I. Information
Background
Human echinococcosis is a zoonotic disease that is caused by parasites of the genus Echinococcus.
Human infection with E. granulosus leads to the development of one or more hydatid cysts located most often in the liver and lungs, and less frequently in the bones, kidneys, spleen, muscles, central nervous system and other locations. The impact of the disease varies with the number, location and size of the cysts and manifests commonly with pain and compromised organ function, worsening as the cysts enlarge. Infection is debilitating and fatal in some patients. It is a significant public health problem in large pastoral areas (the disease cycle of the parasite involves dogs and mainly sheep) in South America, North Africa, Eastern Europe, the Middle East, Central Asia, Russia and China.
Treatment: CE is often expensive and complicated to treat, sometimes requiring extensive surgery and/or prolonged drug therapy. The choice is primarily based on the imaging characteristics of the cyst, following a stage-specific approach, and on the health care infrastructure and human resources available. The approach is primarily guided by an assessment of the emergency signs and symptoms of the patient at presentation.
Objectives and desired impact of the WHO guideline
Due to (i) the complexity of CE, (ii) the range of disease manifestations and (iii) the infrastructural, technical and skills’ requirements for the various treatment options (availability and safety), it is important for the patient’s wellbeing to stratify treatment recommendations by health services setting.
It is important not to overtreat patients, who might for example, undergo unnecessary surgeries. It is expected that clear and appropriate guidance will reduce and avoid over and maltreatment of patients.
This Guideline will be able to make recommendations to enable clinicians in their respective health care environments to treat CE patients appropriately and at the highest standards of care possible by providing recommendations on the indications of the four main treatment modalities: (1) anti-parasitic drug treatment, (2) percutaneous methods, (3) surgery, (4) “watch & wait” depending on the classification and location of the cysts.
The World Health Organization (WHO) has issued an open call for experts (link) and subsequently is now considering the following experts to join its Guideline Development Group (GDG) on treatment of patients with cystic echinococcosis:
II. Experts
You can find the list of experts with biographies.
III. For comments and inquiries
Biographies will remain posted for 14 days for public consultation. For comments and inquiries regarding the list of potential members of the guideline development group, please write to Katrin BOTE botek@who.int and Dimitra KAVALIEROU kavalieroud@who.int with subject line “CE treatment guidelines web consultation”.
IV. Disclaimer
In order to enhance its management of conflicts of interest as well as strengthen public trust and transparency in connection with WHO meetings and activities involving the provision of technical/normative advice, the names and brief biographies of individuals (“Published Information”) being considered for participation in a WHO-convened Guideline Development Group are disclosed for public notice and comment.
The Published Information is provided by the experts themselves and is the sole responsibility of the individuals concerned. WHO is not responsible for the accuracy, veracity and completeness of the published information provided. Furthermore, in no event will WHO be responsible or liable for damages in relation to the use of, and reliance upon, the Published Information.
The comments received by WHO through the public notice and comment process are treated confidentially and their receipt will be acknowledged through a generic email notification to the sender. Comments brought to the attention of WHO through this process are an integral component of WHO’s conflict of interest assessment process and are carefully reviewed. WHO reserves the right to discuss information received through this process with the relevant expert. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies.
Guideline Development Groups provide technical and/or normative advice and recommendations to WHO. Participation in a Guideline Development Group convened by WHO does not necessarily mean that the views expressed by the expert concerned are shared by WHO and/or represent the decisions or stated policy of WHO.
The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interests, will be reported publicly in accordance with WHO policies.