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Nagasbekov M, Baimakhanov Z, Doskhanov M, Nurlanbayev E, Kaniyev S, Akhan O, Baimakhanov B, Fakhradiyev I. Cystic echinococcosis of the liver in Kazakhstan: The effectiveness of the PAIR method in comparison with laparoscopic and «open» surgical methods. Asian J Surg 2024:S1015-9584(24)01061-3. [PMID: 38825418 DOI: 10.1016/j.asjsur.2024.05.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND One of the urgent problems of surgical parasitology in the Republic of Kazakhstan is liver cystic echinococcosis. The study aimed to analyze the effectiveness and safety of the percutaneous treatment with different techniques in comparison with the results of laparoscopic and "open" surgical methods. METHODS Retrospectively, we analyzed the outcome of 485 patients with active echinococcal cysts in the period from January 2017-July 2023. Indications for surgical treatment and the choice of the intervention method were based on this classification. Patients were conditionally divided into 3 groups: Laparoscopy-33, Laparotomy-319, PAIR-133. RESULTS The duration of the operation in the PAIR was significantly shorter compared to the Laparotomy and Laparoscopy groups (55.4vs.225.2 and 215.3, p = 0.0001). There was no intraoperative blood loss in PAIR, whereas in Laparotomy and Laparoscopy there were 146.0 and 111.0. The postoperative stay of patients in PAIR is significantly shorter than in Laparotomy and Laparoscopy (3.8 compared to 7.5 and 6.4, p = 0.0001). The follow-up time averaged 39.8 months ± 21. There were no statistically significant differences in relapses. Laparotomy and PAIR groups had 11 (3.5 %) and 6 (4.5 %) relapses, respectively. CONCLUSION In cystic echinococcosis of the liver types CE1, CE3a regardless of the localization, the optimal volume is a PAIR is characterized by a shorter postoperative stay of the patient, early recovery and cure. In the CE2, CE3b stages, laparoscopic pericystectomy is the most effective and safe in individual patients. In case of an intimate arrangement of cysts to tubular structures, the safest method is laparotomy.
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Affiliation(s)
- Madiyar Nagasbekov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan; «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
| | | | - Maxat Doskhanov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Erik Nurlanbayev
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Shokan Kaniyev
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Okan Akhan
- «Hacettepe University», Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Bolatbek Baimakhanov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan; «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
| | - Ildar Fakhradiyev
- «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan.
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Yang Z, Liu K, Wen B, Fu T, Qin X, Li R, Lu M, Wang Y, Zhang W, Shao Z, Long Y. Changes in the global epidemiological characteristics of cystic echinococcosis over the past 30 years and projections for the next decade: Findings from the Global Burden of Disease Study 2019. J Glob Health 2024; 14:04056. [PMID: 38547498 PMCID: PMC10978057 DOI: 10.7189/jogh.14.04056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Background Despite ongoing changes in the global epidemiology of cystic echinococcosis (CE), there is a lack of research conducted to date. Methods We extracted data on incidence and disability-adjusted life years for 204 countries and territories from 1990 to 2019 to evaluate the epidemiological characteristics and burden of CE through the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We used locally weighted linear regression to analyse the primary driving factors of the prevalence of CE at the national and regional levels and utilised a Bayesian Age-Period-Cohort model to forecast the global incidence of CE in the next decade. Results Globally, the incidence of CE remained constantly high from 1990 (2.65 per 100 000 population) to 2019 (2.60 per 100 000 population), resulting in an estimated 207 368 new cases in 2019. We observed substantial variations in the disease burden regarding its spatiotemporal distribution, population demographics, and Socio-Demographic Index levels. According to established models, factors such as health care capacity, livestock husbandry, agricultural activities, rural populations, and education levels are likely to play significant roles in determining the prevalence of CE across different countries. By 2030, the worldwide number of CE cases could reach as high as 235 628, representing an increase of 13.63% compared to 2019. Conclusions Over the past three decades, the global burden of CE has persistently remained high, especially in Central Asia, as well as North Africa and the Middle East. Efforts should focus on more effective prevention and control measures in these key regions and should specifically target vulnerable populations to prevent the escalation of epidemics.
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Affiliation(s)
- Zurong Yang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Centre for Disease Prevention and Control in Northern Theater Command, Shenyang, China
| | - Kun Liu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Bo Wen
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Lintong Rehabilitation and Convalescent Centre, Xi’an, China
| | - Ting Fu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Xiaoang Qin
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Rui Li
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Mengwei Lu
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
- Department of Epidemiology, School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yuhua Wang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Wenkai Zhang
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Zhongjun Shao
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
| | - Yong Long
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
- Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi’an, China
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Baysal İ, Örsten S, Cengiz G, Ünal E, Doğrul AB, Çiftçi T, Çiftçi SY, Akinci D, Akhan O. Assessing the Potential Apoptotic Effects of Different Hydatid Cyst Fluids on Human Healthy Hepatocytes and Hepatocellular Carcinoma Cells. Acta Parasitol 2024; 69:700-709. [PMID: 38372909 PMCID: PMC11001659 DOI: 10.1007/s11686-024-00797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/09/2024] [Indexed: 02/20/2024]
Abstract
Cystic Echinococcosis (CE) is a zoonotic infection caused by the larval form of Echinococcus granulosus in humans. Emerging evidence suggests an intriguing inverse association between E. granulosus infection and the occurrence of cancer. This study aimed to investigate the influence of diverse host-derived hydatid cyst fluids (HCF) with distinct genotypes on human liver hepatocytes (HC) and hepatocellular carcinoma cells (HepG2). Specifically, we examined their effects on cell proliferation, apoptosis sensitivity (BAX/BCL-2), apoptosis-related p53 expression, and the expression of cancer-related microRNA (hsa-miR-181b-3p). Cell proliferation assays, real-time PCR, and ELISA studies were conducted to evaluate potential anti-cancer properties. The findings revealed that animal-origin HCF (G1(A)) induced direct cell death by augmenting the susceptibility of HepG2 cells to apoptosis. Treatment with both G1(A) and G1(H) HCF sensitized HepG2 and HC cell lines to apoptosis by modulating the BAX/BCL-2 ratio, accompanied by upregulation of the p53 gene. Additionally, G1(A) HCF and human-derived HCFs (G1(H), G7(H)) reduced the expression of miR-181b-3p in HepG2 cells. Consequently, this study demonstrates the potential anti-cancer effect of HCF in HepG2 cells and provides the first comparative assessment of HCFs from human and animal sources with diverse genotypes, offering novel insights into this field.
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Affiliation(s)
- İpek Baysal
- Vocational School of Health Services, Hacettepe University, 06100, Ankara, Turkey.
| | - Serra Örsten
- Vocational School of Health Services, Hacettepe University, 06100, Ankara, Turkey
| | - Görkem Cengiz
- Vocational School of Health Services, Yüksek İhtisas University, 06291, Ankara, Turkey
| | - Emre Ünal
- Faculty of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey
| | - Ahmet Bülent Doğrul
- Faculty of Medicine, Department of General Surgery, Hacettepe University, 06100, Ankara, Turkey
| | - Türkmen Çiftçi
- Faculty of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey
| | - Samiye Yabanoğlu Çiftçi
- Faculty of Pharmacy, Department of Biochemistry, Hacettepe University, 06100, Ankara, Turkey
| | - Devrim Akinci
- Faculty of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey
| | - Okan Akhan
- Faculty of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey
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Li YP, Zhang J, Li ZD, Ma C, Tian GL, Meng Y, Chen X, Ma ZG. Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China. World J Gastroenterol 2024; 30:462-470. [PMID: 38414590 PMCID: PMC10895592 DOI: 10.3748/wjg.v30.i5.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Some hydatid cysts of cystic echinococcosis type 1 (CE1) lack well-defined cyst walls or distinctive endocysts, making them difficult to differentiate from simple hepatic cysts. AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries. METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region (China) from January 2018 to September 2023 were retrospectively analyzed. Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis, routine abdominal ultrasound, high-frequency ultrasound, abdominal computed tomography (CT) scan, and laparoscopy. Subsequent to the treatments, these patients underwent reexaminations at the outpatient clinic until October 2023. The evaluations included the diagnostic precision of diverse examinations, the efficacy of surgical approaches, and the incidence of CE recurrence. RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan. Among them, 16 patients were preoperatively diagnosed with atypical CE1, and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound. All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy, of whom 14 patients were intraoperatively confirmed to have CE1, which was consistent with the postoperative pathological diagnosis, one patient was diagnosed with a mesothelial cyst of the liver, and the other was diagnosed with a hepatic cyst combined with local infection. Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts, 4 received aspiration sclerotherapy of hepatic cysts, and 19 received laparoscopic fenestration. These patients were intraoperatively diagnosed with simple hepatic cysts. During the follow-up period, none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices. One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space. CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts. The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.
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Affiliation(s)
- Yu-Peng Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Jie Zhang
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-De Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Chao Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Guang-Lei Tian
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Yuan Meng
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Xiong Chen
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-Gang Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
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Elmalki H, Moutawekkil M. Silent Rupture in the Inferior Vena Cava: A Complication Not to Be Ignored in the Presence of a Segment I Hydatid Cyst. Cureus 2024; 16:e53703. [PMID: 38455814 PMCID: PMC10919200 DOI: 10.7759/cureus.53703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
The presence of a cysto-caval fistula is a serious and rare complication of hepatic hydatid cysts, which can be life-threatening. We report a case of a 22-year-old patient with a segment I hepatic hydatid cyst discovered following scannographic imaging for non-specific abdominal pain. Management consisted of albendazole-based premedication for two weeks, followed by hepatic and venous resection surgery with prosthetic replacement after venous exclusion under extracorporeal circulation. To avoid hemorrhagic and/or embolic complications, it is essential to discuss rare cases of hydatid cysts with intimate contact or invasion of the vena cava in a multidisciplinary setting, to plan repair or reconstruction away from intraoperative surprises that are often fatal for benign pathology.
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Affiliation(s)
- Hicham Elmalki
- Cardiothoracic Surgery Department, Laboratory of Anatomy, Microsurgery, and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Mehdi Moutawekkil
- Cardiothoracic Surgery Department, Laboratory of Anatomy, Microsurgery, and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
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Hogea MO, Ciomaga BF, Muntean MM, Muntean AA, Popa MI, Popa GL. Cystic Echinococcosis in the Early 2020s: A Review. Trop Med Infect Dis 2024; 9:36. [PMID: 38393125 PMCID: PMC10891927 DOI: 10.3390/tropicalmed9020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/14/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus. Although the World Health Organization (WHO) has defined CE as a neglected disease, it is the second most important foodborne parasitic disease, and it remains an important public health issue, considering its zonal endemicity and potential morbidity. The control and prevention of CE is a relevant WHO target, especially from a One Health perspective, as the disease affects not only animals and humans but also the food chain. Since not all countries have a CE surveillance strategy or reporting system and specific management guidelines, recent epidemiological data are relatively scarce, and research concerning the specific geographical distribution of the disease is ongoing. To add new information to the subject, we have analyzed and collected data from national guidelines and several medical databases. Out of the 751 research articles that were originally identified, only 52 were included in the investigation after applying specific inclusion and exclusion criteria. Notable international projects that have provided significant contributions and had a positive impact are presented. The available data were correlated with WHO recommendations on the subject, thus showcasing the measures taken and those that are still needed to properly control the disease's spread.
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Affiliation(s)
- Mihai-Octav Hogea
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Bogdan-Florin Ciomaga
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Mădălina-Maria Muntean
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Andrei-Alexandru Muntean
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Gabriela Loredana Popa
- Parasitic Disease Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Abstract
This report by the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring and surveillance activities carried out in 2022 in 27 Member States (MSs), the United Kingdom (Northern Ireland) and 11 non-MSs. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. In 2022, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The number of cases of campylobacteriosis and salmonellosis remained stable in comparison with 2021. Nineteen MSs and the United Kingdom (Northern Ireland) achieved all the established targets in poultry populations for the reduction of Salmonella prevalence for the relevant serovars. Salmonella samples from carcases of various animal species, and samples for Campylobacter quantification from broiler carcases, were more frequently positive when performed by the competent authorities than when own checks were conducted. Yersiniosis was the third most reported zoonosis in humans, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases, with the most hospitalisations and highest case fatality rates. In 2022, reporting showed an increase of more than 600% compared with 2021 in locally acquired cases of human West Nile virus infection, which is a mosquito-borne disease. In the EU, the number of reported foodborne outbreaks and cases, hospitalisations and deaths was higher in 2022 than in 2021. The number of deaths from outbreaks was the highest ever reported in the EU in the last 10 years, mainly caused by L. monocytogenes and to a lesser degree by Salmonella. Salmonella and in particular S. Enteritidis remained the most frequently reported causative agent for foodborne outbreaks. Norovirus (and other calicivirus) was the agent associated with the highest number of outbreak human cases. This report also provides updates on brucellosis, Coxiella burnetii (Q fever), echinococcosis, rabies, toxoplasmosis, trichinellosis, infection with Mycobacterium tuberculosis complex (focusing on Mycobacterium bovis and Mycobacterium caprae) and tularaemia.
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Manciulli T, Brunetti E. Stepping stones and challenges in the use of artificial intelligence in the diagnosis of echinococcosis. Lancet Digit Health 2023; 5:e750-e751. [PMID: 37770336 DOI: 10.1016/s2589-7500(23)00183-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Tommaso Manciulli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; WHO Collaborating Center for the Clinical Management of Cystic Echinococcosis, University of Pavia, Pavia, Italy.
| | - Enrico Brunetti
- WHO Collaborating Center for the Clinical Management of Cystic Echinococcosis, University of Pavia, Pavia, Italy; Immunology and Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy; Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
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Brunetti E, Tamarozzi F. Watch-and-wait approach for inactive echinococcal cysts: scoping review update since the issue of the WHO-IWGE Expert Consensus and current perspectives. Curr Opin Infect Dis 2023; 36:326-332. [PMID: 37466115 PMCID: PMC10487372 DOI: 10.1097/qco.0000000000000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
PURPOSE OF REVIEW This work aims to provide an update of knowledge on the evolution of inactive cystic echinococcosis (CE) cysts (CE4-CE5) managed by 'watch-and-wait', by means of a scoping review of the literature published after the publication of the WHO-IWGE (Informal Working Group on Echinococcosis) Expert Consensus document in 2010. RECENT FINDINGS A total of 31 articles were included. Population ultrasound-based studies showed that spontaneously inactivated CE cysts represent 50.2% (95% confidence interval 38.7-61.8) of all detected untreated CE cysts, and that the prevalence of CE4-CE5 cysts tends to increase with age. Four longitudinal population-based studies showed that CE cysts naturally tend to evolve towards inactivation and that spontaneously inactivated cysts reactivate in a minority of cases. This was confirmed by four hospital-based studies, showing that spontaneously inactivated cysts reactivate rarely, while rate of reactivation is higher if inactivity was obtained posttreatment. It was not possible to drive conclusions on any difference in the clinical course of infection in immunocompromised or pregnant patients. SUMMARY CE cysts tend to evolve spontaneously to inactivation over time. The published literature supports the safety of the watch-and-wait approach for inactive cysts, sparing treatment to a substantial proportion of asymptomatic patients. A regular follow-up with ultrasound of all inactive cysts is required to detect reactivations.
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Affiliation(s)
- Enrico Brunetti
- Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, WHO Collaborating Centre on Clinical Management of Cystic Echinococcosis, Pavia
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, WHO Collaborating Centre on Strongyloidiasis and other Neglected Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Paduraru AA, Lupu MA, Sima L, Cozma GV, Olariu SD, Chiriac SD, Totolici BD, Pirvu CA, Lazar F, Nesiu A, Mihu AG, Cumpanas AA, Cretu OM, Olariu TR. Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007-2022. Microorganisms 2023; 11:2388. [PMID: 37894047 PMCID: PMC10609572 DOI: 10.3390/microorganisms11102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Cystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18-90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50-59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases.
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Affiliation(s)
- Ana Alexandra Paduraru
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Maria Alina Lupu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania
| | - Laurentiu Sima
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- General Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Gabriel Veniamin Cozma
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- Thoracic Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Sorin Dan Olariu
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgery I, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Sorin Dan Chiriac
- Discipline of Surgery III, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Bogdan Dan Totolici
- Department of General Surgery, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania
| | - Catalin Alexandru Pirvu
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgical Emergencies, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Fulger Lazar
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgery II, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandru Nesiu
- Department of Biology and Life Sciences, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania;
- Department of Urology, Arad County Emergency Clinical Hospital, 310037 Arad, Romania
| | - Alin Gabriel Mihu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Biology and Life Sciences, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania;
| | - Alin Adrian Cumpanas
- Discipline of Urology, Department XV, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Octavian Marius Cretu
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- General Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Tudor Rares Olariu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
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Kaya V, Tahtabasi M, Konukoglu O, Yalcin M. Percutaneous Treatment of Giant Hydatid Cysts and Cystobiliary Fistula Management. Acad Radiol 2023; 30 Suppl 1:S132-S142. [PMID: 37120402 DOI: 10.1016/j.acra.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 05/01/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the efficacy and safety of percutaneous treatment in cystic echinococcosis (CE) type 1 and 3a giant cysts (with at least one diameter>10 cm) according to the World Health Organization classification and to evaluate the management of complications, especially cystobiliary fistulas (CBFs). MATERIALS AND METHODS This retrospective study included 66 patients with 68 CE1 and CE3a giant cysts treated with percutaneous catheterization between January 2016 and December 2021. The characteristics of the cysts, major and minor complications, time to catheter removal, and length of hospital stay were recorded. RESULTS Among the 68 cysts, CBFs occurred in 35 (51.5%), cavity infections in 11 (16.1%), recollection in five (7.4%), and anaphylaxis in three (4.5%). There was no mortality. Biliary drainage was observed intraoperatively in 20 (29.4%) and only postoperatively in 15 (22.1%) of the 35 cysts with CBFs. A plastic biliary stent was placed in 18 (51.5%) of the 35 cysts with CBFs. The patients with CBFs had a longer hospital stay and time to catheter removal than those without fistulas (15.3 ± 10.9 vs. 6.1 ± 2.6 days and 32.7 ± 51.8 vs. 6.2 ± 3.1 days, respectively; P < 0.001). Of the patients who developed recollection, three were treated with secondary catheterization, and two underwent surgery. In total, three patients underwent surgery. The rate of clinical success was 95.4%. All cysts were followed up for an average of 19.1 (range, 12-60) months, and there was an average 88.8% reduction in cyst volume compared to the initial evaluation. CONCLUSION CE1 and CE3a giant cysts can be treated effectively and safely with high clinical success using the catheterization technique. Contrary to what has previously been reported for these patients, the rate of CBFs is high, but these patients can successfully be treated with percutaneous drainage and/or endoscopic retrograde cholangiopancreatography without the requirement of surgery.
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Affiliation(s)
- Veysel Kaya
- Department of Radiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey (V.K.).
| | - Mehmet Tahtabasi
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Osman Konukoglu
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Metin Yalcin
- Department of General Surgery, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.Y.).
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12
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Yang Y, Cairang Y, Jiang T, Zhou J, Zhang L, Qi B, Ma S, Tang L, Xu D, Bu L, Bu R, Jing X, Wang H, Zhou Z, Zhao C, Luo B, Liu L, Guo J, Nima Y, Hua G, Wa Z, Zhang Y, Zhou G, Jiang W, Wang C, De Y, Yu X, Cheng Z, Han Z, Liu F, Dou J, Feng H, Wu C, Wang R, Hu J, Yang Q, Luo Y, Wu J, Fan H, Liang P, Yu J. Ultrasound identification of hepatic echinococcosis using a deep convolutional neural network model in China: a retrospective, large-scale, multicentre, diagnostic accuracy study. Lancet Digit Health 2023; 5:e503-e514. [PMID: 37507196 DOI: 10.1016/s2589-7500(23)00091-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/08/2023] [Accepted: 04/29/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Ultrasonography is the most widely used technique to diagnose echinococcosis; however, challenges in using this technique and the demand on medical resources, especially in low-income or remote areas, can delay diagnosis. We aimed to develop a deep convolutional neural network (DCNN) model based on ultrasonography to identify echinococcosis and its types, especially alveolar echinococcosis. METHODS This retrospective, large-scale, multicentre study used ultrasound images from patients assessed at 84 hospitals in China, obtained between Jan 1, 2002, and Dec 31, 2021. Patients with a diagnosis of cystic echinococcosis, alveolar echinococcosis, or seven other types of focal liver lesions were included. We tested ResNet-50, ResNext-50, and VGG-16 as the backbone network architecture for a classification DCNN model and input the perinodular information from the ultrasound images. We trained and validated the DCNN model to diagnose and classify echinococcosis using still greyscale ultrasound images of focal liver lesions in four stages: differentiating between echinococcosis and other focal liver lesions (stage one); differentiating cystic echinococcosis, alveolar echinococcosis, and other focal liver lesions (stage two); differentiating cystic echinococcosis, alveolar echinococcosis, benign other focal liver lesions, and malignant focal liver lesions (stage three); and differentiating between active and transitional cystic echinococcosis and inactive cystic echinococcosis (stage four). We then tested the algorithm on internal, external, and prospective test datasets. The performance of DCNN was also compared with that of 12 radiologists recruited between Jan 15, 2022, and Jan 28, 2022, from Qinghai, Xinjiang, Anhui, Henan, Xizang, and Beijing, China, with different levels of diagnostic experience for echinococcosis and other focal liver lesions in a subset of ultrasound data that were randomly chosen from the prospective test dataset. The study is registered at ClinicalTrials.gov (NCT03871140). FINDINGS The study took place between Jan 1, 2002, and Dec 31, 2021. In total, to train and test the DCNN model, we used 9631 liver ultrasound images from 6784 patients (2819 [41·7%] female patients and 3943 [58·3%] male patients) from 87 Chinese hospitals. The DCNN model was trained with 6328 images, internally validated with 984 images, and tested with 2319 images. The ResNet-50 network architecture outperformed VGG-16 and ResNext-50 and was generalisable, with areas under the receiver operating characteristic curve (AUCs) of 0·982 (95% CI 0·960-0·994), 0·984 (0·972-0·992), and 0·913 (0·886-0·935) in distinguishing echinococcosis from other focal liver lesions; 0·986 (0·966-0·996), 0·962 (0·946-0·975), and 0·900 (0·872-0·924) in distinguishing alveolar echinococcosis from cystic echinococcosis and other focal liver lesions; and 0·974 (0·818-1·000), 0·956 (0·875-0·991), and 0·944 (0·844-0·988) in distinguishing active and transitional cystic echinococcosis from inactive echinococcosis in the three test datasets. Specifically, in patients with the hepatitis B or hepatitis C virus, the model could distinguish alveolar echinococcosis from hepatocellular carcinoma with an AUC of 0·892 (0·812-0·946). In identifying echinococcosis, the model showed significantly better performance compared with senior radiologists from a high-endemicity area (AUC 0·942 [0·904-0·967] vs 0·844 [0·820-0·866]; p=0·027) and improved the diagnostic ability of junior, attending, and senior radiologists before and after assistance with AI with comparison of AUCs of 0·743 (0·714-0·770) versus 0·850 (0·826-0·871); p<0·0001, 0·808 (0·782-0·832) versus 0·886 (0·864-0·905); p<0·0001, and 0·844 (0·820-0·866) versus 0·870 (0·847-0·890); p=0·092, respectively. INTERPRETATION The DCNN model was shown to be accurate and robust, and could improve the ultrasound diagnostic ability of radiologists for echinococcosis and its types for highly endemic and remote regions. FUNDING National Natural Science Foundation of China and National Key Research & Development Program of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yongfeng Yang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China; Graduate School of Chinese People's Liberation Army, General Hospital, Beijing, China
| | - Yangdan Cairang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Tian'an Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianhua Zhou
- Department of Ultrasound, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Li Zhang
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Baowen Qi
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Shumei Ma
- Department of Ultrasound Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Lina Tang
- Department of Diagnostic Ultrasound, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Dong Xu
- Colorectal Surgery and Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Hangzhou, China
| | - Lingdai Bu
- Department of Ultrasound, People's Hospital of Bortala Mongol Autonomous Prefecture, Bortala Mongol Autonomous Prefecture, China
| | - Rui Bu
- Department of Ultrasound, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiang Jing
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zubang Zhou
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liwen Liu
- Department of Ultrasound, The Xijing Hospital of Air Force Medical University, Xi'an, China
| | - Jianqin Guo
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical College, Hainan, China
| | - Yuzhen Nima
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Guoyong Hua
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Zengcheng Wa
- Department of Ultrasound, Qinghai Red Cross Hospital, Xining, China
| | - Yuying Zhang
- Department of Ultrasound, Qinghai Provincial People's Hospital, Xining, China
| | - Guoyi Zhou
- Innovation Research Center, SonoScape, Shenzhen, China
| | - Wen Jiang
- Innovation Research Center, SonoScape, Shenzhen, China
| | | | - Yang De
- Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hui Feng
- Department of Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Chong Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ruifang Wang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jie Hu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qi Yang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yanchun Luo
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiapeng Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Haining Fan
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Jie Yu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
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Erginöz E, Ergün S, Tunç E, Pekmezci S. Popliteal Echinococcosis: A Long Journey from the Liver. Acta Parasitol 2023:10.1007/s11686-023-00669-y. [PMID: 36995509 DOI: 10.1007/s11686-023-00669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Intra-abdominal and pelvic seeding of hepatic cystic echinococcosis to various organs is a known feature of the disease. Dissemination into distal extremities is uncommon and in this report, we present a case of disseminated cystic echinococcosis extending toward the right popliteal fossa. CASE PRESENTATION A 68-year-old male presented with swelling in the right upper leg and discomfort in the right popliteal region. Work-up revealed various cystic mass lesions of different sizes within the liver, intra-abdominal cavity, right inguinal region, right femoral region, and right popliteal fossa. Diagnosis of hepatic cystic echinococcosis was made and the patient was started on medical therapy. DISCUSSION Hepatic cysts can be easily observed with ultrasonography and the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) classification system is commonly used to further classify cysts. The work-up of the disseminated disease involves further radiological modalities such as computerized tomography and magnetic resonance imaging. Management includes medical therapy, percutaneous drainage, or surgery depending on hepatic cyst localization and the presence of dissemination. CONCLUSION Extrahepatic dissemination of cystic echinococcosis is commonly encountered in endemic areas. Rarely, hepatic cysts can spread beyond the abdomen towards the distal extremities. Therefore, cystic echinococcosis should be included in the differential diagnosis in endemic areas where patients present with cystic masses.
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Affiliation(s)
- Ergin Erginöz
- Department of General Surgery, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Cerrahpasa Mah., Kocamustafapaşa Cad., No: 34, Fatih, Istanbul, Turkey.
| | - Sefa Ergün
- Department of General Surgery, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Cerrahpasa Mah., Kocamustafapaşa Cad., No: 34, Fatih, Istanbul, Turkey
| | - Emre Tunç
- Department of General Surgery, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Cerrahpasa Mah., Kocamustafapaşa Cad., No: 34, Fatih, Istanbul, Turkey
| | - Salih Pekmezci
- Department of General Surgery, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Cerrahpasa Mah., Kocamustafapaşa Cad., No: 34, Fatih, Istanbul, Turkey
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Inceboz T. Introductory Chapter: Changes in Eco-System Change Echinococci - “One Health Concept” against Echinococci. Infect Dis (Lond) 2023. [DOI: 10.5772/intechopen.109303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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15
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Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project. THE LANCET. INFECTIOUS DISEASES 2023; 23:e95-e107. [PMID: 36427513 DOI: 10.1016/s1473-3099(22)00638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/24/2022]
Abstract
The neglected zoonosis cystic echinococcosis affects mainly pastoral and rural communities in both low-income and upper-middle-income countries. In Europe, it should be regarded as an orphan and rare disease. Although human cystic echinococcosis is a notifiable parasitic infectious disease in most European countries, in practice it is largely under-reported by national health systems. To fill this gap, we extracted data on the number, incidence, and trend of human cases in Europe through a systematic review approach, using both the scientific and grey literature and accounting for the period of publication from 1997 to 2021. The highest number of possible human cases at the national level was calculated from various data sources to generate a descriptive model of human cystic echinococcosis in Europe. We identified 64 745 human cystic echinococcosis cases from 40 European countries. The mean annual incidence from 1997 to 2020 throughout Europe was 0·64 cases per 100 000 people and in EU member states was 0·50 cases per 100 000 people. Based on incidence rates and trends detected in this study, the current epicentre of cystic echinococcosis in Europe is in the southeastern European countries, whereas historical endemic European Mediterranean countries have recorded a decrease in the number of cases over the time.
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Comparison of ethanol and hypertonic saline as a single ıntracystic agent in the percutaneous treatment of liver hydatid cysts. Abdom Radiol (NY) 2023; 48:1148-1153. [PMID: 36627404 DOI: 10.1007/s00261-022-03795-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE In this study, the effects of hypertonic saline and ethanol as a single intracystic agents in the percutaneous treatment of liver hydatid cysts were compared. METHODS The 50 patients were separated into two groups as those administered 30% hypertonic saline alone as the intracystic agent in percutaneous treatment (33 patients, 52 cysts), and those administered 96% ethanol alone (17 patients, 26 cysts). Both groups were compared in terms of percentage of cyst volume reduction, complications, and treatment success. RESULTS The follow-up period was median 17.0 months (11.0-20.0) in the ethanol group and 17.0 (14.0-22.0) in the hypertonic saline group (p = 0.269). Complications were observed in 5 (19.2%) cysts applied with ethanol as the intracystic agent and in 7 (13.5%) of the cysts where hypertonic saline was used (p = 0.521). Clinical success was evaluated as 100% in both groups. The percentage of cyst volume reduction according to the initial volume was determined as mean 75.6 ± 20.43 (28.19-98.13) in the ethanol group cysts and as 68.2 ± 16.45 (26.39-97.48) in the hypertonic saline group (p = 0.427). CONCLUSION The results of this study demonstrated similar efficacy of hypertonic saline and ethanol in the percutaneous treatment of CE1 and CE3A liver hydatid cysts. These results suggest that the use of hypertonic saline as a single intracystic agent in the percutaneous treatment of CE1 and CE3A liver hydatid cysts provides sufficient efficacy of treatment and cyst volume reduction. Nevertheless, there is a need for further prospective, randomized studies to support these findings.
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Trueba-Argamasilla AA, Iborra-Bendicho MA, Simón-Páez M, Ros-de San Pedro J, Segovia-Hernández M. Cerebral echinococcosis: Case report and literature review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:107-110. [PMID: 35907775 DOI: 10.1016/j.eimce.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
Echinococcosis is a zoonosis caused by the larval form of the cestode Echinococcus granulosus. The cerebral affectation in the human is uncommon; only in 1-2% cases is observed encephalic involvement. This condition occurs mainly in the pediatric population and it is characterized by the presence of single and unilocular cysts. We report a case of a 29-year-old patient who came to the emergency department with a disabling headache of several weeks of evolution. In the brain imaging study a mass of unknown origin was visualized, finally it turned out to be a bilobed hydatid cyst. Regarding this case, the clinic-epidemiological, diagnostics and treatments aspects of cerebral hydatid disease will be reviewed.
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Affiliation(s)
| | - María Asunción Iborra-Bendicho
- Servicio de Microbiología y Parasitología, H. C. U. Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - Marina Simón-Páez
- Servicio de Microbiología y Parasitología, H. C. U. Virgen de la Arrixaca, Murcia, Spain
| | | | - Manuel Segovia-Hernández
- Servicio de Microbiología y Parasitología, H. C. U. Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
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Govindasamy A, Bhattarai PR, John J. Liver cystic echinococcosis: a parasitic review. Ther Adv Infect Dis 2023; 10:20499361231171478. [PMID: 37197609 PMCID: PMC10184195 DOI: 10.1177/20499361231171478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 05/19/2023] Open
Abstract
Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato. Humans are accidental hosts in this zoonotic disease process, and hepatic infection accounts for over two-thirds of all cases. Since signs and symptoms are mainly non-specific, especially in early disease, clinicians should have a low threshold to include CE as a differential diagnosis in patients with positive serology and suggestive radiological findings, especially in endemic regions. The standard management for liver CE depends on the patient's symptoms, the radiological stage, the size and location of the cyst, the presence of complications and the treating clinicians' expertise. In this review, we discuss the lifecycle of Echinococcus granulosus sensu lato and its epidemiology and then focus on discussing the clinical features, diagnosis and treatment options of CE of the liver.
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Affiliation(s)
| | - Pushpa Raj Bhattarai
- Division of General Surgery, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
| | - Jeff John
- Division of Urology, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
- Division of Urology, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
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Abstract
This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring and surveillance activities carried out in 2021 in 27 MSs, the United Kingdom (Northern Ireland) and nine non-MSs. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. In 2021, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. Cases of campylobacteriosis and salmonellosis increased in comparison with 2020, but decreased compared with previous years. In 2021, data collection and analysis at the EU level were still impacted by the COVID-19 pandemic and the control measures adopted in the MSs, including partial or total lockdowns. Sixteen MSs and the United Kingdom (Northern Ireland) achieved all the established targets in poultry populations for reduction in Salmonella prevalence for the relevant serovars. Salmonella samples from carcases of various animal species and samples for Campylobacter quantification from broiler carcases were more frequently positive when performed by the competent authorities than when own-checks were conducted. Yersiniosis was the third most reported zoonosis in humans, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases, with the most hospitalisations and highest case fatality rates. Overall, MSs reported more foodborne outbreaks and cases in 2021 than in 2020. S. Enteritidis remained the most frequently reported causative agent for foodborne outbreaks. Salmonella in 'eggs and egg products' and in 'mixed foods' were the agent/food pairs of most concern. Outbreaks linked to 'vegetables and juices and products thereof' rose considerably compared with previous years. This report also provides updates on brucellosis, Coxiella burnetii (Q fever), echinococcosis, rabies, toxoplasmosis, trichinellosis, tuberculosis due to Mycobacterium bovis or M. caprae, and tularaemia.
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Tamarozzi F, Kibona T, de Glanville WA, Mappi T, Adonikamu E, Salewi A, Misso K, Maro V, Casulli A, Santoro A, Santolamazza F, Mmbaga BT, Cleaveland S. Cystic echinococcosis in northern Tanzania: a pilot study in Maasai livestock-keeping communities. Parasit Vectors 2022; 15:396. [PMID: 36307877 PMCID: PMC9616617 DOI: 10.1186/s13071-022-05518-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background There are close similarities between the life-cycles of Echinococcus granulosus sensu lato (E. granulosus s.l.) that causes cystic echinococcosis (CE) in humans and Taenia multiceps/Coenurus cerebralis that causes cerebral coenurosis in small ruminants. Recent evidence highlights that livestock in Maasai communities of northern Tanzania are suffering from increases in the prevalence of cerebral coenurosis, leading to concerns about a possible concurrent increased risk of human CE. The aim of this study was to estimate the prevalence of human abdominal CE and the prevalence and species/genotypes of E. granulosus s.l. in livestock in Maasai communities. Methods Human CE was diagnosed by abdominal ultrasound on volunteers aged ≥ 7 years in five villages in the Longido and Ngorongoro Districts in northern Tanzania. Infection in ruminants was evaluated through inspection in local abattoirs, followed by molecular identification of one cyst per animal, with a priority for hepatic cysts, using PCR targeting of the cytochrome c oxidase I gene (COX1), followed by restriction fragment length polymorphism and multiplex PCR, and sequencing of non-E. granulosus s.l. samples. Results Ultrasound was performed on 823 volunteers (n = 352 in two villages in Longido District, and n = 471 in three villages of Ngorongoro). Hepatic CE cases were diagnosed only in Ngorongoro (n = 6; 1.3%), of which three had active cysts. Village-level prevalence of CE ranged between 0 and 2.4%. Of the 697 ruminants inspected, 34.4% had parasitic cysts. Molecular identification was achieved for 140 of the 219 (63.9%) cysts sampled. E. granulosus s.l. and T. hydatigena/Cysticercus tenuicollis were identified in 51.4% and 48.6%, respectively, of livestock cysts. E. granulosus s.l. was identified in livestock from both Longido (35.3% of 116 genotyped cysts) and Ngorongoro (91.2% of 34 genotyped cysts). Of the total of 72 E. granuslosus s.l. cysts identified in livestock, 87.5% were E. granulosus sensu stricto (G1–G3 genotypes), 9.7% were E. ortleppi (G5) and one cyst was E. canadensis (G6–10). The three active human cysts, which were removed surgically, were G1–G3 genotypes. Conclusions Multiple species/genotypes of E. granulosus s.l. are circulating in Maasai communities of northern Tanzania. Human CE was detected in villages of Ngorongoro District and a high prevalence of echinococcal cysts was observed in livestock in both districts. More precise estimation of the prevalence in this area and a better understanding of the specific risk factors for CE among Maasai communities in northern Tanzania is needed. Interventions targeting transmission routes common to both E. granulosus s.l. and T. multiceps would have dual benefits for preventing both human and livestock disease. Graphical Abstract ![]()
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Affiliation(s)
- Francesca Tamarozzi
- IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
| | - Tito Kibona
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Tauta Mappi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Anande Salewi
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Kennedy Misso
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Venance Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | | | | | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Örsten S, Baysal İ, Çiftçi T, Ünal E, Yabanoğlu Çiftçi S, Doğrul AB, Akıncı D, Akyön Y, Akhan O. Evaluation of Potential Inflammatory Markers for Cystic Echinococcosis: P-selectin and Resistin. TURKIYE PARAZITOLOJII DERGISI 2022; 46:195-200. [PMID: 36094120 DOI: 10.4274/tpd.galenos.2022.55265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Cystic echinococcosis (CE) is one of the most common zoonotic diseases worldwide. Diagnosis of CE is predominantly based on imaging techniques and serological tests are used in cases of non-characteristic imaging findings as diagnostic reference. However, serological test results cannot be completely reliable as they are affected by multi-factors. P-selectin and resistin are inflammatory markers that are altered during the acute stages of infection. In this purpose, inflammatory markers as P-selectin and resistin have been investigated for a potential diagnostic reference for CE diagnosis. METHODS A total of 60 patients who were diagnosed with CE and twenty-five healthy individuals were included in this study. Blood samples were obtained from all participants. Obtained sera were evaluated using the P-selectin and resistin ELISA kits for protein levels. Additionally, the relative expression of SELP (P-selectin) and RETN (resistin) genes were determined using the comparative CT (ΔΔCT) method between groups as CE patients with active and inactive cysts, CE patients and healthy controls. RESULTS SELP (13.9-fold change, p<0.05) and RETN (8.1-fold change, p<0.05) were differentially expressed in CE patients compared in the control group. Whereas resistin protein levels were significantly higher in CE patients than the healthy controls (p<0.001), the difference in P-selectin protein levels was not significant (p>0.05). There was no difference between active and inactive CE patients in terms of P-selectin and resistin in gene and protein levels (p>0.05). CONCLUSION Although there was no difference between the active and inactive CE patients, the good differentiation between the healthy controls and the CE patients suggested that resistin is a potential inflammatory diagnostic reference.
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Affiliation(s)
- Serra Örsten
- Hacettepe University Vocational School of Health Services, Ankara, Turkey
| | - İpek Baysal
- Hacettepe University Vocational School of Health Services, Ankara, Turkey
| | - Türkmen Çiftçi
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Emre Ünal
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | | | - Ahmet Bülent Doğrul
- Hacettepe University Faculty of Medicine, Department of General Surgery, Ankara, Turkey
| | - Devrim Akıncı
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Yakut Akyön
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Okan Akhan
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey
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Kronenberg PA, Deibel A, Gottstein B, Grimm F, Müllhaupt B, Meyer zu Schwabedissen C, Aitbaev S, Omorov RA, Abdykerimov KK, Minbaeva G, Usubalieva J, Siles-Lucas M, Pepe P, Rinaldi L, Spiliotis M, Wang J, Müller N, Torgerson PR, Deplazes P. Serological Assays for Alveolar and Cystic Echinococcosis—A Comparative Multi-Test Study in Switzerland and Kyrgyzstan. Pathogens 2022; 11:pathogens11050518. [PMID: 35631039 PMCID: PMC9146094 DOI: 10.3390/pathogens11050518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
Both alveolar (AE) and cystic echinococcosis (CE) are lacking pathognomonic clinical signs; consequently imaging technologies and serology remain the main pillars for diagnosis. The present study included 100 confirmed treatment-naïve AE and 64 CE patients that were diagnosed in Switzerland or Kyrgyzstan. Overall, 10 native Echinococcus spp. antigens, 3 recombinant antigens, and 4 commercial assays were comparatively evaluated. All native E. multilocularis antigens were produced in duplicates with a European and a Kyrgyz isolate and showed identical test values for the diagnosis of AE and CE. Native antigens and three commercial tests showed high diagnostic sensitivities (Se: 86–96%) and specificities (Sp: 96–99%) for the diagnosis of AE and CE in Swiss patients. In Kyrgyz patients, values of sensitivities and specificities were 10–20% lower as compared to the Swiss patients’ findings. For the sero-diagnosis of AE in Kyrgyzstan, a test-combination of an E. multilocularis protoscolex antigen and the recombinant antigen Em95 appears to be the most suitable test strategy (Se: 98%, Sp: 87%). For the diagnosis of CE in both countries, test performances were hampered by major cross-reactions with AE patients and other parasitic diseases as well as by limited diagnostic sensitivities (93% in Switzerland and 76% in Kyrgyzstan, respectively).
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Affiliation(s)
- Philipp A. Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
| | - Ansgar Deibel
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Bruno Gottstein
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Felix Grimm
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
| | - Beat Müllhaupt
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Cordula Meyer zu Schwabedissen
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Sezdbek Aitbaev
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Rakhatbek A. Omorov
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Kubanychbek K. Abdykerimov
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
- Life Science Zürich Graduate School, University of Zürich, 8057 Zurich, Switzerland
| | - Gulnara Minbaeva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Jumagul Usubalieva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiologia (IRNASA-CSIC), 37008 Salamanca, Spain;
| | - Paola Pepe
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Laura Rinaldi
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Markus Spiliotis
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Junhua Wang
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland;
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
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Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts. Pathogens 2022; 11:pathogens11040408. [PMID: 35456083 PMCID: PMC9025470 DOI: 10.3390/pathogens11040408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
Cystic echinococcosis (CE) is a neglected worldwide distributed parasitic disease caused by the Echinococcusgranulosus sensu lato (s.l.) species complex. For a better understanding of the pathways of transmission of this parasite, clinical and molecular epidemiological studies are particularly needed from endemic areas where data are scant, such as in the Middle East. The study aimed to identify the characteristics, location, cyst stage and species/genotypes of E. granulosus s.l. complex in humans from the Kurdistan region, Iraq. To this aim, from June 2019 to February 2021, 64 echinococcal cysts were surgically removed from 62 patients in Azadi and Vajeen reference Hospitals at Duhok city, Duhok governorate (Kurdistan region, Iraq). The results confirmed the liver as the most common anatomical site of CE with 72.58% of the cases, followed by the lungs in 19.35%, while 66.13% of CE cases were females. The highest rate of infections occurred in the age class 21−30 (27.42%). High rates of CE were reported among patients living in rural areas and housewives, which were 54.84% and 43.55% of the CE patients, respectively. The fertility of echinococcal cysts was 82.81%, and the viability of fertile protoscoleces was 70.53%. Cysts were staged with ultrasound according to the WHO-IWGE classification as 32.8% CE1, 32.8% CE2, 7.8% CE3a, 9.4% CE3b, 15.6% CE4 and 1.6% CE5. Molecular analyses using mitochondrial NAD5 gene showed that all analyzed samples (n = 59) belonged to the genotypes G1 or G3 of E. granulosussensu stricto (s.s.), thus, confirming sheep−dog−human transmission in the Kurdistan region, Iraq. No statistically significant correlation was found between the genotypes G1−G3 of E. granulosus s.s. and variables, such as the fertility, location and cyst stage classification. Based on the present findings, it is necessary to implement monitoring and control programs in sheep and dog populations to decrease the odds of human infections. Public health education campaigns are required to be implemented at the community level to reduce the risk of acquiring CE in humans in the Kurdistan region, Iraq.
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Prevalence rate and risk factors of human cystic echinococcosis: A cross-sectional, community-based, abdominal ultrasound study in rural and urban north-central Chile. PLoS Negl Trop Dis 2022; 16:e0010280. [PMID: 35263331 PMCID: PMC8936472 DOI: 10.1371/journal.pntd.0010280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/21/2022] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cystic echinococcosis (CE) caused by Echinococcus granulosus sensu lato (s.l.) is a neglected and underdiagnosed parasitic zoonosis that has a significant socioeconomic impact on rural communities relying on livestock farming. CE is endemic across Latin America, including Chile, where the Coquimbo region exhibits a relatively high record of hospital-based human cases and infected animals. However, the incidence of hospitalized CE cases may underestimate the real burden of infection in a population, since the majority of cases never reach medical attention or official disease records. Methodology/Principal findings In 2019, a cross-sectional, community-based study was conducted with the objectives of estimating for the first time the prevalence of human abdominal CE using abdominal ultrasound (US) screening in volunteers residing in urban and rural localities of the Monte Patria municipality located in Limarí province, Coquimbo region, Chile, and identifying the risk factors associated with human infection. Pre-screening activities included a 16-h lecture/hands-on training aimed at rural physicians that focused on the diagnosis of CE by US, based on current WHO recommendations. A total of 2,439 (~8% of municipality inhabitants) people from thirteen target localities were screened by abdominal US in June-July 2019. We found an overall CE prevalence of 1.6% (95% CI 1.1–2.2) with a significantly higher likelihood of infection in rural localities, older age classes and people drinking non-potable water; 84.6% of infected volunteers were newly diagnosed with CE. Cysts were either in active or inactive stages in equal proportions; active cysts were detected in all age classes, while 95.7% of inactive cysts occurred in >40 years-old subjects. Conclusions/Significance This is the first US survey aimed at detecting human infection caused by Echinococcus granulosus s.l. in Chile. Our findings indicate a high CE prevalence in the area, and contribute to define the demographic and behavioral risk factors promoting the transmission of the parasitic infection within target communities. Our results support the implementation of cost-effective strategies for the diagnosis, treatment and control of CE, and the need to improve the epidemiological surveillance system in Chile. Human cystic echinococcosis (CE) is a parasitic disease caused by Echinococcus granulosus s.l. complex; its cycle involves canids and livestock, mainly sheep. It is endemic in areas with extensive livestock breeding activities, where close contact occurs between humans and the domestic dog-livestock parasite cycle. After ingestion of parasite eggs, people may develop fluid-filled cysts, mainly in the liver. CE is a neglected disease, which causes significant socioeconomic impact mainly on poor communities worldwide. Prevalence data in many affected areas is lacking or largely underestimated, partly because human cases typically do not reach medical attention or official disease records. We determined the prevalence of abdominal CE by ultrasound population-based screening in volunteers residing in urban and rural localities of the Monte Patria Municipality, Limarí province, Coquimbo region, which is an E. granulosus s.l. endemic area of northern Chile, and assessed the risk factors associated with human infection. We performed an ultrasound survey on 2,439 people residing in thirteen localities and found an overall prevalence of 1.6% (95% CI 1.1–2.2). A higher risk of infection was associated with residing in rural localities, older age and drinking non-potable water. CE cysts were either in active or inactive stages in equal proportions and 84.6% of infected volunteers were newly diagnosed with CE. Our findings will serve to support the implementation of cost-effective diagnostic, treatment and control strategies and to improve the epidemiological surveillance system for CE in Chile.
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Khan H, Casulli A, Harandi MF, Afzal MS, Saqib MAN, Ahmed H. A Retrospective Cohort Study on Human Cystic Echinococcosis in Khyber Pakhtunkhwa Province (Pakistan) Based on 16 Years of Hospital Discharge Records. Pathogens 2022; 11:pathogens11020194. [PMID: 35215137 PMCID: PMC8876560 DOI: 10.3390/pathogens11020194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
Human cystic echinococcosis (CE) is a worldwide-distributed parasitic zoonotic disease, which represents a threat for both human and animals. The current study aimed at estimating the prevalence of human CE in Khyber Pakhtunkhwa (KPK) province of Pakistan. Clinical records from four major hospitals in this region were reviewed for CE human cases during the period of 2006–2021. Out of 251 (0.00071%) CE patients identified during the considered period, 142 (56.6%) were females, and 109 (43.4%) were males. The highest number of CE cases was recorded in the 21–30 (27.9%) age group, followed by 31–40 (23.1%) and 41–50 (16.3%). Most of the CE patients in KPK province were members of the Afghani ethnic group (17.1%); secondarily, they were Pakistani (6.4%), while for 76.5% ethnicity data were not available. The liver (41%) and the lungs (4.8%) were the most infected organs identified among CE patients in KPK province. The present study identified CE as a significant public health problem in KPK province, and the current findings demonstrated a constant endemicity of CE during the last 15 years. Further filed studies on the active search of CE carriers by means of ultrasound population-based surveys are needed to fill knowledge gaps on clinical and molecular epidemiology of human CE in Pakistan.
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Affiliation(s)
- Huma Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 4550, Pakistan;
| | - Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
- Correspondence: (A.C.); (H.A.)
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, Kerman University of Medical Sciences, Kerman 761, Iran;
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore 54782, Pakistan;
| | - Muhammad Arif Nadeem Saqib
- Department of Medical Laboratory Technology, National Skills University Islamabad, Islamabad 4550, Pakistan;
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 4550, Pakistan;
- Correspondence: (A.C.); (H.A.)
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Ozturk EA, Manzano-Román R, Sánchez-Ovejero C, Caner A, Angın M, Gunduz C, Karaman Ü, Altintas N, Bozkaya H, Unalp O, Dokumcu Z, Divarci E, Casulli A, Altintas N, Siles-Lucas M, Unver A. Comparison of the multi-epitope recombinant antigen DIPOL and hydatid fluid for the diagnosis of patients with cystic echinococcosis. Acta Trop 2022; 225:106208. [PMID: 34687646 DOI: 10.1016/j.actatropica.2021.106208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/21/2021] [Accepted: 10/13/2021] [Indexed: 11/01/2022]
Abstract
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.
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Cindea CN, Saceleanu V, Saceleanu A. Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options. Brain Sci 2021; 11:brainsci11121604. [PMID: 34942906 PMCID: PMC8699760 DOI: 10.3390/brainsci11121604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
A 23-year-old woman was presented to the Emergency Unit with intracranial hypertension syndrome and blindness in her left eye which had started recently. A cranial native computed tomography scan and a magnetic resonance imaging (MRI) with contrast examinations revealed a giant intracranial cystic lesion, extending into the left frontal lobe, which was compressing the optic chiasm and eroding the internal plate of the left frontal bone. Surgical craniotomy was performed for evacuation and decompression, but during the craniotomy the cyst ruptured. After assessing the degree of erosion of the internal bone plate, we concluded that the primary origin of the cyst was intraosseous. With the dura mater being intact, abundant lavage with H2O2 was applied and the bone flap was replaced after rigorous bone scraping. Imaging control at six and twelve months identified no recurrence of the cyst. In the literature, hydatid cysts located in the skull bone are very rare and most of them rupture intraoperatively. Given their extremely low incidence in developed countries, any neurosurgeons’ experience with such pathology is limited and in some cases surgery cannot be delayed. In the case of intracerebral hydatid cysts, a neurosurgeon usually has only one shot at surgery, so simple and quick-to-access therapeutic guidelines must be developed in order to inform the choice of surgical technique. We conclude that the most successful surgical approach could be double concentric craniotomy. This surgical technique is used in intracerebral tumors, which also have an important bone invasion.
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Affiliation(s)
- Cosmin-Nicodim Cindea
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania; (C.-N.C.); (A.S.)
- Department of Neurosurgery, County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Vicentiu Saceleanu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania; (C.-N.C.); (A.S.)
- Department of Neurosurgery, County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Correspondence:
| | - Adriana Saceleanu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania; (C.-N.C.); (A.S.)
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Fakhar M, Keighobadi M, Hezarjaribi HZ, Montazeri M, Banimostafavi ES, Sayyadi S, Ghaffari Hamadani MM, Sharifpour A, Tabaripour R, Asadi S, Soosaraei M, Khasseh AA. Two decades of echinococcosis/hydatidosis research: Bibliometric analysis based on the web of science core collection databases (2000-2019). Food Waterborne Parasitol 2021; 25:e00137. [PMID: 34849415 PMCID: PMC8608866 DOI: 10.1016/j.fawpar.2021.e00137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/31/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022] Open
Abstract
Echinococcus granulosus sensu lato and Echinococcus multilocularis are responsible for serious health and economic implications for humans and animals. This study was designed to conduct a bibliometric analysis of global research on echinococcosis/hydatidosis included in the Web of Science Core Collection databases from 2000 to 2019. A total of 7066 relevant articles between 2000 and 2019 were identified. Most articles were published in 2015 (502 articles), 2017 (492 articles) and 2018 (493 articles), with the Veterinary Parasitology journal publishing the largest number of articles (237). Researchers from Xinjiang Medical University, China authored the most articles (388) in the field. Authors Craig, P.S. and Deplazes, P. were the most active in publishing143 and 126 hydatid cyst research papers, respectively. The most echinococcosis/hydatidosis publications originated from Turkey, China and Iran, with 1210, 708 and 531 articles, respectively. The highest levels of research collaboration were evident between China- England, China-France, England-France, China-Australia, and China-Japan. Also, the top researchers in this field had relatively extensive collaborations with each other. Our bibliometric analysis provides a picture of the scientific research into the echinococcosis/hydatidosis field. Further multi-national collaborative research efforts in this field should show promising progress in the future.
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Affiliation(s)
- Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Iranian National Registry Center for Hydatid Cyst (INRCHC), Department of Radiology, Imam Khomeini Hospital, Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Keighobadi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hajar Ziaei Hezarjaribi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding authors at: Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, School of Medicine, Mazandaran University of Medical Sciences, Farah-Abad Road, PO Box: 48471-91971, Sari, Iran.
| | - Mahbobeh Montazeri
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding authors at: Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, School of Medicine, Mazandaran University of Medical Sciences, Farah-Abad Road, PO Box: 48471-91971, Sari, Iran.
| | - Elham S. Banimostafavi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Iranian National Registry Center for Hydatid Cyst (INRCHC), Department of Radiology, Imam Khomeini Hospital, Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahram Sayyadi
- Iranian National Registry Center for Hydatid Cyst (INRCHC), Department of Surgery, Mazandaran Branch, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad M. Ghaffari Hamadani
- Iranian National Registry Center for Hydatid Cyst (INRCHC), Department of Surgery, Mazandaran Branch, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Iranian National Registry Center for Hydatid Cyst (INRCHC), Department of Radiology, Imam Khomeini Hospital, Mazandaran Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rabeeh Tabaripour
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Asadi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Soosaraei
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali A. Khasseh
- Department of Knowledge and Information Sciences, Payame Noor University, Tehran, Iran
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Abstract
This report of the EFSA and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2020 in 27 EU Member States (MS) and nine non-MS. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. Two events impacted 2020 MS data collection and related statistics: the Coronavirus Disease 2019 (COVID-19) pandemic and the withdrawal of the United Kingdom from the EU. In 2020, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The EU trend for confirmed human cases of these two diseases was stable (flat) from 2016 to 2020. Fourteen of the 26 MS reporting data on Salmonella control programmes in poultry met the reduction targets for all poultry categories. Salmonella results for carcases of various species performed by competent authorities were more frequently positive than own-checks conducted by food business operators. This was also the case for Campylobacter quantification results from broiler carcases for the MS group that submitted data from both samplers, whereas overall at EU level, those percentages were comparable. Yersiniosis was the third most reported zoonosis in humans, with 10-fold less cases reported than salmonellosis, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. Illnesses caused by L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases with the highest case fatality. In 2020, 27 MS reported 3,086 foodborne outbreaks (a 47.0% decrease from 2019) and 20,017 human cases (a 61.3% decrease). Salmonella remained the most frequently reported causative agent for foodborne outbreaks. Salmonella in 'eggs and egg products', norovirus in 'crustaceans, shellfish, molluscs and products containing them' and L. monocytogenes in 'fish and fish products' were the agent/food pairs of most concern. This report also provides updates on tuberculosis due to Mycobacterium bovis or Mycobacterium caprae, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever) and tularaemia.
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Örsten S, Baysal İ, Yabanoglu-Ciftci S, Ciftci T, Ünal E, Akıncı D, Akyön Y, Akhan O. Can parasite-derived microRNAs differentiate active and inactive cystic echinococcosis patients? Parasitol Res 2021; 121:191-196. [PMID: 34811587 DOI: 10.1007/s00436-021-07382-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
Cystic Echinococcosis (CE) is a neglected zoonotic disease caused by the metacestode form of Echinococcus granulosus sensu lato. Non-invasive imaging techniques, especially ultrasound, are primarily used for CE diagnosis. MicroRNAs (miRNAs) are small, non-coding RNA molecules that act as post-transcriptional regulators in various biological processes. After identification of parasite-derived miRNAs, these miRNAs are considered to be potential biomarkers for diagnosis and follow-up. The focus of this research is to compare the expression profiles of certain parasite-derived miRNAs in CE patients with active and inactive cysts as well as healthy controls. Parasite-derived miRNAs, egr-let-7-5p, egr-miR-71a-5p, and egr-miR-9-5p, of inactive CE patients were found to be differentially expressed with 3.74-, 2.72-, and 20.78-fold change (p < 0.05), respectively, when compared with active CE patients. In this study, we evaluated for the first time the expression profile of three parasite-derived miRNAs in the serum of CE patients to determine their potential to distinguish between active and inactive CE. It was concluded that serum levels of parasite-derived miRNAs, egr-let-7-5p and egr-miR-9-5p, could be promising new potential biomarkers for stage-specific diagnosis of CE. Further studies are needed with larger sample set to validate discriminating potential of these miRNAs.
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Affiliation(s)
- Serra Örsten
- Vocational School of Health Services, Hacettepe University, Ankara, Turkey.
| | - İpek Baysal
- Vocational School of Health Services, Hacettepe University, Ankara, Turkey
| | | | - Türkmen Ciftci
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Ünal
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Devrim Akıncı
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yakut Akyön
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Single-Cell RNA Sequencing Reveals the Heterogeneity of Infiltrating Immune Cell Profiles in the Hepatic Cystic Echinococcosis Microenvironment. Infect Immun 2021; 89:e0029721. [PMID: 34491790 DOI: 10.1128/iai.00297-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Human cystic echinococcosis, caused by the larval stage of Echinococcus granulosus sensu lato, has been reported a near-cosmopolitan zoonotic disease. Various infiltrating immune cells gather around the lesion and produce a lesion microenvironment; however, cellular composition and heterogeneity in hepatic cystic echinococcosis lesion microenvironments are incompletely understood. Here, 81,865 immune cells isolated from peripheral blood, perilesion liver tissue, and adjacent normal liver tissue from four cystic echinococcosis patients were profiled using single-cell RNA sequencing. We identified 23 discrete cell populations and found distinct differences in infiltrating immune cells between tissue environments. Despite the significant similarity between perilesion and adjacent normal liver tissue-resident immune cells, the cellular proportions of type 2 innate lymphoid cells (ILC2s) and plasmacytoid dendritic cells (pDCs) were higher in perilesion liver tissue. Interestingly, the immunosuppressive gene NFKBIA was upregulated in these cells. Seven subsets of CD4+ T cell populations were found, and there were more regulatory-CD4+ T cells (Treg-CD4+) and Th2-CD4+ T cells in perilesion tissue than in adjacent normal tissue. There was close contact between CD4+ T cells and ILC2s and pDCs, which caused upregulation of genes related to positive immune activity in adjacent normal liver tissue. However, expression of genes related to immunosuppression, especially the immune inhibitory checkpoint gene NKG2A/HLA-E, was obviously higher in perilesion tissue, suggesting that cellular interaction resulted in an inhibitory microenvironment in the cystic echinococcosis (CE) lesion. This work offers new insights into the transcriptional heterogeneity of infiltrating immune cells in hepatic cystic echinococcosis lesion microenvironments at a single-cell level and provides potential target signatures for diagnosis and immunotherapies.
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Benecke J, Benecke C, Ciutan M, Dosius M, Vladescu C, Olsavszky V. Retrospective analysis and time series forecasting with automated machine learning of ascariasis, enterobiasis and cystic echinococcosis in Romania. PLoS Negl Trop Dis 2021; 15:e0009831. [PMID: 34723982 PMCID: PMC8584970 DOI: 10.1371/journal.pntd.0009831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/11/2021] [Accepted: 09/22/2021] [Indexed: 12/04/2022] Open
Abstract
The epidemiology of neglected tropical diseases (NTD) is persistently underprioritized, despite NTD being widespread among the poorest populations and in the least developed countries on earth. This situation necessitates thorough and efficient public health intervention. Romania is at the brink of becoming a developed country. However, this South-Eastern European country appears to be a region that is susceptible to an underestimated burden of parasitic diseases despite recent public health reforms. Moreover, there is an evident lack of new epidemiologic data on NTD after Romania's accession to the European Union (EU) in 2007. Using the national ICD-10 dataset for hospitalized patients in Romania, we generated time series datasets for 2008-2018. The objective was to gain deep understanding of the epidemiological distribution of three selected and highly endemic parasitic diseases, namely, ascariasis, enterobiasis and cystic echinococcosis (CE), during this period and forecast their courses for the ensuing two years. Through descriptive and inferential analysis, we observed a decline in case numbers for all three NTD. Several distributional particularities at regional level emerged. Furthermore, we performed predictions using a novel automated time series (AutoTS) machine learning tool and could interestingly show a stable course for these parasitic NTD. Such predictions can help public health officials and medical organizations to implement targeted disease prevention and control. To our knowledge, this is the first study involving a retrospective analysis of ascariasis, enterobiasis and CE on a nationwide scale in Romania. It is also the first to use AutoTS technology for parasitic NTD.
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Affiliation(s)
- Johannes Benecke
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, and Center of Excellence in Dermatology, Mannheim, Germany
| | - Cornelius Benecke
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain
| | - Marius Ciutan
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - Mihnea Dosius
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - Cristian Vladescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
- University Titu Maiorescu, Faculty of Medicine, Bucharest, Romania
| | - Victor Olsavszky
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, and Center of Excellence in Dermatology, Mannheim, Germany
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Parlak E, Kerget F, Demirdal T, Şen P, Ulaş AB, Öztürk Durmaz Ş, Pekok U, Ertürk A, Akyol D, Kepenek Kurt E, Köksal Alay H, Pullukçu H, Taşbakan M, Erol S, Laloğlu E, Öztürk Engin D, Ağalar C, Parlak M. The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study. Vector Borne Zoonotic Dis 2021; 21:948-954. [PMID: 34647813 DOI: 10.1089/vbz.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.
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Affiliation(s)
- Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Kâtip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Pınar Şen
- Department of Infectious Diseases and Clinical Microbiology, Saruhanlı State Hospital, Manisa, Turkey
| | - Ali Bilal Ulaş
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Şenay Öztürk Durmaz
- Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Pendik Hospital, İstanbul, Turkey
| | - Ayşe Ertürk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Esma Kepenek Kurt
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Handan Köksal Alay
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serpil Erol
- Infectious Diseases and Clinical Microbiology Clinic, Istanbul Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Laloğlu
- Department of Biochemistry, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Derya Öztürk Engin
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Ağalar
- Department of Infectious Diseases and Clinical Microbiology, Medıcana Ataşehir Hospital, İstanbul, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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Bakal U, Celik F, Simsek S, Kesik HK, Gunyakti Kilinc S. Genetic diversity and haplotypes of paediatric hydatid cyst isolates and first occurrence of E. canadensis (G6/G7) in paediatric cases in Turkey. Parasitology 2021; 148:1482-1489. [PMID: 34187611 PMCID: PMC11010141 DOI: 10.1017/s0031182021001098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/06/2021] [Accepted: 06/14/2021] [Indexed: 11/05/2022]
Abstract
Cystic echinococcosis (CE) is a neglected zoonotic tropical disease caused by Echinococcus granulosus sensu lato. The aim of this study was to investigate the genetic variation of hydatid cyst isolates obtained from surgically confirmed paediatric cases originating from two different regions in eastern Turkey. Seventeen paediatric cases aged between 6 and 16 were operated by open surgery, and the germinal layers of their cysts were obtained for further molecular analyses. After genomic DNA isolation, 875 bp mt-CO1 gene fragments were amplified in all samples by PCR. Then, the unidirectional sequence analyses of the PCR products were carried out. According to the BLAST analyses of 17 sequences, 16 of these sequences were matched with E. granulosus sensu stricto, while one sequence was identified as E. canadensis (G6/G7) for the first time in paediatric cases in Turkey. High haplotype diversity and low nucleotide diversity were observed in the E. granulosus s.s. sequences.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazig, Turkey
| | - Figen Celik
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazig, Turkey
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazig, Turkey
| | - Harun Kaya Kesik
- Department of Parasitology, Faculty of Veterinary Medicine, University of Bingol, Bingol, Turkey
| | - Seyma Gunyakti Kilinc
- Department of Parasitology, Faculty of Veterinary Medicine, University of Bingol, Bingol, Turkey
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Cassini R, Canali M, Tamarozzi F, Angheben A, Capelli G, Gobbi F, Legnardi M, Brichese M, Napoletano G, Cestaro F, Casulli A, Drigo M, Aragrande M. A One-Health evaluation of the burden of cystic echinococcosis and its prevention costs: Case study from a hypo-endemic area in Italy. One Health 2021; 13:100320. [PMID: 34504939 PMCID: PMC8413884 DOI: 10.1016/j.onehlt.2021.100320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 11/25/2022] Open
Abstract
An integrated model, based on a One Health approach, was implemented to estimate the epidemiological and economic outcomes of cystic echinococcosis (CE) in Veneto region, an hypo-endemic area of Northern Italy, and the costs for its prevention. Data and information needed to populate the model were retrieved from published literature, official statistics, expert opinions, or actively searched through data mining (i.e., Hospital and slaughterhouse data), when fundamental data were not available. Human-health and animal-health costs, both public and private, were considered. The overall impact of CE in the study area was estimated in an yearly cost of about 0.5 million €, due to an average of 19.5 human hospitalized cases and about 200 infected animals among cattle and sheep, per year. The human:animal costs ratio was about 8:1. Most of the infected animals were autochthonous, while the identification of an autochthonous source of the infection for the human cases was extremely difficult, and unlikely in most cases. No specific action resulted to be in place for human surveillance, while veterinary surveillance accounted for a yearly cost of about 22,000 €. Sheepherders were found to pay privately an overall amount of around 2000 € for the preventive treatment of their dogs every year, but the applied protocol proved to be sub-optimal. The source of most of the human cases was likely external to the study area, and their economic impact accounts for a cost that is far exceeding that of surveillance and preventive actions in place in the veterinary sector. Although autochthonous human cases appeared to be very rare, the strengthening of preventive actions and surveillance systems can reduce the risk of their increment. The study integrated epidemiology and economic aspects in a One Health perspective. The research estimates in detail the overall impact of CE in a hypo-endemic region in Italy. The study provided data for evidence-based actions to control CE in the study area. The investigated case study represents a reproducible model for zoonotic diseases evaluation.
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Affiliation(s)
- Rudi Cassini
- Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy
| | - Massimo Canali
- Dept. of Agricultural and Food Sciences, University of Bologna, Viale Giuseppe Fanin, 50, 40127 Bologna, Italy
| | - Francesca Tamarozzi
- Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
| | - Andrea Angheben
- Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
| | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10, 35020 Legnaro, PD, Italy
| | - Federico Gobbi
- Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
| | - Matteo Legnardi
- Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy
| | - Michele Brichese
- Veneto Region, Prevention and Public Health, Dorsoduro 3493, 30123 Venezia, Italy
| | | | - Fabrizio Cestaro
- Azienda ULSS 9 Scaligera (Local Health Unit), Prevention Department, Via Valverde 42, 37122 Verona, Italy
| | - Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy.,European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy
| | - Michele Drigo
- Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy
| | - Maurizio Aragrande
- Dept. of Agricultural and Food Sciences, University of Bologna, Viale Giuseppe Fanin, 50, 40127 Bologna, Italy
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Mustapayeva A, Luca D'Alessandro G, Doszhanova G, Colpani A, Sadybekov N, Baimakhanov Z, Assanov E, Salybekov S, Kaniyev S, Serikuly E, Tagabayeva L, Budke CM, Vola A, Mariconti M, De Silvestri A, Yalisheva S, Sadykova A, Zholdybay Z, Katarbayev A, Zhakenova Z, Brunetti E, Juszkiewicz K, Duisenova A, Manciulli T. Ultrasound-based evaluation of the prevalence of abdominal cystic echinococcosis in the Turkestan region of Kazakhstan. Trans R Soc Trop Med Hyg 2021; 116:222-226. [PMID: 34499709 DOI: 10.1093/trstmh/trab105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human cystic echinococcosis (CE) is a zoonotic disease caused by Echinococcus granulosus sensu lato. CE is known to be endemic in some parts of Central Asia. We present findings from an ultrasound-based survey to estimate the prevalence of CE in the Turkestan oblast of Kazakhstan. METHODS In October 2019, six villages were chosen based on records from a national surveillance dataset. Inhabitants aged 5-90 y were invited to undergo a free abdominal ultrasound to screen for CE cysts. All identified cysts were staged according to the WHO-endorsed classification for CE cysts. RESULTS A total of 2252 individuals underwent ultrasound screening. Twenty-two (0.98%) individuals had CE, with a combined total of 33 cysts: 25 (75.7%) inactive (14 CE4, 11 CE5) and 8 (24.3%) active/transitional (2 CE1, 1 CE2, 3 CE3a, 2 CE3b). One patient had a postsurgical cavity. Sixty-eight patients (3.0%) reported CE prior to surgical treatment. In 25 (36.8%) previously diagnosed patients, albendazole prophylaxis was not used. CONCLUSIONS CE is endemic in the study region, with ongoing transmission. The number of surgically treated CE patients suggests an underestimation of the disease burden by the current surveillance system. Further studies on local CE epidemiology and the implementation of expert treatment recommendations are needed.
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Affiliation(s)
- Aigerim Mustapayeva
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Gian Luca D'Alessandro
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
| | - Gaukhar Doszhanova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Agnese Colpani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
| | - Nurbol Sadybekov
- Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | - Zhasulan Baimakhanov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Ernar Assanov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Samat Salybekov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Shokan Kaniyev
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Erbol Serikuly
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Lyazzat Tagabayeva
- Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | | | - Ambra Vola
- Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Mara Mariconti
- Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Unit of Biostatistics, IRCCS San Matteo Hospital Foundation, Piazzale Gogli 2, 27100 Pavia, Italy
| | - Sofyia Yalisheva
- Department of Genetics and Molecular Biology, Al Farabi Kazakh National University, 71 al-Farabi Ave., 050040 Almaty, Kazakhstan
| | - Ainur Sadykova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Zhamilya Zholdybay
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan.,Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | - Adil Katarbayev
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Zhanar Zhakenova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy.,Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Piazzale Gogli 2, 27100 Pavia, Italy
| | - Konrad Juszkiewicz
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan.,KIT Royal Tropical Institute, Amsterdam, Netherlands
| | - Amangul Duisenova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Tommaso Manciulli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
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Ciftci TT, Yabanoglu-Ciftci S, Unal E, Akinci D, Baysal I, Yuce G, Dogrul AB, Orsten S, Akhan O, Nemutlu E. Metabolomic profiling of active and inactive liver cystic echinococcosis. Acta Trop 2021; 221:105985. [PMID: 34048790 DOI: 10.1016/j.actatropica.2021.105985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/26/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023]
Abstract
Cystic Echinococcosis (CE) is one of the life-threatening diseases worldwide. It is a parasitic zoonosis caused by tapeworms of the species Echinococcus granulosus sensu lato (s.l). The treatment options of CE vary from simple "watch and wait" approach to invasive treatment, based on the type and especially the nature of the cyst (active/inactive). Serological tests are inadequate to distinguish between active and inactive CE. A diagnostic reference that can determine whether the cyst is active or inactive can easily guide the treatment strategy. We aimed to test whether gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-quadropole time of flight mass spectrometry (LC-qTOF-MS) based metabolomics can establish a plasma metabolic fingerprint of CE patients and identify a diagnostic reference to discriminate active and inactive CE cysts. Metabolite concentrations were measured in plasma samples of 36 active CE patients, 17 inactive CE patients and 31 healthy controls. Multivariate statistical analysis on 232 identified metabolites obtained from two analytical platforms was performed by using principle component analysis (PCA) and partial least square-discriminant analysis (PLS-DA) methods. The PLS-DA scores plot of the combined data set demonstrated a good separation between the groups. Compared to the healthy control group, decreased levels of squalene and increased levels of glyceric acid, 3-phosphoglycerate, glutamic acid, palmitoleic acid and oleic acid were determined in the CE patients. However, decreased levels of 3-phosphoglycerate and increased levels of 4-hydroxyphenylacetylglutamine, docosahexanoic acid were determined in active CE patients compared to the inactive CE patients. Determination of differences in metabolites may provide detailed understandings of potential metabolic process associated with active and inactive CE patients, and altered specific metabolic changes may provide some clues to obtain diagnostic reference for CE. This study has certain limitations: a. various factors affecting results of metabolomic studies such as lifestyle and dietary habits of the patients could not be fully controlled b. other infectious or malignant diseases of the liver should also be included as a positive control to evaluate the specificity of the diagnostic references.
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Affiliation(s)
- Turkmen T Ciftci
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Samiye Yabanoglu-Ciftci
- Hacettepe University, Faculty of Pharmacy, Department of Biochemistry, Ankara 06100, Turkey.
| | - Emre Unal
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Devrim Akinci
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Ipek Baysal
- Hacettepe University, Faculty of Pharmacy, Department of Biochemistry, Ankara 06100, Turkey.
| | - Gokhan Yuce
- Ministry of Health, Ankara City Hospital, Department of Radiology, Ankara, Turkey.
| | - Ahmet Bulent Dogrul
- Hacettepe University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey
| | - Serra Orsten
- Hacettepe University, Vocational School of Health Services, Ankara, Turkey.
| | - Okan Akhan
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Emirhan Nemutlu
- Hacettepe University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara 06100, Turkey; Hacettepe University, Faculty of Pharmacy, Bioanalytic and Omics Laboratory, Ankara 06100, Turkey.
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Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts. PLoS Negl Trop Dis 2021; 15:e0009648. [PMID: 34415898 PMCID: PMC8378729 DOI: 10.1371/journal.pntd.0009648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a complex disease for which clear understanding of clinical manifestations is needed to avoid misdiagnosis, inappropriate treatment, and severe complications. We evaluated the accuracy of a whole-blood stimulation test based on Interleukin (IL)-4 detection in response to Antigen B (AgB) of Echinococcus granulosus sensu lato to discriminate cyst viability and detect cyst reactivation in patients with hepatic CE. METHODOLOGY/PRINCIPAL FINDINGS Thirty patients with CE3b cysts and 37 patients with spontaneously-inactivated CE4-CE5 cysts were recruited (T0). After enrollment, 5 patients with CE3b cysts received albendazole, resulting in cyst solidification (CE4) in 4/5. Within a two-year follow-up, the whole-blood test was repeated at two time-points, in ≥14 (T1) and in ≥4 (T2) patients per group. IL-4 and a panel of other soluble factors were measured in the stimulated plasma. Baseline IL-4 levels were significantly higher in patients with CE3b compared to those with CE4 cysts (p = 0.006). Test accuracy for CE3b diagnosis had a sensitivity of 33-60% and a specificity of 76-95%, depending on the cut-off applied. Overall, IL-4 levels did not change significantly over time in either group; however, patients within the CE3b group showed a significant decrease of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF at T1 compared to T0 (p≤0.042). CONCLUSIONS/SIGNIFICANCE Whole-blood IL-4-response to AgB is significantly higher in patients with active compared to inactive CE but apparently not modulated over time after treatment. On the contrary, the levels of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF significantly decreased in active CE during follow-up. Additional studies are needed to understand whether these findings might have a clinical significance for patients' follow-up.
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Trueba-Argamasilla AA, Iborra-Bendicho MA, Simón-Páez M, Ros-de San Pedro J, Segovia-Hernández M. Cerebral echinococcosis: Case report and literature review. Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00226-3. [PMID: 34426035 DOI: 10.1016/j.eimc.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022]
Abstract
Echinococcosis is a zoonosis caused by the larval form of the cestode Echinococcus granulosus. The cerebral affectation in the human is uncommon; only in 1-2% cases is observed encephalic involvement. This condition occurs mainly in the pediatric population and it is characterized by the presence of single and unilocular cysts. We report a case of a 29-year-old patient who came to the emergency department with a disabling headache of several weeks of evolution. In the brain imaging study a mass of unknown origin was visualized, finally it turned out to be a bilobed hydatid cyst. Regarding this case, the clinic-epidemiological, diagnostics and treatments aspects of cerebral hydatid disease will be reviewed.
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Affiliation(s)
| | - María Asunción Iborra-Bendicho
- Servicio de Microbiología y Parasitología. H. C. U. Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, España
| | - Marina Simón-Páez
- Servicio de Microbiología y Parasitología, H. C. U. Virgen de la Arrixaca, Murcia, España
| | | | - Manuel Segovia-Hernández
- Servicio de Microbiología y Parasitología. H. C. U. Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, España
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40
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Gao Y, Wang W, Lyu C, Wei XY, Chen Y, Zhao Q, Ran ZG, Xia YQ. Meta-Analysis of the Prevalence of Echinococcus in Sheep in China From 1983 to 2020. Front Cell Infect Microbiol 2021; 11:711332. [PMID: 34381740 PMCID: PMC8350519 DOI: 10.3389/fcimb.2021.711332] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022] Open
Abstract
Echinococcosis is a zoonosis caused by the larval stage of cestode species that belong to the genus Echinococcus. The infection of hydatid in sheep is very common in China, especially in the northwestern China. Here, we conducted the first systematic review and meta-analysis of echinococcosis in sheep in China. Six databases (PubMed, ScienceDirect, Baidu Library, CNKI, Wanfang, and VIP Chinese Journal Database) were used to retrieve the literatures on echinococcosis in sheep in China from 1983 to 2020, and 74 studies. The random effects model was used in the “meta” package of the R software and the PFT was chosen for rate conversion. The research data were analyzed through subgroup analysis and univariate meta-regression analysis to reveal the factors that lead to research heterogeneity. The combined prevalence of Echinococcus in the selected period was estimated to be 30.9% (192,094/826,406). In the analysis of sampling year, the lowest positive rate was 13.9% (10,296/177,318) after 2011. The highest prevalence of Echinococcus was 51.1% (278/531) in the southwestern China. The highest infection rate in sheep was 20.1% (58,344/597,815) in the liver. The analysis based on age showed that the infection rate of elderly sheep was significantly higher than that in younger animals (P < 0.05). We also evaluated the effects of different geographic and climatic factors on the prevalence of Echinococcus in sheep. The results showed that the prevalence of Echinococcus was higher in high altitude, cold, humid, and high rainfall areas. It is necessary to carry out long-term monitoring and control of echinococcosis, cut off the infection route, and reduce the risk of infection in the high risk areas.
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Affiliation(s)
- Yang Gao
- The Key Sericultural Laboratory of Agricultural Ministry, College of Biotechnology, Southwest University, Chongqing, China.,Research and Development Department, Chongqing Auleon Biological Co., Ltd., Chongqing, China
| | - Wei Wang
- College of Life Science, Changchun Sci-Tech University, Shuangyang, China.,College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing, China
| | - Chuang Lyu
- Animal Health Center, Shandong New Hope Liuhe Group Co., Ltd., Qingdao, China.,Animal Health Center, Qingdao Jiazhi Biotechnology Co., Ltd., Qingdao, China
| | - Xin-Yu Wei
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing, China
| | - Yu Chen
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing, China
| | - Quan Zhao
- College of Life Science, Changchun Sci-Tech University, Shuangyang, China
| | - Zhi-Guang Ran
- Research and Development Department, Chongqing Auleon Biological Co., Ltd., Chongqing, China
| | - You-Qing Xia
- The Key Sericultural Laboratory of Agricultural Ministry, College of Biotechnology, Southwest University, Chongqing, China
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41
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Peters L, Burkert S, Grüner B. Parasites of the liver - epidemiology, diagnosis and clinical management in the European context. J Hepatol 2021; 75:202-218. [PMID: 33636243 DOI: 10.1016/j.jhep.2021.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Parasites in the liver cause significant global morbidity and mortality, as they can lead to recurrent cholangitis, cirrhosis, liver failure and cancer. Due to climate change and globalisation, their incidence is increasing, especially in Europe. The correct diagnosis of a hepatic parasite is often delayed because clinicians are unfamiliar with respective entities. Therefore, in this review, we aim to provide clinicians with a comprehensive clinical picture of hepatic parasites and to bring these neglected parasitic liver diseases to the wider attention of hepatology stakeholders in Europe and around the world.
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Affiliation(s)
- Lynn Peters
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Sanne Burkert
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Beate Grüner
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
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42
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Borhani M, Fathi S, Darabi E, Jalousian F, Simsek S, Ahmed H, Kesik HK, Hosseini SH, Romig T, Harandi MF, Mobedi I. Echinococcoses in Iran, Turkey, and Pakistan: Old Diseases in the New Millennium. Clin Microbiol Rev 2021; 34:e0029020. [PMID: 34076492 PMCID: PMC8262809 DOI: 10.1128/cmr.00290-20] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Echinococcosis is considered a cosmopolitan zoonosis caused by different species of small taeniid tapeworms of the genus Echinococcus and is regarded as a neglected zoonosis. Cystic and alveolar echinococcoses are endemic diseases of Tibetan, Pamir, and Iranian plateaus. All of the countries within the Iranian plateau are affected by echinococcosis. Pakistan, Turkey, and Iran are the three most populous countries of the region, in which echinococcosis is highly endemic. The three neighboring countries share strong cultural and socioeconomic ties. The present study aimed to provide a broad review of the status of cystic and alveolar echinococcosis, summarizing the current knowledge about geographical distribution, molecular epidemiology, and transmission dynamics of Echinococcus granulosus sensu lato and Echinococcus multilocularis in this region. Additionally, we aimed to understand disease burden and risk factors as basic requirements for establishing a surveillance system and planning prevention and control programs. A considerable body of information is available on different aspects of echinococcosis in this region; however, several information and research gaps need to be filled before planning control programs. None of the countries in the region have an elaborate echinococcosis control program. Effective control programs require multi/intersectoral coordination within a One Health approach with a long-term political and administrative commitment and enhanced international collaboration among the three countries.
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Affiliation(s)
- Mehdi Borhani
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeid Fathi
- Department of Parasitology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Enayat Darabi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jalousian
- Department of Parasitology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazig, Turkey
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - Harun Kaya Kesik
- Department of Parasitology, Faculty of Veterinary Medicine, University of Bingol, Bingol, Turkey
| | - Seyed Hossein Hosseini
- Department of Parasitology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Thomas Romig
- Parasitology Unit, University of Hohenheim, Stuttgart, Germany
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Mobedi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Demographics of Cystic Echinococcosis Patients Treated Surgically in Lahore, Pakistan: A Single Centre Study from 2007 - 2018. Helminthologia 2021; 58:162-172. [PMID: 34248376 PMCID: PMC8256454 DOI: 10.2478/helm-2021-0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Abstract
Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of Echinococcus granulosus tapeworms. These parasites have a worldwide geographic distribution and pose a serious threat to livestock industry as well as human health in the endemic areas. CE is widely distributed in Pakistan. However, very few reports are available related to the regional transmission of E. granulosus. A retrospective analysis was conducted of surgically confirmed CE patients who were treated at Shoukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Punjab Province, Pakistan from 2007 – 2018. In total, 536 CE patients were evaluated during the study period. Cases originated from the provinces of Khyber Pakhtunkhwa (n=336), Punjab (n=147), Baluchistan (n=18), Sindh (n=3), Islamabad (n=2), Gilgit Baltistan (n=1), and Azad Jammu and Kashmir (n=1). An additional 28 cases were from Afghanistan. The highest number of CE cases was reported in 2013 (n=90). Females made up a larger proportion of cases (n=310; 57.8 %) than males (n=226; 42.2 %). Most patients were members of the Pashtun (n=197; 36.7 %), Hindku (n=142; 26.5 %), and Punjabi (n=118; 22.0 %) ethnic groups. The largest number of cysts was obtained from the liver (137/536; 25.6 %). This study showed that CE is likely present throughout Pakistan. In order to control the disease, a comprehensive control program and regional surveillance are needed.
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Educational Intervention for the Awareness Improvement and Control Programme Design on Echinococcosis in Izmir, Turkey. Helminthologia 2021; 58:152-161. [PMID: 34248375 PMCID: PMC8256451 DOI: 10.2478/helm-2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/22/2021] [Indexed: 11/20/2022] Open
Abstract
In Turkey, cyst hydatid disease (CHD) or cystic echinococcosis (CE) is publicly known as “dog cyst”, a fatal and serious disease not only affects livestock husbandry and human health but also brings about economic loss to our country. According to the data of the Ministry of Health; number of annual cases was 408 in 2008, and this number reached 1,867 by the end of 2019. Cystic echinococcosis is especially taken up during childhood and emerged at an older age. They become exposed to the eggs of the tapeworm after close contact with an infected dog or its contaminated environment. The infected dogs also pass in their feces E. granulosus eggs that adhere to the dogs’ hairs, and pass on to the children who are in the course of playful and intimate contact with the infected dogs. This study was to create the awareness of risk factors of CE among 10 different districts of Izmir province. Awareness raising seminars are essential component of this study because local people living in CE endemic areas, are crucial to continue and sustain the long-time effort that is needed to tackle this disease. In each district, 3 awareness raising seminars were held to the target groups: (a) in schools for students, teachers, administrators, (b) for general public, (c) for healthcare professionals. 4090 students attended to the trainings, 242 administrators and teachers who attended to the presentations together with the students, 524 people were attended to the trainings and 327 health workers attended to the trainings from different institutions. This study helped improving this situation by organising educational events for the rural populations for preventing transmission of the disease. This is the first educational intervention study regarding creating awareness on CE in Izmir Province which includes 10 districts between January 2019 to January 2020.
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Abstract
The second World Neglected Tropical Diseases (NTDs) Day was celebrated on 30 January 2021. To mark the occasion, the World Health Organization (WHO) launched its roadmap for NTDs for the period 2021 to 2030, which is aimed at increasing prevention and control of these too-long neglected diseases. Described here is a global overview on past achievements, current challenges, and future prospects for the WHO NTDs roadmap 2021–2030.
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Affiliation(s)
- Adriano Casulli
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- * E-mail:
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Ciftci TT, Unal E, Azizova A, Ayyildiz VA, Akinci D, Akhan O. Renal Cystic Echinococcosis: Long-Term Outcomes of Percutaneous Treatment. J Vasc Interv Radiol 2021; 32:890-895.e2. [PMID: 33727151 DOI: 10.1016/j.jvir.2021.03.519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To evaluate the long-term outcomes of percutaneous treatment of renal cystic echinococcosis (CE) stratified by cyst stages according to the World Health Organization (WHO) classification. MATERIALS AND METHODS Between January 1997 and February 2019, 34 patients with renal CE (18 women; mean age, 38 years) were treated with 3 different percutaneous techniques. According to the World Health Organization classification, the cysts were classified as CE1, CE2, CE3a, and CE3b. Puncture, aspiration, injection, reaspiration (PAIR) or standard catheterization was used for the dimension-based treatment of CE1 and CE3a cysts. Modified catheterization (MoCaT) was used to treat all CE2 and CE3b cysts. Technical and clinical success, complications, and reduction in cyst cavities were evaluated. RESULTS The technical success rate was 100%. PAIR, standard catheterization, and MoCaT were used to treat 12, 9, and 13 cysts, respectively. The only severe adverse event was a bacterial superinfection that occured in the cyst cavity of a patient (3%) treated with MoCaT. Four patients (12%) experienced mild/moderate periprocedural allergic adverse events and were managed conservatively. The mean length of hospital stay was 1, 5, and 7 days for patients treated with PAIR, standard catheterization, and MoCaT, respectively. The clinical success rate was 97%. In 1 of 34 cysts (3%), recurrence was detected and the cyst was successfully re-treated. During the 10.5-year follow-up period, 95% volume reduction was achieved. The median final cyst volume was 10 mL. CONCLUSIONS Renal CE can be successfully treated with minimum adverse events and recurrence rates using appropriate percutaneous techniques selected according to their stages as classified according to WHO.
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Affiliation(s)
- Turkmen Turan Ciftci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emre Unal
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aynur Azizova
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Veysel Atilla Ayyildiz
- Department of Radiology, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Devrim Akinci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Okan Akhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
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van der Giessen J, Deksne G, Gómez-Morales MA, Troell K, Gomes J, Sotiraki S, Rozycki M, Kucsera I, Djurković-Djaković O, Robertson LJ. Surveillance of foodborne parasitic diseases in Europe in a One Health approach. Parasite Epidemiol Control 2021; 13:e00205. [PMID: 33665388 PMCID: PMC7900597 DOI: 10.1016/j.parepi.2021.e00205] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/10/2020] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
In 2012, WHO/FAO ranked 24 foodborne parasites (FBP) using multicriteria decision analysis (MCDA) to provide risk assessors with a basis for prioritising control of highly ranked FBP on the global level. One conclusion was that ranking may differ substantially per region. In Europe, the same methodology was used to rank FBP of relevance for Europe. Of the 24 FBP, the top-five prioritised FBP were identified for Europe as Echinococcus multilocularis, Toxoplasma gondii, Trichinella spiralis, E. granulosus, and Cryptosporidium spp., all of which are zoonotic. The objective of the present study was to provide an overview of surveillance and reporting systems in Europe for these top five prioritised FBP in the human and animal populations, to identify gaps, and give recommendations for improvement. Information on the surveillance systems was collected from 35 European countries and analysed according to the five different regions. For most FBP, human surveillance is passive in most countries and regions in Europe and notification differs between countries and regions. Adequate surveillance programmes for these FBP are lacking, except for T. spiralis, which is notifiable in 34 countries with active surveillance in susceptible animals under EU directive. Although human and animal surveillance data are available for the five prioritised FBP, we identified a lack of consistency in surveillance and reporting requirements between national experts and European bodies. Recommendations for improved surveillance systems are discussed.
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Affiliation(s)
- Joke van der Giessen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, P.O. Box 1, Bilthoven 3720 BA, Netherlands
| | - Gunita Deksne
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Str. 3, Riga LV-1076, Latvia.,Faculty of Biology, University of Latvia, Jelgavas Str. 1, Riga LV-1004, Latvia
| | - Maria Angeles Gómez-Morales
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
| | - Karin Troell
- National Veterinary Institute, Ulls väg 2B, Uppsala SE-751 89, Sweden
| | - Jacinto Gomes
- National Institute for Agrarian and Veterinary Research, Av. da República, Quinta do Marquês, Oeiras 2780-157, Portugal
| | - Smaragda Sotiraki
- Veterinary Research Institute, Hellenic Agricultural Organisation-Demeter, Thermi, Thessaloniki 57001, Greece
| | - Miroslaw Rozycki
- National Veterinary Research Institute, Aleja Partyzantów 57, Puławy 24-100, Poland
| | - István Kucsera
- National Public Health Center, Albert Flórián út 2-6, Budapest 1097, Hungary
| | - Olgica Djurković-Djaković
- Centre of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, University of Belgrade, Dr. Subotića 4, Belgrade 11129, Serbia
| | - Lucy J Robertson
- Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, Ullevålsveien 72, Oslo 0454, Norway
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48
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Abstract
This report of the EFSA and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2019 in 36 European countries (28 Member States (MS) and eight non-MS). The first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The EU trend for confirmed human cases of these two diseases was stable (flat) during 2015-2019. The proportion of human salmonellosis cases due to Salmonella Enteritidis acquired in the EU was similar to that in 2017-2018. Of the 26 MS reporting on Salmonella control programmes in poultry, 18 met the reduction targets, whereas eight failed to meet at least one. The EU prevalence of Salmonella target serovar-positive flocks has been stable since 2015 for breeding hens, laying hens, broilers and fattening turkeys, with fluctuations for breeding turkey flocks. Salmonella results from competent authorities for pig carcases and for poultry tested through national control programmes were more frequently positive than those from food business operators. Shiga toxin-producing Escherichia coli (STEC) infection was the third most reported zoonosis in humans and increased from 2015 to 2019. Yersiniosis was the fourth most reported zoonosis in humans in 2019 with a stable trend in 2015-2019. The EU trend of confirmed listeriosis cases remained stable in 2015-2019 after a long period of increase. Listeria rarely exceeded the EU food safety limit tested in ready-to-eat food. In total, 5,175 food-borne outbreaks were reported. Salmonella remained the most detected agent but the number of outbreaks due to S. Enteritidis decreased. Norovirus in fish and fishery products was the agent/food pair causing the highest number of strong-evidence outbreaks. The report provides further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, West Nile virus, Coxiella burnetii (Q fever) and tularaemia.
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49
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MicroRNA expression profile in patients with cystic echinococcosis and identification of possible cellular pathways. J Helminthol 2021; 95:e1. [PMID: 33441208 DOI: 10.1017/s0022149x2000098x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cystic echinococcosis (CE) is a neglected tropical disease, caused by metacestode (larval) form of the Echinococcus granulosus sensu lato (sl) in humans. MicroRNAs (miRNAs) are small, stable, tissue-specific RNA molecules encoded by the genome that are not translated into proteins. Circulating miRNA expression profiles vary in health and disease. The aim of this study is to determine the altered cellular pathways in CE by comparing the miRNA profiles of controls and CE patients with active or inactive cysts. Following abdominal ultrasonography (US) examination, 20 patients diagnosed with active CE (CE1, CE2, CE3a and CE3b) or inactive CE (CE4 and CE5) and three healthy controls were included in the study. The expression profiles of 372 biologically relevant human miRNAs were investigated in serum samples from CE patients and healthy controls with miScript miRNA HC PCR Array. Compared with the control group, expression of 6 miRNAs (hsa-miR-4659a-5p, hsa-miR-4518, hsa-miR-3977, hsa-miR-4692, hsa-miR-181b-3p, hsa-miR-4491) and one miRNA (hsa-miR-4687-5p) were found to be downregulated in CE patients with active and inactive cysts, respectively (p < 0.05). For downregulated miRNAs in this study, predicted targets were found to be associated mainly with cell proliferation, apoptosis, cell-cell interactions and cell cycle regulation. Further studies in this direction may elucidate the pathogenesis of human CE and the relationship between CE and other pathologies.
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50
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Khan A, Ahmed H, Khan H, Saleem S, Simsek S, Brunetti E, Afzal MS, Manciulli T, Budke CM. Cystic Echinococcosis in Pakistan: A Review of Reported Cases, Diagnosis, and Management. Acta Trop 2020; 212:105709. [PMID: 32956637 DOI: 10.1016/j.actatropica.2020.105709] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 02/07/2023]
Abstract
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.
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