Francesca Tamarozzi1, Okan Akhan2, Carmen Michaela Cretu3, Kamenna Vutova4, Devrim Akinci2, Rossitza Chipeva4, Turkmen Ciftci2, Corina Manuela Constantin5, Massimo Fabiani6, Branimir Golemanov7, Denisa Janta8, Patricia Mihailescu9, Marin Muhtarov10, Serra Orsten11, Marius Petrutescu12, Patrizio Pezzotti6, Alexandru Cosmin Popa13, Loredana Gabriela Popa14, Mircea Ioan Popa15, Valeri Velev4, Mar Siles-Lucas16, Enrico Brunetti17, Adriano Casulli18. 1. 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. 2. Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 3. Parasitology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania. 4. Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Prof Ivan Kirov, Department of Infectious, Parasitic and Tropical Diseases, Sofia, Bulgaria. 5. Surgery, Colentina Clinical Hospital, Bucharest, Romania. 6. Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. 7. Clinical Centre of Gastroenterology, University Hospital Queen Joanna- Institute for Specialization and Improvement of Medical Doctors, Medical Faculty, Medical University, Sofia, Bulgaria. 8. National Institute of Public Health, Bucharest, Romania. 9. Eco-Para-Diagnostic, Colentina Clinical Hospital, Bucharest, Romania; Colentina Clinical Hospital, Eco-Para-Diagnostic, Bucharest, Romania. 10. Multi-Profile Hospital for Active Treatment Kardzhali, Gastroenterology Ward, Kardzhali, Bulgaria. 11. School of Health Services, Hacettepe University, Ankara, Turkey. 12. Parasitology, Colentina Clinical Hospital, Bucharest, Romania. 13. Surgery, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania. 14. Microbiology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania. 15. Microbiology, Carol Davila University of Medicine and Pharmacy, Cantacuzino National Institute for Research, Bucharest, Romania. 16. Parasitology Unit, Instituto de Recursos Naturales y Agrobiología de Salamanca, IRNASA-CSIC, Salamanca, Spain. 17. 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. 18. 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. Electronic address: adriano.casulli@iss.it.
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.
BACKGROUND:Cystic echinococcosis is a neglected zoonotic infection that is distributed worldwide and prioritised by WHO for control efforts. The burden of humancystic 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.
Authors: Philipp A Kronenberg; Ansgar Deibel; Bruno Gottstein; Felix Grimm; Beat Müllhaupt; Cordula Meyer Zu Schwabedissen; Sezdbek Aitbaev; Rakhatbek A Omorov; Kubanychbek K Abdykerimov; Gulnara Minbaeva; Jumagul Usubalieva; Mar Siles-Lucas; Paola Pepe; Laura Rinaldi; Markus Spiliotis; Junhua Wang; Norbert Müller; Paul R Torgerson; Peter Deplazes Journal: Pathogens Date: 2022-04-27
Authors: Tommaso Manciulli; Riccardo Serraino; Gian Luca D'Alessandro; Letizia Cattaneo; Mara Mariconti; Ambra Vola; Francesco Taccari; Roberta Narra; Giuseppe De Vito; Enrico Maria Trecarichi; Maria Mazzitelli; Giovanni Matera; Adriano Casulli; Nadia Marascio; Enrico Brunetti; Francesca Tamarozzi; Carlo Torti Journal: Am J Trop Med Hyg Date: 2020-11 Impact factor: 2.345
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