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Hydatid Disease: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Hydatid disease is associated with the parasitic infestation of a tapeworm of the genus named Echinococcus. It is mostly passed between sheep and dogs. Other animals including dingoes, goats, horses and foxes are also involved. The dogs carry hydatid parasites in their bowel without any indication of an infection. Sheep are generally affected while grazing in certain areas contaminated by dog faeces. On the other hand dogs are infected by having the uncooked organs of dead sheep. This process leads to humans getting infected by eating (ingesting) parasitic eggs, in cases where there is hand-to-mouth transfer of these eggs in dog faeces. This occurs while people handle dogs or objects contaminated with dog excrement.

Cysts commonly occur in either liver or lungs, but may also occur in any other organ like heart, brain, and even bones. Cysts are diagnosed by CT scan, MRI, ultrasound or x-ray and sometimes even confirmed by a blood test. The cyst fluid’s microscopic examination is also required occasionally. The incubation period may vary from months to years depending upon the number of cysts, their location and their rapid growth. The most common form of treatment of the cysts is the surgical removal of them. Most often this is in association with a combination anti-parasitic drug therapy.

How is the treatment done?

The only anthelmintics which are effective against hydatid disease are the two benzimidazolic drugs called mebendazole and albendazole. These drugs are well tolerated but tend to show different efficacy. Albendazole is slightly more effective than mebendazole while treating liver cysts. The duration and doses of the therapy are very important. According to a study, therapy of a single dose of albendazole, produced a 93.8% ‘’reduction rate’’ of eggs and 79.3% ‘’cure rate’’ of adult worms which leads to exhaustion, paralysis and finally death. Albendazole is given at 400 mg per day for 3 days. Another drug which has proven to be beneficial in treating hydatid disease is mebendazole. This drug works by irreversibly or selectively blocking glucose uptake and nutrients in the intestine. This drug is given at 100 mg for 3 days. In mass treatment programs 500 mg of mebendazole is used. The efficacy of albendazole will keep increasing with courses of up to 3-4 months. Patients receive these drugs in a cycle of 4 weeks with a gap of 1-2 weeks without drugs. The preference is usually a continuous treatment for up to 2 years without any noticeable side effect. Overall, albendazole is demonstrated to be an effective advancement towards managing hydatid disease as a sole treatment method or even as an adjunct to surgery. There has been a recent suggestion of a drug called praziquantel which should be taken at 40 mg/day during treatment with albendazole.

Who is eligible for the treatment? (When is the treatment done?)

A child whose weight is more than 15 kg (33 lb) is considered eligible for the treatment. Women who aren’t expecting a child anytime soon are also eligible.

Who is not eligible for the treatment?

Children under 15 kg (33 lb) and pregnant women are not eligible to receive the treatment. Individuals who happen to have an underlying medical condition which is not yet treated are precluded from receiving the treatment.

Are there any side effects?

Side effects of this treatment are minimal. These include rectal prolapse and malnutrition. In rare cases, there are serious complications too, such as infection leading to anaemia and developmental delay in children.

What are the post-treatment guidelines?

After medications the patient should follow certain guidelines to ensure quick recovery. In case the patient experiences symptoms like severe pain, fever and blood in his urine, he should contact a doctor immediately. He should not skip any of the medicines that the doctor has prescribed. It is important to drink plenty of water and stay hydrated. A proper diet that includes a lot of vegetables and fresh fruits is recommended by the doctor. The quantity of salt intake should be decreased. A follow up routine check with your doctor once a while is recommended. Avoiding fatty products or junk food is a must.

How long does it take to recover?

It may take between 2 to 3 months for the tapeworm eggs to become inactive. As soon as the treatment ends, the patient recovers. It takes 3 to 4 months of medication for full recovery.

What is the price of the treatment in India?

The treatment cost of hydatid disease may range from Rs. 50 to Rs. 200.

Are the results of the treatment permanent?

The result of the treatment can never be permanent in this case. A patient once hit with this infection is most likely to get hit by it again. If the environment remains unchanged and the contamination persists, it is likely to reoccur every 3 months or at the least, every year.

What are the alternatives to the treatment?

Difetarzone treatment method is proven to be an effective alternate treatment. It is actually an antiprotozoal agent. Various studies have shown good results of this medication against the parasite. It has a history of properly treating the patients having this parasite.

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