCC [16]. Our results are supported by another observation [17] and suggest that an extension of the duration of albendazole therapy may be a good choice for patients with NCC.
Results of safety assessment showed that this prolonged regime of albendazole seems to have a favorable safety profile. Liver enzymes were only mildly and temporarily elevated, while urea and creatinine concentrations were within normal limits. The proportion of patients with elevated liver enzymes in our study (> 80%) was far higher than that usually reported in those taking albendazole (10—20%) [14]. A possible reason for this difference was the high rate of patients with increased liver enzymes before therapy
Table 3. Biochemical parameters before and after therapy (n = 60)
Parameters Course Before After p-value
1 38.16±27.45 72.43±140.33 0.036
AST (U/L, X±SD) 2 34.20±13.34 54.02±43.81 0.000
3 39.14±14.44 61.54±64.45 0.003
1 35.87±19.07 93.67±110.31 0.000
ALT (U/L, X±SD) 2 36.71±17.48 75.91±45.14 0.000
3 44.63±22.16* 83.30±105.73 0.002
1 5.43±1.03 5.31±1.12 0.478
Urea (mmol/L, X±SD) 2 5.06±0.62 5.29±0.84 0.023
3 4.99±0.57 5.48±0.81 0.000
1 80.30±14.12 80.40±10.18 0.946
Creatinine (mmol/L, X±SD) 2 79.46±8.06 79.19±8.42 0.746
3 79.30±7.12 80.78±6.99 0.052
Note. *The mean ALT concentration before the third course was higher than that before the first and the second course (p < 0.001).
(Table 1). Another reason could be the prolonged use of albendazole (90 days) compared to short courses (7—28 days) used in most previous studies [2, 3, 10, 11]. Although a high rate of patients with elevated liver enzymes was seen, the proportion of severe elevation was low (1.7%); this is in agreement with a scarcity of reported cases of albendazole-induced liver injury [1, 13, 18]. The unchanged levels of urea and creatinine in our patients are similar to other results [17]. During therapy, some patients developed headaches, vomiting, or exacerbation of seizures. These manifestations could be adverse reactions or predictors of drug effectiveness, so they are not included in safety assessments [21].
Some limitations remain in our study. There were only a small number of patients willing to complete treatment and undergo final assessment six months
References
after therapy, so the small sample size is unavoidable. A control group taking placebo drugs is lacking as this is not acceptable practice in our country.
Conclusion
Three 30-day cycles of albendazole appear to have favorable outcomes in patients with neurocysticerco-sis. Almost all patients had an improvement in cystic lesions and the rate of complete disappearance is encouraging. This regime has good tolerability, but monitoring of liver transaminase levels is critical.
Conflict of interest
The authors declare that they have no conflict of interests.
1. Bilgic Y., Yilmaz C., Cagin Y.F., Atayan Y., Karadag N., Harputluoglu M.M.M. Albendazole induced recurrent acute toxic hepatitis: a case report. Acta Gastroenterol. Belg., 2017, vol. 80, no. 2, pp. 309—311.
2. Carpio A., Kelvin E.A., Bagiella E., Leslie D., Leon P., Andrews H., Hauser W.A., Effects of albendazole treatment on neurocysticercosis: a randomised controlled trial. J. Neurol. Neurosurg. Psychiatry, 2008, vol. 79, no. 9, pp. 1050—1055. doi: 10.1136/ jnnp.2008.144899
3. Carpio A., Santillán F., León P., Flores C., Hauser, W.A. Is the course of neurocysticercosis modified by treatment with anthelmintic agents? Arch. Intern. Med., 1995, vol. 155, no. 18, pp. 1982-1988.
4. Del Brutto O.H., Nash T.E., White A.C. Jr., Rajshekhar V., Wilkins P.P., Singh G., Vasquez C.M., Salgado P., Oilman R.H., Garcia H.H. Revised diagnostic criteria for neurocysticercosis. J. Neurol. Sci., 2016, vol. 372, pp. 202-210. doi: 10.1016/j. jns.2016.11.045
5. Del Brutto O.H., Rajshekhar V., White A.C. Jr., Tsang V.C., Nash T.E., Takayanagui O.M., Schantz P.M., Evans C.A., Flisser A., Correa D., Botero D., Allan J.C., Sarti E., Gonzalez A.E., Oilman R.H., García H.H. Proposed diagnostic criteria for neurocysticercosis. Neurology, 2001, vol. 57, no. 2, pp. 177-183. doi: 10.1212/wnl.57.2.177
6. Fogang Y.F., Savadogo A.A., Camara M., Toffa D.H., Basse A., Sow A.D., Ndiaye M.M. Managing neurocysticercosis: challenges and solutions. Int. J. Gen. Med., 2015, vol. 8, pp. 333-344. doi: 10.2147/IJGM.S73249
7. García H.H., Del Brutto O.H. Imaging findings in neurocysticercosis. Acta Trop., 2003, vol. 87, no. 1, pp. 71-78. doi: 10.1016/ s0001-706x(03)00057-3
8. Garcia H.H., Gilman R.H., Horton J., Martinez M., Herrera G., Altamirano J., Cuba J.M., Rios-Saavedra N., Verastegui M., Boero J., Gonzalez A.E. Albendazole therapy for neurocysticercosis. Neurology, 1997, vol. 48, no. 5, pp. 1421-1427. doi: 10.1212/ wnl. 48.5.1421
9. García H.H., Gonzalez A.E., Evans C.A.W., Gilma, R.H. Taenia solium cysticercosis. Lancet, 2003, vol. 362, no. 9383, pp. 547556. doi: 10.1016/S0140-6736(03)14117-7
10. Garcia H.H., Gonzales I., Lescano A.G., Bustos J.A., Zimic M., Escalante D., Saavedra H., Gavidia M., Rodriguez L., Najar E., Umeres H., Pretell E.J. Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a double-blind, randomised controlled trial. Lancet. Infect. Dis., 2014, vol. 14, no. 8, pp. 687-695. doi: 10.1016/S1473-3099(14)70779-0
11. Garcia H.H., Lescan, A.G., Gonzales I., Bustos J.A., Pretell E.J., Horton J., Saavedra H., Gonzalez A.E., Gilman R.H. Cysticidal efficacy of combined treatment with praziquantel and albendazole for parenchymal brain cysticercosis. Clin. Infect. Dis., 2016, vol. 62, no. 11, pp. 1375-1379. doi: 10.1093/cid/ciw134
12. Garcia H.H., Pretell E.J., Gilman R.H., Martinez S.M., Moulton L.H., Del Brutto O.H., Herrera G., Evans C.A.W., Gonzalez A.E. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N. Engl. J. Med., 2004, vol. 350, no. 3, pp. 249-258. doi: 10.1056/NEJMoa031294
13. Hong S.T. Albendazole and praziquantel: review and safety monitoring in Korea. Infect. Chemother., 2018, vol. 50, no. 1, pp. 1-10. doi: 10.3947/ic.2018.50.1.1
14. Horton R. Albendazole in treatment of human cystic echinococcosis: 12 years of experience. Acta Trop., 1997, vol. 64, no. 1-2, pp. 79-93. doi: 10.1016/s0001-706x(96)00640-7
15. Johnson N., Saini A.G., Malhi P., Khandelwal N., Singhi P. Comparison of long-term outcomes between 7 days and 28 days albendazole monotherapy in the treatment of single-lesion neurocysticercosis in children. J. Child Neurol., 2021, vol. 37, no. 1, pp. 28-34. doi: 10.1177/08830738211035864
16. Padma M., Behari M., Misra N., Ahuja G. Albendazole in neurocysticercosis. Natl Med. J. India., 1995, vol. 8, no. 6, pp. 255-258.
17. Pandey S., Malhotra H.S., Garg R.K., Malhotra K.P., Kumar N., Rizvi I., Jain A., Kohli N., Verma R., Sharma P., Uniyal R., Pandey S. Quantitative assessment of lesion load and efficacy of 3 cycles of albendazole in disseminated cysticercosis: a prospective evaluation. BMC Infect. Dis., 2020, vol. 20, no. 1:220. doi: 10.1186/s12879-020-4891-5
18. Piloiu C., Dumitrascu D.L. Albendazole-induced liver injury. Am. J. Ther., 2021, vol. 28, no. 3, pp. e335-e340. doi: 10.1097/
MJT.0000000000001341
19. Singhi P. Neurocysticercosis. Ther. Adv. Neurol. Disord., 2011, vol. 4, no. 2, pp. 67-81. doi: 10.1177/1756285610395654
20. Singhi P., Dayal D., Khandelwal N. One week versus four weeks of albendazole therapy for neurocysticercosis in children: a randomized, placebo-controlled double blind trial. Pediatr. Infect. Dis. J., 2003, vol. 22, no. 3, pp. 268-272. doi: 10.1097/01. inf. 0000055095.84136.a2
21. Sotelo J., Del Brutto O.H., Penagos P.J., Escobedo F., Torres B., Rodriguez-Carbajal J., Rubio-Donnadieu F. Comparison of therapeutic regimen of anticysticercal drugs for parenchymal brain cysticercosis. J. Neurol., 2004, vol. 237, no. 2, pp. 69-72. doi: 10.1007/BF00314663
22. The Ministry of Health. The Guidelines for the diagnosis and treatment of clonorchiasis/opisthorchiasis, paragonimiasis, taenia-sis and cysticercosis (Decision 1450/2004/QD-BYT) [in Vietnamese]. 2004.
23. Walker H., Hall W., Hurst J. (eds.). Clinical Methods: The history, physical, and laboratory examinations. Boston: Butterworths, 1990. 1087p.
24. WHO, Landscape analysis: management of neurocysticercosis with an emphasis on low- and middle-income countries (WHO/ HTM/NTD/NZD/2015.05). Geneva: World Health Organization, 2015. 62p.
25. WHO. Taeniasis/cysticercosis, key facts. World Health Organization, 2022. URL: https://www.who.int/news-room/fact-sheets/ detail/taeniasis-cysticercosis#:~:text=solium%20taeniasis%20is%20acquired%20by,also%20become%20infected%20with%20T (12.09.2022)
26. Zhao J.-L., Lerner A., Shu Z., Gao X.-J., Zee C.-S. Imaging spectrum of neurocysticercosis. Radiol. Infect. Dis. 2015, vol. 1, no. 2, pp. 94-102. doi: 10.1016/j.jrid.2014.12.001
Авторы:
Шинь Ц.Т., доцент, врач отделения внутренних болезней
больницы Медицинского университета Винь, Нгеан, Вьетнам;
Тханг Ч.Т., врач департамента медицинской экспертизы
Глазной больницы Нгеан, Нгеан, Вьетнам;
Тханг Т.Д., врач отделения внутренних болезней Больницы
Тхай Тхыонг Хоанг, Нгеан, Вьетнам;
Лой К.Б., доцент, врач, отдел научного менеджмента
и обучения Национального института малярии, паразитологии
и энтомологии, Ханой, Вьетнам;
Ань Л.Ч., доцент кафедры паразитологии Вьетнамского
военно-медицинского университета, Ханой, Вьетнам.
Поступила в редакцию 24.03.2022 Отправлена на доработку 20.04.2022 Принята к печати 11.09.2022
Authors:
Sinh C.T., Associate Professor, MD, PhD, Department of Internal medicine, Vinh Medical University Hospital, Vinh Medical University, Nghe An, Vietnam;
Thang T.T., Department of Medical examination, Nghe An Eye Hospital, Nghe An, Vietnam;
Thang T.D., MD, Department of Internal medicine, Thai Thuong Hoang Hospital, Nghe An, Vietnam;
Loi C.B., Associate Professor, MD, PhD, Scientific and Training
Management Department, National Institute of Malaria, Parasitology
and Entomology, Ha Noi, Vietnam;
Anh L.T., Associate Professor, MD, PhD, Department
of Parasitology, Vietnam Military Medical University, Ha Noi,
Vietnam.
Received 24.03.2022 Revision received 20.04.2022 Accepted 11.09.2022
