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Abstract：
Neurocysticercosis, caused by the tapeworm Taenia solium, is a neglected tropical illness that affects millions of people worldwide. The disease leads to seizures and epilepsy as the larvae invade the nervous system. Treatment with albendazole and praziquantel is common, but the comparative effectiveness of combination therapy versus monotherapy is unclear. This study evaluated the effectiveness of albendazole and praziquantel combination therapy versus albendazole monotherapy for lesion resolution in pediatric neurocysticercosis. The study aimed to assess the effectiveness of the antiparasitic combination of albendazole and praziquantel as compared with albendazole monotherapy in the treatment of neurocysticercosis in children. This study is based on a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Randomized controlled trials on pediatric patients receiving the mentioned therapies were included. The risk-of-bias tool for randomized trials assessed the study quality once data extraction and analysis were completed. This study included randomized research in neurocysticercosis pediatric patients diagnosed with neuroimaging outcomes, using albendazole and praziquantel combination therapy or albendazole monotherapy. We searched articles between September 30 and December 1, 2023. All terms followed the Medical Subject Headings (MeSH) browser, and 13 articles were found. The data was quantitatively analyzed using RevMan 5.4.1 (The Nordic Cochrane Center, The Cochrane Collaboration, Copenhagen, Denmark). We applied the relative risk (RR) for the intervention and control groups before and after treatment, obtained from prior studies on lesion result resolution. The statistical method was Mantel-Haenszel. The model analysis we used was a fixed effect model (FEM) for heterogeneity (I2) < 50% and a random effect model (REM) for I2 ≥ 50%. The impact was measured using the risk difference (RD) by study and the overall 95% confidence interval (CI). The meta-analysis indicated that combination therapy was more effective in achieving complete lesion resolution after both three months (pooled RD = 0.18, 95% CI = 0.03-0.33, p= 0.02, I2 =0%) and six months (pooled RD = 0.24, 95% CI = 0.09-0.40, p = 0.002, I2 =0%) of therapy. However, calcification outcomes were also more significant in the combination therapy group. The study demonstrates that the albendazole and praziquantel combination therapy is superior in lesion resolution in pediatric neurocysticercosis. Clinical caution is advised to prevent calcification during treatment.
摘要：
脑囊虫病,由tape虫猪带虫引起的，是一种被忽视的热带病，影响着全世界数百万人。由于幼虫侵入神经系统，该疾病导致癫痫发作和癫痫。阿苯达唑和吡喹酮治疗很常见，但联合治疗与单药治疗的疗效比较尚不清楚.这项研究评估了阿苯达唑和吡喹酮联合治疗与阿苯达唑单药治疗小儿脑囊虫病病灶消退的有效性。该研究旨在评估阿苯达唑和吡喹酮的抗寄生虫组合与阿苯达唑单药治疗儿童脑囊虫病的有效性。本研究基于系统评价和荟萃分析（PRISMA）标准的首选报告项目。纳入了接受上述治疗的儿科患者的随机对照试验。一旦数据提取和分析完成，随机试验的偏倚风险工具就会评估研究质量。这项研究包括随机研究的神经囊虫病儿科患者诊断为神经影像学结果，采用阿苯达唑和吡喹酮联合治疗或阿苯达唑单药治疗。我们搜索了2023年9月30日至12月1日之间的文章。所有术语都遵循医学主题词(MeSH)浏览器，共找到13篇文章。使用RevMan5.4.1对数据进行了定量分析(北欧科克伦中心，科克伦合作,哥本哈根,丹麦)。我们对干预组和对照组进行治疗前后的相对危险度(RR),从先前关于病变结果分辨率的研究中获得。统计方法为Mantel-Haenszel。我们使用的模型分析是异质性（I2）<50％的固定效应模型（FEM）和I2≥50％的随机效应模型（REM）。使用研究的风险差异（RD）和总体95％置信区间（CI）来衡量影响。荟萃分析表明，联合治疗在治疗3个月（合并RD=0.18，95％CI=0.03-0.33，p=0.02，I2=0％）和6个月（合并RD=0.24，95％CI=0.09-0.40，p=0.002，I2=0％）后更有效地实现病变完全消退。然而,联合治疗组钙化结局也更显著。该研究表明，阿苯达唑和吡喹酮联合疗法在小儿脑囊虫病的病变解决方面具有优势。建议临床谨慎，以防止治疗期间钙化。
