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An Overview of Helminthiasis
Published in Venkatesan Jayaprakash, Daniele Castagnolo, Yusuf Özkay, Medicinal Chemistry of Neglected and Tropical Diseases, 2019
Leyla Yurttaș, Betül Kaya Çavușoğlu, Derya Osmaniye, Ulviye Acar Çevik
Diethylcarbamazine (2) is a piperazine derivative used in the treatment of filariasis. It is known that diethylcarbamazine interferes with arachidonic acid metabolism of parasites and activates an innate immune response in filarial parasites and host. Diethylcarbamazine is effective against filarial worms of Brugia malayi, Loa loa, Wuchereria bancrofti, Onchocerca volvulus and Mansonella streptocerca. Diethylcarbamazine, N,N-diethyl-4-methylpiperazinecarboxamide, can be easily obtained by acylating 1-methylpiperazine with diethylcarbamoyl chloride, and it is available as diethylcarbamazine citrate (Vardanyan and Hruby 2006, de Silva et al. 1997, Martin et al. 1997). Synthesis of Piperazine (1) and Diethylcarbamazepine (2).
Surgical Lympho-Venous Anastomoses for Treatment of Lymphedema
Published in Waldemar L. Olszewski, Lymph Stasis: Pathophysiology, Diagnosis and Treatment, 2019
Another comment will deal with treatment of filarial lymphedema with lymphovenous shunts. The greatest experience in this area has occurred in Thanjavur, India; there Jamal37,38 reported his experience in over 3000 patients with filarial lymphedema. Diethylcarbamazine in doses of 300 ml/d for 5 d is administered monthly to both block production of microfilaria by indwelling adult worms and also to prevent reinfection. Where simple measures such as elastic support and prevention of sepsis fail to improve edema after 2 months than operative correction is recommended.
Pulmonary Disease of Parasitic Cause
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
These animal ascarids, unable to mature in the human host, may migrate through the tissues until death, thus, the descriptive term visceral larva migrans. During the tissue migratory phase, coughing and wheezing are common. Transient pulmonary infiltrates are seen in half of the patients. Eosinophilic pneumonia, hypergammaglobulinemia, anti-A and anti-B titers, and positive serologic and skin tests suggest the diagnosis. Thiabendazole and diethylcarbamazine shorten the course of the disease.
Pediatric Ocular Toxocariasis in Costa Rica: 1998-2018 Experience
Published in Ocular Immunology and Inflammation, 2021
Joaquin Martinez, Gabriela Ivankovich-Escoto, Lihteh Wu
Currently, there are no treatment guidelines for the treatment of ocular toxocariasis. Our treatment decisions have evolved over the experience gained in the past two decades. In general, if the patient presented acutely and there was a chance that the Toxocara larva was still alive, thiabendazole was prescribed either alone or in combination with corticosteroids to decrease the inflammatory reaction. The role of anti-helminthic drugs remains unclear.19,20 Combination therapy of anti-helminthic and corticosteroids may be of use in specific cases.21 In a very small comparative trial, albendazole appeared to be more effective than thiabendazole in the treatment of patients with visceral or ocular larva migrans secondary to toxocariasis.20 In a slightly larger trial, mebendazole and diethylcarbamazine had similar therapeutic efficacy but mebendazole had a lower rate of adverse events. Despite these reports, it is unclear if these anti-helminthic drugs kill intraocular Toxocara larvae. A case report looked at the thiabendazole concentration in ocular fluids following oral administration of the drug. According to Maguire and collegues,22 anti-parasitic levels of the medication can be achieved intraocularly after oral ingestion. Our impression is that anti-helminthic drugs could have some use only in very acute cases, because once the granuloma is formed, or even before, the larva is already dead.
A holistic approach is needed to control the perpetual burden of soil-transmitted helminth infections among indigenous schoolchildren in Malaysia
Published in Pathogens and Global Health, 2020
Nabil A. Nasr, Hesham M. Al-Mekhlafi, Yvonne A. L. Lim, Fatin Nur Elyana, Hany Sady, Wahib M. Atroosh, Salwa Dawaki, Ahmed K. Al-Delaimy, Mona A. Al-Areeqi, Abkar A. Wehaish, Tengku Shahrul Anuar, Rohela Mahmud
The Orang Asli of Malaysia are not a homogenous population; they are classified into three main ethno-linguistic tribes (Senoi, Proto-Malay and Negrito), with six subtribes belonging to each tribe, forming a total of 18 subgroups that have, to some extent, different social and cultural characteristics. [19,20] Since the 1920s, several studies in Orang Asli communities showed high prevalence rates of A. lumbricoides, T. trichiura and hookworm infections, where the prevalence ranged between 30.2–69.0%, 15.8–98.2% and 6.0–51.0%, respectively [15,21–25]. Malaysia launched a National Worm Control Programme in 1974 in which three million primary schoolchildren from all rural areas including Orang Asli communities received a single dose of 20 mg pyrantel pamoate. However, shortly thereafter the programme ceased due to a number of problems, including the poor efficacy of pyrantel pamoate against T. trichiura and hookworm infections, inadequate monitoring and evaluation of the programme, and unsupportive socioeconomic and environmental conditions in the targeted areas. [26,27] Some years later, rural areas of some Malaysian states, including Terengganu, Kelantan, Pahang, Selangor, and Johor (including Orang Asli communities in these states) participated in a mass drug administration programme against filariasis for at least five years (2004–2008), which involved the administration of a single annual dose of diethylcarbamazine and albendazole. [28,29]
Clinical Profile, Treatment, and Visual Outcome of Ocular Toxocara in a Tertiary Eye Care Centre
Published in Ocular Immunology and Inflammation, 2018
Ekta S. Sahu, Bikramjit Pal, Tarun Sharma, Jyotirmay Biswas
All patients were treated with corticosteroids for intraocular inflammation. Treatment was usually performed with oral steroid only and the decision to use combined anthelmintics (albendazole or diethylcarbamazine) and oral steroids was based on the attending ophthalmologist’s discretion. Data collected revealed the use of diethylcarbamazine twice daily in three of these five patients of combined therapy, as the study group included patients over a decade. Newer patients were given albendazole (Figure 1). Three of the patients presenting with intense inflammation did not show favorable responses to oral medications and hence were advised for the therapeutic vitrectomy at 1 week follow-up time. Despite the advice, two of the patients refused surgical intervention and long-term follow-up to 16 years showed phthisis of the eye. Eight (50%) eyes had vitreo-retinal surgery; one eye for severe inflammation with vitreous opacity, and seven eyes for vitreo-retinal comorbidities that included epiretinal membrane, retinal folds, and tractional or rhegmatogenous retinal detachment (Figure 2). The proportion of patients undergoing surgery appears high, as their presentation to the clinic was in the late course of disease, with comorbidities unrelated to any particular age group.