Knowledge, Attitude, and Beliefs of Communities and Health Staff about Echinococcus granulosus Infection in Selected Pastoral and Agropastoral Regions of Uganda

Risk factors and economic losses associated with cystic echinococcosis among livestock in selected pastoral and agro-pastoral areas of Uganda

BACKGROUND

Cystic echinococcosis is a parasitic cyclo-zoonotic disease caused by the taeniid Echinococcus and causes significant economic losses in livestock production, yet its impact is often overlooked and under estimated.

METHODS

This study investigated the risk factors and economic impact of cystic echinococcosis in livestock, in Uganda's pastoral and agro-pastoral communities. In the study, 14,937 livestock were examined at selected slaughterhouses in Moroto, Kumi, Luwero and Nakasongola districts from March 2019 to February 2020. The visceral organs were examined for hydatid cysts during slaughter and the prevalence correlated with the risk factors got from livestock traders and livestock owners through questionnaire survey. Production losses and economic losses due to organ condemnations were also estimated.

RESULTS

This is the first study to provide insights into the financial impacts and risk factors towards Cystic Echinococcosis (CE) in livestock in Uganda. The key significant risk factors for the persistence of CE in goats were place of origin from Lira (P ≤ 0.000), Nakasongola (P ≤ 0.002), Luwero and Bukedea (P ≤ 0.002), and tethering (P ≤ 0.001); in cattle was communal grazing (P ≤ 0.0000); and in sheep was being kept in large flocks (P ≤ 0.004). The total annual economic losses due to CE on livestock inspected in abattoirs in the study districts was USD 21,352.7 (1 USD = 3,809.3 UGX) of which 11.7% was due to organ condemnation and 88.3% due to livestock production losses. More significant mean annual economic losses per livestock species examined occurred in Moroto district among Zebu cattle USD 8.4, goats USD 1.4 and sheep USD 1.4 than other districts.

CONCLUSION

Results show that CE is a disease of significant economic and public health importance in PAP areas in Uganda with urgent need to create awareness and institute community-based control measures involving multistakeholder particiapation.to break livestock-dog cycle.

Prevalence of cystic echinococcosis among livestock in pastoral and agro-pastoral areas in Uganda

Cystic echinococcosis (CE) remains a significant challenge in Uganda with precise status largely undocumented in most communities. To determine CE prevalence, post-mortem examination was done on 14 937 livestock (5873 goats, 1377 sheep, 3726 zebu cattle and 3054 Ankole cattle) slaughtered in abattoirs in the districts of Moroto in Karamoja region, Kumi in Teso region and Nakasongola and Luwero in Buganda region. The overall CE prevalence was 21.9% in sheep, 15.2% in zebu cattle, 5.5% in goats and 2.1% in Ankole cattle. Moroto district had a higher prevalence of CE than other districts with 31.3% in zebu cattle, sheep 28%, goats 29.1% and (0%) in Ankole cattle. On organ locations, the lungs were the most affected in all livestock in all the study areas. Considering cyst fertility, 33.9, 1.7 and 6.4% of Ankole cattle, sheep and zebu cattle respectively had fertile cysts in the liver while 4.5% of goats and 4% Ankole cattle had fertile cysts in the lungs. In conclusion, CE is widespread and occurs among cattle, sheep and goats in pastoral and agro-pastoral areas in Uganda. Therefore, there is an urgent need to create awareness among the communities on role of livestock in CE epidemiology and transmission.

Knowledge, awareness and practice regarding cystic echinococcosis in Algeria: A cross-sectional survey among the general population

Cystic echinococcosis (CE) is a parasitic zoonotic disease with a widespread occurrence, particularly in developing countries. Known as a neglected disease, it is highly prevalent in Algeria with a significant public health concern and substantial financial losses. The objectives of this study was to explore knowledge and awareness and practice of the Algerian population regarding this disease. A cross-sectional online-based survey was conducted between July 15 and September 25, 2022 using a self-administered questionnaire targeting all Algerian people of more than 18 years of age. Out of the total respondents, 87.7% have ever heard of CE with livestock rearing connection (OR:2.550, CI 95% OR: 1.108-5.870) and educational level (OR:3.826, CI 95% OR: 1.599-9.156) as the main factors associated with the level of awareness. Regarding their knowledge, results showed dispersing notions about the disease. The majority (84.8%) were aware of the zonnotic nature of the disease while only 49.6% knew that CE is caused by parasitic disease. Also, 83.3% were knowledgeable of the role of contaminated offal in the contamination of dogs which are considered as the main source of contamination of humans (65.19%). Regarding their practices, even home slaughtering was common (92.96%), some positive attitudes were prevalent where most of the participants declared washing vegetable before consumption (97.41%) and washing their hands after touching a dog (91.11%). Also, 68.29% among the dog owners declared that deworming their pets. This study has revealed that despite the high level of awareness and some positive attitudes, the level of knowledge about CE among the Algerian public has shown some gaps related to the epidemiology of the disease. These results could be helpful for the awareness campaigns programmers in their missions through focusing their efforts on raising the level of knowledge for the items that have shown a lack of understand which will be of great importance in the strategy of CE elimination.

Attitude and awareness of Algerian university students about cystic echinococcosis: A cross-sectional study

Cystic echinococcosis is a neglected tropical parasitic disease affecting both humans and animals with considerable socioeconomic impact on affected pastoral and poor communities. CE is endemic in the Mediterranean basin, including Algeria posing a real threat for either animal and public health. This study was conducted to evaluate the level of awareness and knowledge of Algerian university students about this disease and to describe their attitude toward some risky practices. Results showed that despite that a high number of students (76.1%) have heard about CE, their level of knowledge is however medium (63.3%) especially among students of non medical and life sciences specialties. The gaps of knowledge concerns especially the life cycle of the parasite even they are aware about the association of dogs (43.7%) and sheep (59.4%) and considered that dogs are the main source of contamination of humans (58.1%) through contaminated foods (45%) or direct contact with their faeces (44.5%). Regarding their practice, a good level was shown since washing vegetables (99.2%) and washing hands after touching a dog (97.9%) and dogs deworming (82%) were common. These results highlight the need to improve knowledge about the transmission cycle of the parasite through awareness campaign targeting students which could be helpful in CE eradication.

Educational Intervention for the Awareness Improvement and Control Programme Design on Echinococcosis in Izmir, Turkey

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.

Molecular characterization and expression analysis of annexin B3 and B38 as secretory proteins in Echinococcus granulosus

Background

Cystic echinococcosis is a parasitic zoonotic disease, which poses a threat to public health and animal husbandry, and causes significant economic losses. Annexins are a family of phospholipid-binding proteins with calcium ion-binding activity, which have many functions.

Methods

Two annexin protein family genes [Echinococcus granulosus annexin B3 (EgAnxB3) and EgAnxB38] were cloned and molecularly characterized using bioinformatic analysis. The immunoreactivity of recombinant EgAnxB3 (rEgAnxB3) and rEgAnxB38 was investigated using western blotting. The distribution of EgAnxB3 and EgAnxB38 in protoscoleces (PSCs), the germinal layer, 18-day strobilated worms and 45-day adult worms was analyzed by immunofluorescence localization, and their secretory characteristics were analyzed preliminarily; in addition, quantitative real-time reverse transcription polymerase chain reaction was used to analyze their transcript levels in PSCs and 28-day strobilated worms stages. The phospholipid-binding activities of rEgAnxB3 and rEgAnxB38 were also analyzed.

Results

EgAnxB3 and EgAnxB38 are conserved and contain calcium-binding sites. Both rEgAnxB3 and rEgAnxB38 could be specifically recognized by the serum samples from E. granulosus-infected sheep, indicating that they had strong immunoreactivity. EgAnxB3 and EgAnxB38 were distributed in all stages of E. granulosus, and their transcript levels were high in the 28-day strobilated worms. They were found in liver tissues near the cysts. In addition, rEgAnxB3 has Ca²⁺-dependent phospholipid-binding properties.

Conclusions

EgAnxB3 and EgAnxB38 contain calcium-binding sites, and rEgAnxB3 has Ca²⁺-dependent phospholipid-binding properties. EgAnxB3 and EgAnxB38 were transcribed in PSCs and 28-day strobilated worms. They were expressed in all stages of E. granulosus, and distributed in the liver tissues near the hydatid cyst, indicating that they are secreted proteins that play a crucial role in the development of E. granulosus.

Molecular and Functional Characterization of Inhibitor of Apoptosis Proteins (IAP, BIRP) in Echinococcus granulosus

The larval stage of Echinococcus granulosus sensu lato, resulting in cystic echinococcosis, a parasitic zoonosis, causes huge economic losses to the livestock industry and poses a threat to public health. Inhibitor of apoptosis proteins (IAPs) is a class of endogenous anti-apoptotic family, which plays a significant functional role in the regulation of organism’s development. Herein, to explore potential functions of IAPs in E. granulosus, two members of IAPs from E. granulosus (Eg-IAP and Eg-BIRP) were cloned, expressed, and molecularly characterized. Eg-IAP and Eg-BIRP encoded putative 331 and 168 residue proteins, respectively. Bioinformatic analysis showed that both proteins contained a type II BIR domain-the essential functional domain of IAPs. Fluorescence immunohistochemistry revealed that both proteins were ubiquitously localized in all life-cycle stages of E. granulosus. Our fluorescent quantitative PCR (RT-qPCR) results revealed relatively higher transcription levels of two Eg-IAPs in protoscoleces (PSCs) compared to the 18-day strobilated worms. We further used different concentrations of LCL161, a Smac-mimetic pan-IAPs inhibitor, to induce the apoptosis in PSCs in vitro, and revealed that the survival rate of PSCs and transcription levels of both genes were negatively correlated with the concentration of LCL161. While the results of light microscopy, transmission electron microscopy (TEM), and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay also showed a higher apoptotic rate in PSCs with the increasing concentrations of LCL161. Taken together, our findings provide the reasonable evidence that both Eg-IAP and Eg-BIRP have potential implication in critical anti-apoptotic roles during the development of E. granulosus.