Microsatellite Investigations of Multiple Echinococcus Granulosus Sensu Stricto Cysts in Single Hosts Reveal Different Patterns of Infection Events between Livestock and Humans

Zoonotic threat of cystic echinococcosis in Tunisia: insights into livestock prevalence and identification of the G1 genotype

Introduction

Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the Echinococcus granulosus sensu lato (s.l.) complex. CE is globally distributed, with a particularly high prevalence in North African countries, especially Tunisia. Despite its significant public health impact and the economic burden it places on livestock production, recent data on CE prevalence in Tunisian livestock remain scarce. This study aimed to assess the prevalence of CE in livestock, investigate potential differences across host species, and identify risk factors contributing to the CE transmission dynamics.

Methods

The study was conducted in two governorates located in the North-Eastern region of Tunisia. A multidimensional approach included post-mortem inspection of slaughtered animals, fertility and viability analyses of the isolated CE cysts, and molecular genotyping of the parasite was conducted.

Results and discussion

A total of 21,487 animals were examined, 15.86% of the sheep and 9.57% of the cattle were infected with at least one CE cyst, with females showing higher prevalence rates. No CE cases were detected in goats or dromedaries. In all infected animals, the infection rate increased with the age of the host. CE cysts were predominantly found in both the liver and lung of the same animal in sheep and cattle. Aborted lesions were the most common stage of infection, and multiple CE cysts were frequently observed in affected animals. Fertile CE cysts were highly prevalent in both sheep and cattle, with rates increasing with host age, confirming the critical role of sheep in the parasite transmission cycle and demonstrating that cattle in Tunisia also play a significant role in the propagation of CE. Molecular analysis confirmed the predominance of the zoonotic G1 genotype of E. granulosus sensu stricto. This is particularly concerning as the G1 genotype is also the most common genotype affecting humans. This underscores a strong zoonotic potential and highlights the need for integrated control strategies. The findings emphasize the role of the livestock-dog cycle in CE transmission, posing risks to humans living near infected animals. Effective measures, including slaughter regulations, dog deworming, public education, and enhanced veterinary surveillance within a One Health approach, are essential for reducing CE's impact on human and animal health.

Genetic diversity of Echinococcus granulosus sensu lato from animals and humans in Bosnia and Herzegovina

BACKGROUND

Cystic echinococcosis (CE) is recognized as one of the most prevalent zoonotic diseases in Bosnia and Herzegovina. However, no systemic investigation of the genetic diversity of Echinococcus granulosus sensu lato circulating among animals and humans in the country has been performed to date.

METHODS

In this preliminary study, we analysed one cyst each from 36 sheep, 27 cattle, 27 pigs, 11 wild boars and 16 human patients for amplification and partial sequencing of the adenosine triphosphate 6 (atp6) and cytochrome c oxidase 1 (cox1) genes. The host species, fertility rate and organ cyst location were recorded for each subject involved in the study.

RESULTS

Overall, the atp6 gene was successfully amplified and sequenced from 110 samples, while 96 of the PCRs for cox1 were positive. Three zoonotic genotypes of E. granulosus sensu stricto (G1 and G3) and Echinococcus canadensis (G7) were identified in our isolates based on analyses of the atp6 gene. These genotypes were represented by 11 different genetic variants (haplotypes), six of which were identified for the first time in the present study.

CONCLUSIONS

This study demonstrates, for the first time, that CE in Bosnia and Herzegovina is predominantly caused by E. granulosus sensu stricto and E. canadensis clusters, which exhibited a lower genetic diversity compared to isolates from other European countries. Further molecular studies employing other mitochondrial and nuclear genes are required to better understand the transmission cycles of E. granulosus sensu stricto among intermediate and definitive hosts in the country.

Echinococcus granulosus sensu lato Genotypes in Different Hosts Worldwide: A Systematic Review

INTRODUCTION

The aim of this study was to develop a synthesis of the evidence available regarding verified E. granulosus sensu lato (s.l.) genotypes in different species worldwide.

MATERIAL AND METHODS

A systematic review was performed including studies concerning genotypes of E. granulosus s.l. without language or genotyped method restriction, published between 1990 and 2020. A systematic search was carried out in Trip Database, BIREME, SciELO, LILACS, IBECS, PAHO-WHO, EMBASE, PubMed, Scopus, and WoS. Variables of interest were year of publication, country, number of samples, and hosts; genotypes, molecular marker, haplotypes and molecular biology techniques used. Descriptive statistics were applied.

RESULTS

2411 articles were analyzed, however 135 met the selection criteria, representing 8643 liver and lung samples. Of the samples selected 24% were human, the remaining samples pertained to non-human animal hosts; cattle and sheep prevailed with 28.6% and 26.6% of the studied samples, respectively. The reported evidence is mainly from Iran, Turkey, Argentina, China and Chile; with 50, 11, 6, 6 and 5 studies, respectively, published between 1992 and 2020 [most frequently during 2015-2020 (76/135 studies; 56.3%)]. The mitochondrial gene cox1 was generally sequenced and informative (91.8%). Genotypes most frequently identified were E. granulosus sensu stricto (s.s.) (83.2%).

CONCLUSIONS

Based on this overall evidence, it can be concluded that publications related to genotypes of E. granulosus s.l. are heterogeneous. E. granulosus ss accounts for the vast majority of the global burden of E. granulosus s.l. worldwide. Further studies including larger number of cases and adequate internal validity are required to specify the distribution of genotypes in various host species.

TRIAL REGISTRATION

PROSPERO CRD42018099827.

Genetic diversity of Echinococcus granulosus sensu stricto infecting humans in western Algeria

Human cystic echinococcosis is a zoonosis due to the flat worm Echinococcus granulosus sensu lato. The disease remains a major public health problem in Northern Africa. Molecular typing enables a better understanding of the parasite circulation from animals to humans. In this study, we investigated the genotypic diversity of 46 Echinococcus granulosus isolates collected from humans in the western part of Algeria by the mean of partial sequences of 4 mitochondrial loci, namely cox1a, cox1b, nd3, and atp6. Nucleotide polymorphism ranges from 0.6 (nd3) to 2.7% (cox1a). Eight alleles had not been previously reported. Multilocus analysis showed that all the isolates were from the Echinococcus granulosus sensu stricto (G1 genotype). Nineteen different haplotypes made of the concatenation of 4 sequenced loci were observed, the most common type clustering 13 isolates (36.1%). Twelve of these haplotypes had never been described previously and fifteen (41.7%) haplotypes were represented by only one isolate. Using sequences from this study and others retrieved from the GenBank database, any clustering either according to the geographic origin within Algeria or according to the human or animal origin of the isolates could be demonstrated supporting that genotype G1 population genetics has been shaped by intensive animal breeding.

Fasciola hepatica co-infection enhances Th1 immune response in the adventitial layer of non-fertile Echinococcus granulosus cysts

Cystic echinococcosis is a widespread zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus. In intermediary hosts, two types of echinococcal cysts can be found: fertile, which produce protoscoleces, the infective form of the parasite to dogs; and infertile, that do not present protoscoleces and therefore are not able to continue with the parasite life cycle. The adventitial layer, the local immune response against the cyst, plays an important role in cyst fertility. Grazing cattle can often feature Fasciola hepatica co-infection, a parasite known to modulate the host systemic immune response. In this work the cellular Th1/Th2 immune profiles were evaluated in the adventitial layer of fertile and non-fertile cysts with and without co-infection with Fasciola hepatica. Measuring with immunohistochemistry and qPCR in adventitial layer, we report that non-fertile cysts present higher levels of Th1 cytokines (IFN-γ (P < 0.0001) and TNF-α (P < 0.05)), and fertile cysts have higher levels of Th2 cytokines (IL-4 (P < 0.001)). Co-infection with Fasciola hepatica is associated with a decrease in the expression of IL-4 (P < 0.05) and an increase in the expression of IFN-γ (P < 0.0001) in the adventitial layer of fertile cysts. Non-fertile cysts were associated with higher levels of Th1 cytokines in the adventitial layer, with IFN-γ expression enhanced by F. hepatica co-infection (P < 0.0001), confirming that polyparasitism should be considered in the treatment and control of naturally infected cattle.