Introduction: Although humans are accidental hosts for Echinocococcus tapeworms, echinococcosis possesses serious threats for rural populations and requires precise microbiological prevention actions. Echinococcosis has two major infectious species. One of them being E.granulosis and E.multilocularis, which have the same definitive host while differentiating in intermediate hosts. Dogs, wolves, and foxes are the definitive host for both species, while E.granulosis utilizes sheep and cattle the latter uses rats as their intermediate host. Diagnosing the infected animal and following a quick and effective treatment is the most efficient action plan to prevent more infections whilst keeping the economic losses to the minimum. As such identifying, the most effective treatment method is very important.
Since the discovery of Benzimidazoles, Mebendazole and Albendazole are two of the most efficient drugs to treat echinococcosis at the larval stage. Researchers found that Albendazole is the most efficient drug in the early stages of the disease development. Another invasive way to inhibit cystic echinocccosis specifically is to use the PAIR method (Puncture, aspiration, injection of a scolecidal agent, and reaspiration. ) which involves the injection of a scolicidal agent that aims to destroy the germinal membrane. Although this method holds a massive therapeutic advantage but comes with certain blocks, such as limitation of the operating area, cysts that have high solid material, and cyst that bears multiple daughter vesicles. Also, it is not recommended to utilize PAIR method for cysts that contain materials that cannot be absorbed, also cyst in critical areas that have the risk of spreading into the abdominal cavity, peritoneal cavity or biliary tract renders PAIR method ineffective.
Surgical treatment is the most common invasive method up to this day, and currently, it is only applied to the complicated cysts that may have developed perforated cysts or biliary fistula. Surgical treatment is also applied to the cysts that bear daughter cysts. Considering the amount of invasion in surgical operations this paper focuses on the comparison of non-invasive or partially invasive methods in the treatment process of chinococcosis.
Methods: In this review, online scientific databases such as The National Center for Biotechnology Information and Google scholar have been used. This article is a result of more than 35 articles of which 14 of them have been used directly.
Results: Comparing the effectiveness of various treatment methods and identifying the most efficient treatment is severely important. However, cyst size and classification is a differentiative factor in treatment path.
In general cysts smaller than 5 cm are treated with albendazole, providing effectiveness in the early infection phase, while larger cysts require the PAIR method and Albendazole treatment to control the cyst, however in both AE and CE cases, radical surgeries have been proven to be more effective.
Conclusion: Iran has been identified as an endemic country for Hydatid disease and has an average higher than some of the countries. Livestock slaughtering outside the certified facilities and lack of veterinary supervision might be of an amplifying element. A novel treatment method is required so that echinococcosis could be dealt with efficiently. Also, more comparative research is required to provide the time sensitivity of this disease.
Keywords: Human cystic echinococcosis, hydatid disease, parasiticide, zoonosis