Parasites and Biliary stones

Echinococcosis ٥١
Perioperative and long-term adjuvant chemotherapy with
albendazole (doses up to 20 mg/kg per day) has been associated with 10-
year survival of approximately 80%, compared with less than 25% in
historical controls (Wilson et al., 1992). Albendazole is only
parasitostatic against the E. multilocularis metacestode. Chemotherapy
should be continued for 2 years after surgery. Liver transplantation has
been under trials in some patients with alveolar echinococcosis The
therapeutic immunosuppression may allow proliferation of metacestode
remnants or proliferation of previously inapparent metastases elsewhere
(eg, the brain) (Mboti et al., 1996).
Prevention and control:
Preventive measures that have been used to control Echinococcus
infections include avoidance of contact with dog or fox faeces,
handwashing and improved sanitation, reducing dog or fox populations,
treatment of dogs with arecoline hydrobromide or praziquantel,
incineration of infected organs, and health education (Conchedda et al.,
2002 and Gemmell et al., 2001).
Control of E. multilocularis is especially problematic, since the
primary cycle is almost always sylvatic. Some progress has been made in
recent years, and praziquantel baits for control of E. multilocularis
infections in foxes may prove of value (Tsukada et al., 2002).