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Helminthiases 

Helminthiases
Chapter:
Helminthiases
DOI:
10.1093/med/9780198729228.003.0078
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date: 26 June 2019

Systemic helminth infections continue to be major global public health threats, especially in the world’s poorest countries of Africa, Asia, and the Americas. Girls and women are disproportionately affected in many cases. Schistosomiasis is one of the commonest diseases of poor people in Africa, with the urogenital form of the disease possibly emerging as a leading co-factor in Africa’s AIDS epidemic. Cysticercosis is responsible for epilepsy in more than one million people, and echinococcosis causes symptomatic disease in the viscera and central nervous system in similar numbers of individuals. Systemic parasitic diseases are also important health disparities in wealthy countries, including the United States and Europe. Toxocariasis is one of the commonest helminthiases in these regions and worldwide—in its covert form, it has been linked to both pulmonary dysfunction and cognitive deficits. Cysticercosis is also an important cause of epilepsy in the United States. Antiparasitic drugs are available to treat most systemic helminth infections. New evidence-based guidelines for the treatment of parenchymal neurocysticercosis have been issued by the American Academy of Neurology. For echinococcosis, treatment modalities that combine medical and surgical management have been described. Finally, for schistosomiasis, mass treatment programmes, using World Health Organization guidelines, are under way in most sub-Saharan African countries. Overall, there is an urgent need for new and improved drugs, diagnostics, and even vaccines for many systemic helminth infections.

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