Critical analysis of cystic echinococcosis control programs and praziquantel use in South America, 1974-2010 Análisis crítico de los programas de control de la equinococosis quística y uso del prazicuantel en América del Sur, 1974-2010

• Main Authors: Edmundo Larrieu, Fabian Zanini
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2012
• Subjects: equinococosis; control de enfermedades transmisibles; praziquantel; vigilancia epidemiológica; América del Sur; echinococcosis; communicable disease control; epidemiologic surveillance; South America; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; New Zealand; Argentina; Uruguay
• Online Access: https://doaj.org/article/62b92efdec99496eb5a25cda4c1f4604

Cystic echinococcosis (CE) is one of the most prevalent zoonoses in Argentina, Brazil, Chile, Peru, and Uruguay. Control programs in South America were originally modeled after programs developed in insular territories, such as Tasmania and New Zealand. The advent and proven effectiveness of praziquantel, plus the experience of insular models, produced high expectations for rapid advances; however, after 30 years of praziquantel use, no endemic area in South America has obtained eradication. In fact, only modest gains in CE control have been made and impact on prevalence among humans has been slight. A major impediment has been the infrastructure needed to administer praziquantel to dogs in rural areas 8 times per year over numerous years, a requirement for rapid attack stage 1. Such an infrastructure has not been financially or politically sustainable in endemic areas, which tend to be the poorest. On the other hand, certain areas in Argentina have had success with simple and economically viable alternatives. Based primarily on continuous field work supported by the local community, these strategies have significantly decreased transmission to humans, the health sector's main objective. In addition, new possibilities and tools, such as the EG95 vaccine, are being evaluated; as are early detection and treatment of asymptomatic carriers. La equinococosis quística (EQ) es una de las zoonosis más prevalentes en Argentina, Brasil, Chile, Perú y Uruguay. Los programas de control en América del Sur fueron originalmente hechos a imitación de los programas desarrollados en territorios insulares, como Tasmania y Nueva Zelandia. El advenimiento y la eficacia comprobada del prazicuantel, sumados a la experiencia de los modelos insulares, dieron lugar a altas expectativas de adelantos rápidos; sin embargo, después de 30 años de uso del prazicuantel, ninguna zona endémica en América del Sur ha logrado la erradicación de la enfermedad. De hecho, solo se han obtenido avances moderados en el control de la EQ, y su repercusión ...