Symptoms and signs compatible with neurocysticercosis in relation to preventive chemotherapy

Overview

Preventive chemotherapy is a powerful tool against many neglected tropical diseases. Various preventive chemotherapy programmes for control of parasitic diseases, including those for taeniasis, schistosomiasis, clonorchiasis and opisthorchiasis, use praziquantel for treatment. However, there are different situations in which preventive chemotherapy using praziquantel (or consecutive doses of albendazole, as is the case for Taenia solium) are not recommended.

This document is designed for medical practitioners and programme staff working in areas endemic or potentially endemic for T. solium, to consider the circumstances in which preventive chemotherapy with praziquantel or consecutive doses of albendazole is not recommended because individuals show signs or symptoms compatible with the presence of T. solium larvae in the central nervous system (neurocysticercosis). In these cases, it is possible that the medicines could reach the central nervous system, causing an inflammatory reaction around the parasites, even though both medicines are used in much lower doses for preventive chemotherapy than for the clinical treatment of neurocysticercosis. Even at a low dose, it may be possible for these medicines to cause or aggravate potentially severe neurological symptoms, and precautions should be taken to prevent this and minimize risk.