Cystic Echinococcosis in the Mediterranean

Developing a geographical-meteorological indicator system and evaluating prediction models for alveolar echinococcosis in China

BACKGROUND

Geographical and meteorological factors have been reported to influence the prevalence of echinococcosis, but there's a lack of indicator system and model.

OBJECTIVE

To provide further insight into the impact of geographical and meteorological factors on AE prevalence and establish a theoretical basis for prevention and control.

METHODS

Principal component and regression analysis were used to screen and establish a three-level indicator system. Relative weights were examined to determine the impact of each indicator, and five mathematical models were compared to identify the best predictive model for AE epidemic levels.

RESULTS

By analyzing the data downloaded from the China Meteorological Data Service Center and Geospatial Data Cloud, we established the KCBIS, including 50 basic indicators which could be directly obtained online, 15 characteristic indicators which were linear combination of the basic indicators and showed a linear relationship with AE epidemic, and 8 key indicators which were characteristic indicators with a clearer relationships and fewer mixed effects. The relative weight analysis revealed that monthly precipitation, monthly cold days, the difference between negative and positive temperature anomalies, basic air temperature conditions, altitude, the difference between positive and negative atmospheric pressure anomalies, monthy extremely hot days, and monthly fresh breeze days were correlated with the natural logarithm of AE prevalence, with sequential decreases in their relative weights. The multinomial logistic regression model was the best predictor at epidemic levels 1, 3, 5, and 6, whereas the CART model was the best predictor at epidemic levels 2, 4, and 5.

Comparison of the multi-epitope recombinant antigen DIPOL and hydatid fluid for the diagnosis of patients with cystic echinococcosis

The use of serological tests containing multiple immunodominant antigens rather than single antigens have the potential to improve the diagnostic performance in Cystic Echinococcoses (CE) as a complement tool to clear the inconclusive imaging data. Here, we comparatively evaluated the diagnostic value of Hydatid Fluid (HF) and the recently described recombinant multi-epitope antigen DIPOL in IgG-ELISA in a clinically defined cohort of CE patients. The serum samples from 149 CE patients were collected just before surgical or Percutaneous- Aspiration- Injection- Reaspiration (PAIR) procedures. Additionally, serum samples of patients with other parasitic infections (n=49) and healthy individuals (n=21) were also included in the study as controls. To investigate the association between the genotype of the parasite and DIPOL, cyst materials from 20 CE patients were sequenced. In terms of overall sensitivity, HF was higher than DIPOL (82.55%,78.52%, respectively). However, while the sensitivity of HF was higher than DIPOL in patients with active and transitional cysts (83.3%, 75.4%, respectively), sensitivity of DIPOL in inactive cysts was higher compared to HF (95.6%, 78.3%, respectively). The sensitivity of DIPOL depending on cyst stage was statistically significant (P= 0.041). In terms of specificity, DIPOL was found to be better than HF (97.71%, 91.43%, respectively). By genotyping, the majority of 20 patients showed G1 genotype (80%). All patients harboring G3 and G1/G3 cyst genotypes were positive with both antigens, while 87.5% of patients with G1 genotype were seropositive with HF and 75% with DIPOL. The overall sensitivity and high specificity of DIPOL suggest that this recombinant protein containing immunodominant epitopes is a potential substitute for the HF by serological tests for the diagnosis of CE.

Epidemiological, Morphometric, and Molecular Investigation of Cystic Echinococcosis in Camel and Cattle From Upper Egypt: Current Status and Zoonotic Implications

Cystic echinococcosis has been considered one of the major parasitic zoonoses which is associated with severe economic losses. The present study was undertaken to investigate the occurrence, organ distribution, cyst fertility, and viability of cystic echinococcosis in slaughtered camels and cattle from various abattoirs in Assiut Governorate, Egypt. The work also involved morphological, morphometric, and molecular identification of the parasite. The occurrence of hydatid cysts was investigated in total number of 100 lungs of camels and 574 liver and lungs of cattle admitted to three slaughterhouses at Assiut Governorate, Egypt. Moreover, several individual variable factors, including organ involvement, age, sex, and hydatid cyst characteristics, were studied to identify their possible association with the occurrence of the disease. Genomic DNA was extracted from the hydatid cysts, followed by molecular identification of the parasite through amplification of ribosomal DNA internal transcribed spacer (ITS) regions. Hydatid cysts were found in 6 camels (6%) out of 100 inspected camels, while 5 hydatid cysts (0.87%) were detected in a total number of 574 cattle examined. The parasite was detected exclusively in lungs of camels, while lungs were the main organ infected by the parasite in cattle and one hydatid cyst was found in the liver (0.17%). In camel, 66.7, 16.65, and 16.65%of detected cysts were fertile, sterile, and calcified, respectively, while in cattle, these percentages were 60, 20, and 20%, respectively. None of the studied variable factors were significantly associated with the occurrence of the disease in camels, with the exception that all cysts were found in the lung. Conversely, we found a significant association (P < 0.05) between the age and sex of the slaughtered cattle and the occurrence of hydatid cysts. In this respect, the rate of infection was higher in female cattle and those cattle more than 5 years (P < 0.05). The morphological, morphometric, and molecular studies confirmed the presence of the parasite. Taken together, our results concluded that camels and cattle play a potential role in maintaining the transmission cycle of this zoonotic parasite.

Cystic Echinococcosis in Pakistan: A Review of Reported Cases, Diagnosis, and Management

Cystic echinococcosis (CE) is a zoonotic disease that occurs in humans and ungulates due to infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato. It has been estimated that approximately one million people are infected annually, resulting in US$3 billion in human and livestock-associated direct and indirect losses per year. CE is a serious public health concern in many parts of the world, including Pakistan. This review discusses the causative agent as well as the epidemiology, diagnosis, and treatment of CE in Pakistan.

Evidence of Low Prevalence of Cystic Echinococcosis in the Catanzaro Province, Calabria Region, Italy

Cystic echinococcosis (CE) is one of the neglected tropical diseases recognized by the WHO. Echinococcus granulosus sensu lato affects more than 1 million people worldwide and is responsible for high costs in the healthcare system. A clear knowledge of the prevalence of CE and its clinical characteristics could have an important impact on the approach to its diagnosis and to the public health planning of treatment and control interventions. We performed a prevalence study in four municipalities of Catanzaro Province, South Italy. This area is considered to be at high risk of CE because of ovine breeding. We screened by abdominal ultrasound 2,426 volunteers, four of whom had abdominal CE. Given the need for prevention and control programs for CE in endemic areas of Italy, a detailed mapping of prevalence of CE, to complement data obtained through hospital discharge records, appears imperative.