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Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives

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.

Received August 29, 2007. Accepted for publication April 13, 2008.

Disclosure: Some of the authors wish to disclose that they hold stock in GlaxoSmithKline, makers of albendazole. This statement is made in the interest of full disclosure and not because the authors consider this a conflict of interest.

Financial support: TJ, EB, and AMS are supported by the European Union Grant INCO-CT2004-509102 (EchinoNET).

^* Address correspondence to Enrico Brunetti, Division of Infectious and Tropical Diseases, IRCCS S. Matteo Foundation, University of Pavia, Via Taramelli 5, 27100 Pavia, Italy. E-mail: selim{at}unipv.it

Authors’ addresses: Thomas Junghanss, Section of Clinical Tropical Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany, Tel: 49-06221-564904, Fax: 49-06221-565204, E-mail: thomas.junghanss{at}urz.uni-heidelberg.de. Antonio Menezes da Silva, Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Alameda das Linhas de Torres 117, 1769-001 Lisbon, Portugal, Tel and Fax: 35-12175-87232, E-mail: mensilvapt{at}yahoo.com. John Horton, Tropical Projects, 24 The Paddock, Hitchin, Hertfordshire SG4 9EF, UK, Tel: 44-1462-451618, E-mail: Hedgepigs{at}aol.com. Peter L. Chiodini, Department of Clinical Parasitology, Hospital for Tropical Diseases, London, and Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Capper Street, London WC1 6JA, UK, Tel: 44-20-7387-4411, Fax: 44-20-7383-0041, E-mail: peter.chiodini{at}uclh.nhs.uk. Enrico Brunetti, Division of Infectious and Tropical Diseases, S. Matteo Hospital Foundation, University of Pavia, Via Taramelli 5, 27100 Pavia, Italy, Tel: 39-0382-502619, Fax: 39-0382-301987, E-mail: selim{at}unipv.it.

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