Usefulness of pumpkin seeds combined with areca nut extract in community-based treatment of human taeniasis in northwest Sichuan Province, China

. Synergistic effects of pumpkin seeds and areca nut extract on tapeworms. [Display omitted] ► The curative effect of the treatment with pumpkin seeds combined areca nut extract, pumpkin seeds only or areca nut extract alone is assessed in taeniasis patients. ► The pumpkin seed/areca nut extract treatment has much better effect on eliminating of intact tapeworms, compared to either pumpkin seeds or areca nut extract alone. ► Common side-effects include mild and short-term nausea and dizziness. ► The pumpkin seed/areca nut extract treatment is a safe and effective measure for control of cysticercosis in endemic areas. Taeniasis refers to the infection with adult tapeworms of Taenia spp. in the upper small intestine of humans, which is also a cause of cysticercosis infection in either both humans and/or animals. Currently the most commonly applied anthelminthics for treatment of taeniasis are praziquantel and niclosamide. Praziquantel is very effective, but has the risk of induction of epileptic seizures or convulsions in carriers with asymptomatic concurrent neurocysticercosis. In contrast, niclosamide is safe and effective, but is not readily available in many endemic countries including China. In the current community-based study, we assessed the curative effect of either pumpkin seeds or areca nut extract alone in taeniasis, and also looked at synergistic effects of these two herb drugs on tapeworms. In the study group with the pumpkin seed/areca nut extract treatment, 91 (79.1%) of 115 suspected taeniasis cases (with a history of expulsion of proglottids within the previous one year) released whole tapeworms, four (3.5%) expelled incomplete strobila, and no tapeworms or proglottids were recovered in the remaining 20 cases. In these 115 persons, 45 were confirmed as taeniasis before treatment by microscopy and/or coproPCR. Forty (88.9%) of 45 confirmed cases eliminated intact worms following treatment. The mean time period for complete elimination of tapeworms in 91 taeniasis cases was 2h (range 20min to 8h 30min), and 89.0% (81) of 91 patients discharged intact worms within 3h after drug administration. In Control Group A with treatment of pumpkin seeds alone, 75.0% (9/12) of confirmed taeniasis cases expelled whole tapeworms, but the mean time period for complete elimination was about 14h 10min (range 3h 20min to 21h 20min), which was much longer than that (2h) for the study group, whereas in Control Group B treated with areca nut extract alone, only 6