Meta-analysis and clinical guides of the diagnosis and treatment of neurocysticercosis

Neurocysticonsis (NC), is an endemic brain parasitic disease in poor countries, which still causes high mortality and morbidity, including developed countries, due to migration. The Diagnosis of the NC is based on neuroimaging studies (brain tomography and magnetic resonance) that facilitates the diagnosis of the parenchymal NC, not so of the extraponenquimatous. There is no characteristic clinical picture of NC, because it depends on the number and location of the parasite in the brain, as well as the immune response of the host. Immunological tests in blood and céfalo-raquido liquid provide very variable results of sensitivity and specificity; In this context, the diagnosis of the NC is still difficult and controversial. The treatment of the NC depends on the symptoms and antihelmintic drugs (albendazole and prazicuantel) are administered to kill the parasite, whose effectiveness has been demonstrated in the parenchymal form, but there are no randomized clinical trials, to treat extra-peer-peer forms. For these reasons, it is urgent to carry out a systematic review and a meta-analysis of the available scientific evidence, which answers the question of what is the validity of the immunological tests to diagnose the NC and the real effectiveness of the treatment used, in order to develop clinical guides of the diagnosis and treatment of the NC, to avoid the existing confusion and uncertainty in the management of this disease. A search and selection protocol of articles will be developed according to the phases of the Prisma Guide (Preferred Reporting items for Systematic Reviews and Meta-Analys). The search for published original articles will be in the Pubmed, Medline, Scielo, Scopus, Science Direct, Embase and Library Cochrane databases, based on specific search strategies, through inclusion and exclusion criteria to compare the sensitivity and specificity of articles and determine the existence or not of statistical differences. For the realization of the diagnostic and treatment guides, the tasks will be distributed to each member of the research team, in order to follow the following steps: A- Definition of the research questions, through Pico Form (patients, intervention, comparator and outcomes); B- Definition of the type of study; C- Determination of the search for scientific evidence: D- Evaluation and synthesis of evidence through internal validity to reduce the presence of bias. The results will be based on statistical significance and precision (confidence intervals); As well as effect estimators (relative risk) Critical evaluation of studies. F- Formulation of recommendations according to the Assystem Grade (Grading Strength of Recommendationsand Quality of Evidence in Clinical Guidelines): High, moderate, low or very low Once the described methodology is applied, we will obtain a result of meta-analysis to recommend to the international scientific community and the health system in general, the validity of the immunological diagnostic tests, as well as guides of immunological diagnosis, as well as guides Diagnosis and treatment of the NC updated and based on scientific evidence.