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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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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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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: 9] [Impact Index Per Article: 3.0] [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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Amahmid O, El Guamri Y, Zenjari K, Bouhout S, Ait Moh M, Boraam F, Melloul AA, Benfaida H, Bouhoum K, Belghyti D. Epidemiology and clinical features of human cystic echinococcosis in adults from an endemic area (Morocco). CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gülhan ŞE, Kılıçgün A, Samancılar Ö, Altınok T, Kutluk AC, Baysungur VS, Çelik MR, Akın H. Surgery for Pulmonary Hydatidosis in Turkey in 2014: A Nationwide Study. Turk Thorac J 2019; 20:120-124. [PMID: 30958984 DOI: 10.5152/turkthoracj.2018.18109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/25/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Turkey remains among the countries where hydatid disease is endemic. In this study, it was aimed to determine the number of operations performed for the treatment of pulmonary hydatid disease in Turkey during 2014 and to present the distribution of these operations according to the different regions of the country. MATERIALS AND METHODS The Turkish Thoracic Society Thoracic Surgery Study Group connected with the thoracic surgeons in each city through telephone. A data set was sent by email. The age, sex, contact with animals that might be a risk of gaining the hydatid disease, the side of the disease, the type of surgical method, other organ involvement were recorded and collected from each data set to form the final data, and the results were evaluated. Turkey comprises of 81 cities that are grouped in seven different regions. The number of operations was calculated for each city and region to present the distribution. RESULTS Overall, 101 centers from 81 cities were considered in the study. A total of 715 pulmonary hydatid cyst operations were performed in 690 patients during the study period. The most common operation technique was cystotomy and capitonnage through thoracotomy (76%). The highest incidence rate of operated patients was in the Eastern Anatolian Region (2.15 patients per 100 000 person-years). CONCLUSION Pulmonary hydatid disease still has a high incidence rate particularly in the southeast and east of Turkey, which are mainly rural areas and where stockbreeding is very common. Cystotomy and capitonnage is still the most common surgical method used to treat pulmonary hydatid cysts. Preventive methods should be performed strictly in these cities and regions to decrease the risk of infection.
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Affiliation(s)
- Şakir Erkmen Gülhan
- Clinic of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, Ankara, Turkey
| | - Ali Kılıçgün
- Department of Thoracic Surgery, Abant İzzet Baysal University School of Medicine, Bolu, Turkey
| | - Özgür Samancılar
- Clinic of Thoracic Surgery, Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, İzmir, Turkey
| | - Tamer Altınok
- Department of Thoracic Surgery, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Ali Cevat Kutluk
- Clinic of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
| | - Volkan Selami Baysungur
- Clinic of Thoracic Surgery, Süreyypaşa Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
| | - Muhammet Reha Çelik
- Department of Thoracic Surgery, İnönü University School of Medicine, Malatya, Turkey
| | - Hasan Akın
- Clinic of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey
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Tamarozzi F, Akhan O, Cretu CM, Vutova K, Akinci D, Chipeva R, Ciftci T, Constantin CM, Fabiani M, Golemanov B, Janta D, Mihailescu P, Muhtarov M, Orsten S, Petrutescu M, Pezzotti P, Popa AC, Popa LG, Popa MI, Velev V, Siles-Lucas M, Brunetti E, Casulli A. Prevalence of abdominal cystic echinococcosis in rural Bulgaria, Romania, and Turkey: a cross-sectional, ultrasound-based, population study from the HERACLES project. THE LANCET. INFECTIOUS DISEASES 2018; 18:769-778. [PMID: 29793823 DOI: 10.1016/s1473-3099(18)30221-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/26/2018] [Accepted: 03/19/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cystic echinococcosis is a neglected zoonotic infection that is distributed worldwide and prioritised by WHO for control efforts. The burden of human cystic echinococcosis is poorly understood in most endemic regions, including eastern Europe. We aimed to estimate the prevalence of abdominal cystic echinococcosis in rural areas of Bulgaria, Romania, and Turkey. METHODS We did a cross-sectional ultrasound-based survey that recruited volunteers from 50 villages in rural areas of Bulgaria, Romania, and Turkey. These villages were in provinces with annual hospital incidence of cystic echinococcosis within the mid-range for the respective countries. All people who attended a session were allowed to participate if they agreed to be screened. Abdominal ultrasound screening sessions were hosted in public community structures such as community halls, primary health-care centres, schools, and mosques. Lesions were classified using an adapted WHO classification. We reported the prevalence of abdominal cystic echinococcosis adjusted by sex and age through direct standardisation, using the country's rural population as a reference. FINDINGS From July 1, 2014, to Aug 3, 2015, 24 693 individuals presented to screening sessions and 24 687 underwent ultrasound screening. We excluded a further six indivduals due to missing data, leaving 24 681 people in our analysis. Abdominal cystic echinococcosis was detected in 31 of 8602 people screened in Bulgaria, 35 of 7461 screened in Romania, and 53 of 8618 screened in Turkey. The age and sex adjusted prevalence of abdominal cystic echinococcosis was 0·41% (95% CI 0·29-0·58) in Bulgaria, 0·41% (0·26-0·65) in Romania, and 0·59% (0·19-1·85) in Turkey. Active cysts were found in people of all ages, including children, and in all investigated provinces. INTERPRETATION Our results provide population-based estimates of the prevalence of abdominal cystic echinococcosis. These findings should be useful to support the planning of cost-effective interventions, supporting the WHO roadmap for cystic echinococcosis control. FUNDING European Union Seventh Framework Programme.
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Affiliation(s)
- Francesca Tamarozzi
- WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, University of Pavia, Pavia, Italy; Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Center for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, 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
| | - Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Carmen Michaela Cretu
- Parasitology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - Kamenna Vutova
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Prof Ivan Kirov, Department of Infectious, Parasitic and Tropical Diseases, Sofia, Bulgaria
| | - Devrim Akinci
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rossitza Chipeva
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Prof Ivan Kirov, Department of Infectious, Parasitic and Tropical Diseases, Sofia, Bulgaria
| | - Turkmen Ciftci
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Massimo Fabiani
- Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Branimir Golemanov
- Clinical Centre of Gastroenterology, University Hospital Queen Joanna- Institute for Specialization and Improvement of Medical Doctors, Medical Faculty, Medical University, Sofia, Bulgaria
| | - Denisa Janta
- National Institute of Public Health, Bucharest, Romania
| | - Patricia Mihailescu
- Eco-Para-Diagnostic, Colentina Clinical Hospital, Bucharest, Romania; Colentina Clinical Hospital, Eco-Para-Diagnostic, Bucharest, Romania
| | - Marin Muhtarov
- Multi-Profile Hospital for Active Treatment Kardzhali, Gastroenterology Ward, Kardzhali, Bulgaria
| | - Serra Orsten
- School of Health Services, Hacettepe University, Ankara, Turkey
| | | | - Patrizio Pezzotti
- Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alexandru Cosmin Popa
- Surgery, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - Loredana Gabriela Popa
- Microbiology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - Mircea Ioan Popa
- Microbiology, Carol Davila University of Medicine and Pharmacy, Cantacuzino National Institute for Research, Bucharest, Romania
| | - Valeri Velev
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Prof Ivan Kirov, Department of Infectious, Parasitic and Tropical Diseases, Sofia, Bulgaria
| | - Mar Siles-Lucas
- Parasitology Unit, Instituto de Recursos Naturales y Agrobiología de Salamanca, IRNASA-CSIC, Salamanca, Spain
| | - Enrico Brunetti
- WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, University of Pavia, Pavia, Italy; Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Division of Tropical and Infectious Diseases, San Matteo Hospital Foundation, Pavia, 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, Rome, Italy; European Reference Laboratory for Parasites and Unit of Foodborne and Neglected Parasitic Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
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Deplazes P, Rinaldi L, Alvarez Rojas CA, Torgerson PR, Harandi MF, Romig T, Antolova D, Schurer JM, Lahmar S, Cringoli G, Magambo J, Thompson RCA, Jenkins EJ. Global Distribution of Alveolar and Cystic Echinococcosis. ADVANCES IN PARASITOLOGY 2017; 95:315-493. [PMID: 28131365 DOI: 10.1016/bs.apar.2016.11.001] [Citation(s) in RCA: 534] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses. Echinococcus multilocularis (causative agent of AE) is widely distributed in the northern hemisphere where it is typically maintained in a wild animal cycle including canids as definitive hosts and rodents as intermediate hosts. The species Echinococcus granulosus, Echinococcus ortleppi, Echinococcus canadensis and Echinococcus intermedius are the causative agents of CE with a worldwide distribution and a highly variable human disease burden in the different endemic areas depending upon human behavioural risk factors, the diversity and ecology of animal host assemblages and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. Both AE and CE are regarded as neglected zoonoses, with a higher overall burden of disease for CE due to its global distribution and high regional prevalence, but a higher pathogenicity and case fatality rate for AE, especially in Asia. Over the past two decades, numerous studies have addressed the epidemiology and distribution of these Echinococcus species worldwide, resulting in better-defined boundaries of the endemic areas. This chapter presents the global distribution of Echinococcus species and human AE and CE in maps and summarizes the global data on host assemblages, transmission, prevalence in animal definitive hosts, incidence in people and molecular epidemiology.
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Affiliation(s)
- P Deplazes
- University of Zürich, Zurich, Switzerland
| | - L Rinaldi
- University of Naples Federico II, Napoli, Italy
| | | | | | - M F Harandi
- Research centre of Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - T Romig
- University of Hohenheim, Stuttgart, Germany
| | - D Antolova
- Institute of Parasitology SAS, Kosice, Slovak Republic
| | - J M Schurer
- University of Saskatchewan, Saskatoon, SK, Canada; University of Washington, Seattle, WA, United States
| | - S Lahmar
- National School of Veterinary Medicine, Sidi Thabet, Tunisia
| | - G Cringoli
- University of Naples Federico II, Napoli, Italy
| | - J Magambo
- Meru University of Science and Technology, Meru, Kenya
| | | | - E J Jenkins
- University of Saskatchewan, Saskatoon, SK, Canada
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Al-Jawabreh A, Dumaidi K, Ereqat S, Nasereddin A, Al-Jawabreh H, Azmi K, Al-Laham N, Abdeen Z. Incidence of Echinococcus granulosus in Domestic Dogs in Palestine as Revealed by Copro-PCR. PLoS Negl Trop Dis 2015; 9:e0003934. [PMID: 26181591 PMCID: PMC4504717 DOI: 10.1371/journal.pntd.0003934] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/26/2015] [Indexed: 11/18/2022] Open
Abstract
Hydatidosis or echinococcosisis considered a neglected zoonotic disease despite its high burden in the livestock industry and the high risk of infection by humans in endemic areas. In a cross-sectional study we estimated the copro-Incidence and also genotyped Echinococcus granulosus isolates from domestic dogs using polymerase chain reaction (PCR). Medical archives in nine major hospitals in Palestine were reviewed to determine incidence of E. granulosus infection detected in humans during surgery. Faecal samples were collected from 93 domestic dogs in three districts with the highest number of human cases: Al-Khalil (Hebron), Tubas and Jenin. Genomic DNA was extracted from dog faecal samples and amplified by PCR targeting the repeat DNA sequence (EgG1 Hae III) followed by sequencing of five positive samples. Genotyping was determined by sequencing and BLAST searching of mitochondrial cytochrome c oxidase subunit (CO1). The incidence of E. granulosus infection detected in humans at surgery was 1.2 per 100,000 in the West Bank and 1.0 per 100,000 in Gaza Strip. Seventeen of 93 domestic dogs (18%) were positive, based upon comparison with the Echinococcus DNA control. The five sequenced samples were confirmed to be E. granulosus. Successfully genotyped sample belonged to E.granulosus sensu stricto (formerly G1-G3 complex, sheep strain). For domestic dogs, age group (13-24 months) and sex were identified as two risk factors for contracting E. granulosus. The study identified the high incidence of E. granulosus sensu stricto in dogs in Palestine. Echinococcosis is a parasitic disease caused by Echinococcus granulosus. The parasite life cycle is shared between a definitive and an intermediate host with humans as accidental hosts. The dog is a main definitive host while sheep is a major intermediate host. The incidence of E. granulosus infection detected in humans at surgery is a commonly used parameter to evaluate the incidence rate of the disease in Palestine. However, this parameter of Echinococcus detection leads to under-reporting of the infection. This study aims to evaluate the incidence of E. granulosus infection in domestic dogs as a potential source of infection to human using molecular methods. Medical archives in nine major hospitals in Palestine were reviewed for E. granulosus infection detected during surgery. Faecal samples were collected from 93 domestic dogs in areas with the highest levels of E. granulosus infection detected in humans at surgery in southern Palestine, including Al-Khalil, and northern Palestine, including Tubas and Jenin districts. The overall incidence rate of E. granulosus infection detected in humans during surgery was 0.9 per 100,000. Around 18% (17/93) of the dogs were infected. Results that E. granulosus was the causative agent were confirmed by sequencing and BLAST search of five positive samples. Genotyping of one sample showed that infection was caused by E. granulosus sensu stricto. The age and sex of dogs were identified as risk factors for contracting infection.
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Affiliation(s)
- Amer Al-Jawabreh
- Arab American University in Jenin, Jenin, Palestine
- Al-Quds Public Health Society, Jerusalem, Palestine
- * E-mail:
| | | | - Suheir Ereqat
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Quds University, East Jerusalem, Abu-Deis, Palestine
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
| | | | | | - Kifaya Azmi
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Quds University, East Jerusalem, Abu-Deis, Palestine
| | - Nahed Al-Laham
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al Azhar University–Gaza, Gaza Strip, Palestine
| | - Ziad Abdeen
- Al-Quds Public Health Society, Jerusalem, Palestine
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
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Cystic echinococcosis in a single tertiary care center in Rome, Italy. BIOMED RESEARCH INTERNATIONAL 2013; 2013:978146. [PMID: 24151631 PMCID: PMC3789360 DOI: 10.1155/2013/978146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/26/2013] [Accepted: 07/29/2013] [Indexed: 12/28/2022]
Abstract
Background. Cystic echinococcosis (CE) is a chronic, clinically complex, and neglected disease. Its prevalence in Italy, a country of medium to high endemicity, remains poorly defined, as notification has long ceased to be mandatory. Methods. We set up a retrospective cohort study involving all CE patients followed at our institute between January 2005 and December 2012. Demographical and clinical features were recorded and analyzed. Results. CE was found in 28 patients (64.3%), mostly Italians from the central regions (50%), followed by subjects from the islands (33.3%) and Southern Italy (16.7%). Their median age was 45 years (IQR: 38.5–66.5), with Eastern Europeans being significantly younger (28 years, IQR: 19–39) than other patients (P ≤ 0.0001). A total of 149 cysts, mostly with hepatic localization (96%), were described. Based on the WHO classification, the cysts were mainly small (80.5%) and active (CE1 (73.8%); CE2 (7.4%)). Active cysts were more common in Eastern Europeans (85.7%) than Italians (66.7%). Conclusion. Our data confirm CE occurrence in Italy. We emphasize the importance to have a national CE registry, opportunely recently introduced. This is essential to assess CE prevalence in this country, implement appropriate control measures, and improve patient management.
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Vlad DC, Neghina AM, Dumitrascu V, Marincu I, Neghina R, Calma CL. Cystic Echinococcosis in Children and Adults: A Seven-Year Comparative Study in Western Romania. Foodborne Pathog Dis 2013; 10:189-95. [DOI: 10.1089/fpd.2012.1281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daliborca Cristina Vlad
- Department of Biochemistry and Pharmacology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Laboratory, Clinical County Emergency Hospital, Timisoara, Romania
| | - Adriana Maria Neghina
- Department of Biochemistry and Pharmacology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Laboratory, Clinical County Emergency Hospital, Timisoara, Romania
| | - Victor Dumitrascu
- Department of Biochemistry and Pharmacology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Laboratory, Clinical County Emergency Hospital, Timisoara, Romania
| | - Iosif Marincu
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Raul Neghina
- Department of Laboratory, Clinical County Emergency Hospital, Timisoara, Romania
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Crenguta Livia Calma
- Department of Physiology and Immunology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Mastrandrea S, Stegel G, Piseddu T, Ledda S, Masala G. A retrospective study on burden of human echinococcosis based on Hospital Discharge Records from 2001 to 2009 in Sardinia, Italy. Acta Trop 2012; 123:184-9. [PMID: 22634205 DOI: 10.1016/j.actatropica.2012.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 05/07/2012] [Accepted: 05/13/2012] [Indexed: 11/29/2022]
Abstract
Cystic Echinococcosis (CE) is an infective zoonosis that represents a worldwide important public health problem. In humans, its manifestations may range from asymptomatic infection to severe disease and possible death, and lead to economic losses from treatment costs and lost wages. Recent studies suggest that this disease has a large social impact in endemic areas, and estimates of burden in terms of monetary and no-monetary impact on human health are essential to allocate financial and technical resources. In Sardinia, the most affected Italian region per number of inhabitants, CE is still endemic, although three eradication campaigns have been carried out in 1962, 1978, and 1987, respectively. To date, the burden of human CE in Sardinia remains poorly defined. In this work, a retrospective study was carried out using public Hospital Discharge Records spanning from 2001 to 2009. During these years, a total of 1409 discharges were recorded: 1196 (84.88%) records corresponding to patients hospitalized for symptoms directly correlated to CE (primary diagnosis), and 213 (15.11%) records corresponding to patients hospitalized for symptoms not directly correlated to CE and with an afterwards or concurrent diagnosis of echinococcosis made during the hospitalization (secondary diagnosis). The annual regional average record (discharge rate) was 9.3/100,000 inhabitants. Direct cost associated with diagnosis, surgery or chemotherapy, medical care, and hospitalization in humans were evaluated in this work. Furthermore, burden of disease was also evaluated by using the disability-adjusted life years (DALYs), the preferred disease-burden measure of the World Health Organization. Knowing the burden of human CE in Sardinia is extremely important to enable the prioritization of control measures for this preventable neglected disease. This is the first study describing the measure of the overall disease burden in an Italian region endemic for this disease, performed by calculating the number of CE patients from Hospital Discharge Records.
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Affiliation(s)
- S Mastrandrea
- Istituto Zooprofilattico Sperimentale della Sardegna - CeNRE, Sassari, Italy.
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A Pediatric Case of Hepatorenal Hydatidosis in a Patient With Human Immunodeficiency Virus (HIV). INFECTIOUS DISEASES IN CLINICAL PRACTICE 2012. [DOI: 10.1097/ipc.0b013e31824241a0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Çiftçi İ, Yılmaz H. Hepatic Hydatid Cyst and Intraperitoneal
Free Hydatid Cyst. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2012. [DOI: 10.29333/ejgm/82542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Calma CL, Neghina AM, Moldovan R, Dumitrascu V, Marincu I, Neghina R. Cystic echinococcosis in Arad County, Romania. Vector Borne Zoonotic Dis 2012; 12:333-5. [PMID: 22217165 DOI: 10.1089/vbz.2011.0756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cystic echinococcosis (CE) is a major parasitosis in Romania, a country where in the past at least one person from 45.5% of its localities underwent surgery for this disease. This survey aimed to provide new epidemiological and clinical data regarding human cases of CE in a western Romanian county. We have retrospectively investigated the medical records of the patients with CE hospitalized during the period of 2004-2010 in the surgical sections of Arad County. A total of 79 patients aged 5-88 years (mean age: 35.9±20.1 years) were diagnosed with CE during the study period. The average yearly incidence was 2.4 cases per 100,000 inhabitants, and the majority of the patients (29.1%) were aged 0-19 years. Most of the adult cases (≥18 years) were people with limited formal education (laborers) (45.6%). The analysis for trend showed an overall decrease in the affected persons over the study period (R(2)=0.66, p=0.026). Hepatic localizations of the hydatid cysts predominated within the study group (73.4%). Only 21.5% of the diseased presented complications and the mean length of hospital stay was 16.2±10.9 days. Eosinophilia of at least 10% of the leukocyte value occurred in 14% of cases and leukocytosis was noticed in 24.1% of patients. Although the rates of CE cases have decreased in Arad County (Romania), this parasitic disease continues to be a concern for public health services and requires the implementation of more stringent prophylactic measures.
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Affiliation(s)
- Crenguta L Calma
- Department of Microbiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Moldovan R, Neghina AM, Calma CL, Marincu I, Neghina R. Human cystic echinococcosis in two south-western and central-western Romanian counties: a 7-year epidemiological and clinical overview. Acta Trop 2012; 121:26-9. [PMID: 22019934 DOI: 10.1016/j.actatropica.2011.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 09/21/2011] [Accepted: 10/06/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze the epidemiological and clinical characteristics of human cystic echinococcosis (CE) in two Romanian counties, of which one is known from a previous survey as hyperendemic, whereas in the other no extensive studies have been undertaken so far. METHODS Retrospective investigation of the medical records of the patients diagnosed with this condition and hospitalized during 2004-2010 in Caras-Severin and Hunedoara counties. RESULTS A total of 190 patients aged 5-88 years (44.3±21.8 years old) were diagnosed with CE. More than one fifth of cases (21.1%) were younger than 19 years old, indicating active transmission of the disease. The yearly average incidence was 3.3 cases/100,000 inhabitants. The highest incidence was registered in patients aged 60-69 years (6.2 cases/100,000 inhabitants), regardless of their gender. Liver involvement occurred in 84.7% of patients. One fifth of the cases (20%) presented complications. Normal values of the eosinophil counts and leukocyte counts predominated within the study group. The length of the hospital stay varied between 1 and 65 days with a mean of 13.1±9.5 days. CONCLUSIONS CE has a significant burden in this part of Romania, and continues to be a public health concern. Consequently, better implementation of preventive measures and extensive informative campaigns for the population are mandatory.
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Affiliation(s)
- Roxana Moldovan
- Department of Microbiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Calma CL, Neghina AM, Vlaicu B, Neghina R. Cystic echinococcosis in the human population of a western Romanian county, 2004-2010. Clin Microbiol Infect 2011; 17:1731-4. [PMID: 21919995 DOI: 10.1111/j.1469-0691.2011.03633.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This report aims to assess the epidemiological characteristics of cystic echinococcosis (CE) in the largest Romanian county (Timis County). Our study group included 182 patients diagnosed with this condition during 2004-2010. The yearly detection rate of new cases was 3.8 cases per 100 000 inhabitants. People over 40 years old accounted for 52.7% of cases. The incidence was higher in women and in rural inhabitants. No statistically significant decline in the number and incidence of CE cases was observed throughout the study period (R(2) = 0.24, p 0.3). Consequently, more efficient implementation of correct public health measures is required to fully prevent and eradicate CE in this region.
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Affiliation(s)
- C L Calma
- Department of Microbiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Pulmonary hydatid cyst: analysis of 1024 cases. Gen Thorac Cardiovasc Surg 2011; 59:105-9. [PMID: 21308436 DOI: 10.1007/s11748-010-0690-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 08/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE Pulmonary hydatid cyst, a parasitic disease, is a health care problem in developing countries. In this study, we evaluated outcomes of patients with pulmonary hydatid disease who were treated in our department. METHODS Patients admitted with a pulmonary hydatid cyst from 1981 to 2008 were enrolled in this study. Their demographic data, the sites and number of cysts, diagnostic methods, type of operation, outcomes, and recurrence rate were statistically analyzed. RESULTS Among the 1024 patients, the mean±SD age was 30.6±16.1 years, and the male/female ratio was 1.09. The most common symptom was a cough (55.1%). Only 1% of the patients were asymptomatic. Altogether, 53.8% had right-side involvement, 40.0% had left-side involvement, and 6.2% had bilateral disease. The inferior lobe was the lobe most common involved. The cyst was intact in 539 (52.6%) patients; and the others were complicated or perforated. The most common surgical technique entailed removing the cyst membrane without resecting the pericyst and closing the airways (67.2%). The cyst was enucleated in 21.2%; and parenchymal resection was performed in 10.3%. The mortality rate was 0.2%, and morbidity occurred in 8.4% of patients. The most common complications were residual spaces with prolonged air leak and wound infection. The recurrence rate was 2.5%, with most of the recurrences (82.6%) managed by surgery. CONCLUSION The best treatment for pulmonary hydatid cyst disease is surgery, which is associated with low mortality and morbidity rates. The most common and acceptable treatment is extraction of the cyst membrane without manipulating the pericyst and closure of small airways. Pulmonary resection should be reserved for complicated forms of the disease.
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