Med library header>

Two tapeworms that commonly infect cattle and pigs, Taenia saginata and T.solium, are responsible for intestinal infections in humans. The latter is also responsible for a systemic infection, cysticercosis. T.solium occurs in Central and South America, south-east Asia and some parts of eastern Europe and Africa. T. saginata occurs worldwide but its prevalence is particularly high in sub-Saharan Africa. Intestinal infection occurs when the larval form (cysticercus) is eaten live in raw or undercooked meat. The evaginated scolex anchors to the mucosa of the small intestine where it matures into a segmented adult worm capable of living for many years. Distal segments loaded with eggs become detached and are excreted in the faeces. The transmission cycle is completed when eggs are ingested by pigs or cattle reared for human consumption.

tablet, 150 mg, 600 mg

Children over 4 years and Adults:
5-10 mg/kg single dose

chewable tablet, 500 mg

Children < 10 kg:
0.5 g as a single dose

Children 10-35 kg:
1 g as a single dose

Adults:
2 g as a single dose

Note: niclosamide is not active against the larval form of T.solium (cysticerci)

tablet, 150 mg, 600 mg

Children over 4 years and Adults:
A total of 50 mg/kg daily in three divided doses for 14 days

2-3 days beforehand and then throughout the period of treatment.

chewable tablet, 400 mg

Adults:
15 mg/kg for 30 days

In taeniasis, praziquantel is well tolerated and extensively absorbed and kills adult intestinal taenia worms in a single dose. Praziquantel also kills T. solium cysticerci when taken for 14 days in high doses. It thus offers the prospect of a cure for neurocysticercosis, which has been treatable only by surgery, anti-inflammatory corticosteroids and anticonvulsants. However, because dying and disintegrating cysts may induce localized cerebral oedema, treatment with praziquantel must always be undertaken in a hospital setting. In addition, a corticosteroid is usually given to reduce the inflammatory response. Albendazole also kills neurocysticerci when given daily for one month; a corticosteroid or an antihistamine is also given to reduce any inflammatory reaction. The longer-established niclosamide acts only against the adult intestinal worms. Cestode infections, due to T. solium , occurring during pregnancy should always be treated immediately (with praziquantel or niclosamide, but not with albendazole) because of the risk of cysticercosis.

tablet, 150 mg, 600 mg

Children over 4 years and Adults:
A total of 60 mg/kg daily in three divided doses for 6 days

Model Formulary search, enter 'cestode' and see Cestode infections.

Zoonoses and other animal and food related public health risks, Publications and documents, 1981-1999, WHO/CDS/CSR/APH/2000.1

Partners for Parasite Control (PPC), WHO link page

A proposal to declare neurocysticercosis an international reportable disease by G. Román, J. Sotelo, O. Del Brutto, A. Flisser, M. Dumas, N. Wadia, D. Botero, M. Cruz, H. Garcia, P.R.M. de Bittencourt, L. Trelles, C. Arriagada, P. Lorenzana, T.E. Nash, & A. Spina-França: vol.78, no.3, 399-406, 2000.

Basic Food Safety for Health Workers, M.Adams and Y.Motarjemi, WHO/SDE/PHE/FOS/99.1, English, see Appendix, Page 9

WHO Model Prescribing Information. Drugs used in parasitic diseases second edition, 1995. 146 pages [E, F, S] ISBN 92 4 140104 4 Sw.fr. 35.-/US $31.50. In developing countries Sw.fr.24.50.
Note: Where there is discrepancy between this book and the WHO Model Formulary, the Formulary should be considered to be the more authoritative.

Report of the WHO Informal Consultation on the use of praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months, Geneva, 8-9 April, 2002, WHO/CDS/CPE/PVC/2002.4

(1) Use of praziquantel in pregnant and lactating women, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003
(2) Benzimidazoles: use in children, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003

Adult intestinal worms
praziquantel .html tablet, 150 mg, 600 mg	.html Children over 4 years and Adults: 5-10 mg/kg single dose

Alternative for adult intestinal worms
niclosamide .html chewable tablet, 500 mg	.html Children < 10 kg: 0.5 g as a single dose Children 10-35 kg: 1 g as a single dose Adults: 2 g as a single dose *Note: niclosamide is not active against the larval form of T.solium* (cysticerci)

Cysticercosis and neurocysticercosis
praziquantel .html tablet, 150 mg, 600 mg	.html Children over 4 years and Adults: A total of 50 mg/kg daily in three divided doses for 14 days
plus prednisolone .html tablet 1 mg, 5 mg	.html 2-3 days beforehand and then throughout the period of treatment.

Alternative for neurocysticercosis
albendazole .html chewable tablet, 400 mg	.html Adults: 15 mg/kg for 30 days
.html In taeniasis, praziquantel is well tolerated and extensively absorbed and kills adult intestinal taenia worms in a single dose. Praziquantel also kills T. solium cysticerci when taken for 14 days in high doses. It thus offers the prospect of a cure for neurocysticercosis, which has been treatable only by surgery, anti-inflammatory corticosteroids and anticonvulsants. However, because dying and disintegrating cysts may induce localized cerebral oedema, treatment with praziquantel must always be undertaken in a hospital setting. In addition, a corticosteroid is usually given to reduce the inflammatory response. Albendazole also kills neurocysticerci when given daily for one month; a corticosteroid or an antihistamine is also given to reduce any inflammatory reaction. The longer-established niclosamide acts only against the adult intestinal worms. Cestode infections, due to T. solium , occurring during pregnancy should always be treated immediately (with praziquantel or niclosamide, but not with albendazole) because of the risk of cysticercosis.
Dermal cysticercosis
praziquantel .html tablet, 150 mg, 600 mg	.html Children over 4 years and Adults: A total of 60 mg/kg daily in three divided doses for 6 days

1.	.html Model Formulary search, enter 'cestode' and see Cestode infections.
	http://mednet3.who.int/eml/modelFormulary.asp
2.	.html Zoonoses and other animal and food related public health risks, Publications and documents, 1981-1999, WHO/CDS/CSR/APH/2000.1
	http://www.who.int/emc-documents/zoonoses/docs/whocdscsraph2001.pdf
3.	.html Partners for Parasite Control (PPC), WHO link page
	http://www.who.int/ctd/intpara/index.html
4.	.html A proposal to declare neurocysticercosis an international reportable disease by G. Román, J. Sotelo, O. Del Brutto, A. Flisser, M. Dumas, N. Wadia, D. Botero, M. Cruz, H. Garcia, P.R.M. de Bittencourt, L. Trelles, C. Arriagada, P. Lorenzana, T.E. Nash, & A. Spina-França: vol.78, no.3, 399-406, 2000.
	http://www.who.int/bulletin/pdf/2000/issue3/bu0391.pdf
5.	.html Basic Food Safety for Health Workers, M.Adams and Y.Motarjemi, WHO/SDE/PHE/FOS/99.1, English, see Appendix, Page 9
	http://www.who.int/foodsafety/publications/capacity/healthworkers/en/
6.	.html WHO Model Prescribing Information. Drugs used in parasitic diseases second edition, 1995. 146 pages [E, F, S] ISBN 92 4 140104 4 Sw.fr. 35.-/US $31.50. In developing countries Sw.fr.24.50. Note: Where there is discrepancy between this book and the WHO Model Formulary, the Formulary should be considered to be the more authoritative.
	Sales Information: http://www.who.int/bookorders/index.htm
7.	.html Report of the WHO Informal Consultation on the use of praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months, Geneva, 8-9 April, 2002, WHO/CDS/CPE/PVC/2002.4
	http://www.who.int/wormcontrol/documents/en/pvc_20024full.pdf
8.	.html (1) Use of praziquantel in pregnant and lactating women, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003 (2) Benzimidazoles: use in children, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003
	http://www.who.int/druginformation/vol17num1_2003/vol17-1.pdf

Cestodes (tapeworm) - taeniasis and cysticercosis

Introduction, etiology

Recommended treatments

Model Formulary search