Garcia Hector H, Gonzalez Armando E, Gilman Robert H
Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru.
Curr Opin Infect Dis. 2003 Oct;16(5):411-9. doi: 10.1097/00001432-200310000-00007.
Taenia solium taeniasis/cysticercosis is now recognized as a major public health problem in most developing countries because of its association with seizures. Major advances in the diagnosis and epidemiology of taeniasis/cysticercosis have occurred in recent years. However, despite abundant literature on the subject, many questions remain unanswered including the role of anti-parasitic therapy and the potential for long-term control or elimination of the disease in field conditions following active interventions.
Recent advances have included improved knowledge of the availability and optimization of diagnostic tools for the tapeworm stage, a better understanding of the meaning of antibody serology, the introduction of antigen detection assays, a consensus on the use of antiparasitic medication, awareness of inflammation and chronic scars around calcified cysts, population-based neuroimaging studies, application of control measures, and progress in the development of a pig vaccine.
Neurocysticercosis is now much better understood than it was a few years ago. Infection and disease are now classified in terms of parasite viability, resulting in multiple and diverse clinical entities, each of which has a proper prognosis and management. As a result of this, the interpretation of diagnostic assays and imaging examinations is much more coherent. New aspects of this interesting disease have been recognized, mainly in relation to the frequency of calcified neurocysticercosis and its potential association with symptomatic relapses. Consensus diagnostic and treatment schemes have been proposed, and promising alternatives for control are currently being tested in several countries.
由于猪带绦虫病/囊尾蚴病与癫痫发作有关,目前在大多数发展中国家它被视为一个主要的公共卫生问题。近年来,猪带绦虫病/囊尾蚴病的诊断和流行病学取得了重大进展。然而,尽管关于该主题的文献丰富,但许多问题仍未得到解答,包括抗寄生虫治疗的作用以及在积极干预后在现场条件下长期控制或消除该疾病的可能性。
最近的进展包括对绦虫阶段诊断工具的可用性和优化有了更深入的了解,对抗体血清学意义有了更好的认识,引入了抗原检测方法,就抗寄生虫药物的使用达成了共识,认识到钙化囊肿周围的炎症和慢性瘢痕,基于人群的神经影像学研究,控制措施的应用以及猪疫苗开发的进展。
现在对神经囊尾蚴病的了解比几年前要好得多。现在根据寄生虫的活力对感染和疾病进行分类,导致了多种不同的临床实体,每个实体都有适当的预后和管理方法。因此,诊断检测和影像学检查的解释更加连贯。已经认识到这种有趣疾病的新方面,主要涉及钙化神经囊尾蚴病的频率及其与症状复发的潜在关联。已经提出了共识性的诊断和治疗方案,目前在几个国家正在测试有前景的控制替代方案。