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Shafiei R, Mohajerzadeh MS, Masomi HFA, Tavakoli M, Turki H, Firouzeh N. Discordance Therapeutic Protocol of Cystic Echinococcosis With WHO Guideline: A Descriptive Study Based on Liver Ultra-Sonographic Data in North Khorasan Province, Northeastern of Iran. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1279-1287. [PMID: 38497687 DOI: 10.1002/jum.16452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Cystic echinococcosis (CE), a helminth-associated zoonosis caused by Echinococcus granulosus, poses a significant public health problem, particularly in pastoral-rearing regions. The lack of uniform guidelines led to variations in CE management. Based on ultrasound data, the World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification system categorizes cysts into active, transitional, and inactive groups. This study assesses whether the therapeutic approach from liver human operation cases in North Khorasan province aligns with the WHO-IWGE reference based on ultrasound data. METHODS The research is based on ultrasound data from liver CE human operation cases collected between 2018 and 2022. This retrospective study investigates the therapeutic protocol for (CE) in North Khorasan Province, Iran, comparing it with the WHO-IWGE guidelines. We collect data from previously registered patients' medical information from our studied area's main CE surgical hospital. Moreover, as the first hospitalized survey in Iran, this study reveals insights into patient demographics, cyst stage prevalence, and treatment modalities. RESULTS Notably, more than half of the patients were treated for CE1 stage cysts, and CE4 cases, which generally do not require surgery, underwent open surgery. The results suggest a need for adherence to the "watch-and-wait" approach in specific cases. All patients underwent successful surgeries, but we do not have access to follow-up data from patients after discharge. CONCLUSIONS This descriptive study contributes to understanding the implementation of WHO guidelines in a regional context, shedding light on the challenges and variations in CE management. It seems, retraining courses for surgeons are required to update their knowledge of standard CE diagnostic and treatment methods.
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Affiliation(s)
- Reza Shafiei
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mina Sadat Mohajerzadeh
- Department of Radiology and Medical Physics, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Maryam Tavakoli
- Department of Radiology and Medical Physics, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Habibollah Turki
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nima Firouzeh
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Mohammad S, Joshi KS, Muneeba S, Acharya N, Jajoo SS. Echinococcal Disease of the Fallopian Tube as a Rare Cause of Primary Subfertility. Cureus 2023; 15:e46198. [PMID: 37905297 PMCID: PMC10613431 DOI: 10.7759/cureus.46198] [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] [Received: 09/05/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Echinococcosis is a significant zoonotic infection caused by Echinococcus granulosus, which has a worldwide distribution. In India, the annual incidence varies from one to 200 in 100,000 people. The liver and lungs are often affected, making diagnosis difficult when infections occur in uncommon areas. We report a case of a hydatid cyst in the fallopian tube, which presented as subfertility and was confirmed by radiological imaging.
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Affiliation(s)
- Shazia Mohammad
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ketav S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shaikh Muneeba
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neema Acharya
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shubhada S Jajoo
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Habibi B, Gholami S, Bagheri A, Fakhar M, Moradi A, Khazeei Tabari MA. Cystic echinococcosis microRNAs as potential noninvasive biomarkers: current insights and upcoming perspective. Expert Rev Mol Diagn 2023; 23:885-894. [PMID: 37553726 DOI: 10.1080/14737159.2023.2246367] [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: 06/01/2023] [Revised: 07/18/2023] [Accepted: 08/07/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Echinococcosis, also known as hydatidosis, is a zoonotic foodborne disease occurred by infection with the larvae of Echinococcus spp. which can lead to the development of hydatid cysts in various organs of the host. The diagnosis of echinococcosis remains challenging due to limited diagnostic tools. AREAS COVERED In recent years, microRNAs (miRNAs) have emerged as a promising biomarker for various infectious diseases, including those caused by helminths. Recent studies have identified several novel miRNAs in Echinococcus spp. shedding light on their essential roles in hydatid cyst host-parasite interactions. In this regard, several studies have shown that Echinococcus-derived miRNAs are present in biofluids such as serum and plasma of infected hosts. The detection of these miRNAs in the early stages of infection can serve as an early prognostic and diagnostic biomarker for echinococcosis. EXPERT OPINION The miRNAs specific to Echinococcus spp. show great potential as early diagnostic biomarkers for echinococcosis and can also provide insights into the pathogenesis of this disease. This review attempts to provide a comprehensive overview of Echinococcus-specific miRNAs, their use as early diagnostic biomarkers, and their function in host-parasite interactions.
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Affiliation(s)
- Bentolhoda Habibi
- Department of Parasitology, Toxoplasmosis Research Center, Mazandaran Registry Center for Hydatid Cyst, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shirzad Gholami
- Department of Parasitology, Toxoplasmosis Research Center, Mazandaran Registry Center for Hydatid Cyst, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abouzar Bagheri
- Department of Clinical Biochemistry-Biophysics and Genetics, Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Department of Parasitology, Toxoplasmosis Research Center, Mazandaran Registry Center for Hydatid Cyst, Mazandaran University of Medical Sciences, Sari, Iran
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alimohammad Moradi
- Department of General Surgery Division of HPB and Transplantation Surgery, Tehran University of Medical Sciences, Tehran, Iran
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Alvi MA, Ali RMA, Khan S, Saqib M, Qamar W, Li L, Fu BQ, Yan HB, Jia WZ. Past and Present of Diagnosis of Echinococcosis: A Review (1999-2021). Acta Trop 2023; 243:106925. [PMID: 37080264 DOI: 10.1016/j.actatropica.2023.106925] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
The larval forms of taeniid cestodes belonging to the genus Echinococcus are the source of the zoonotic infection known as echinococcosis. Alveolar and cystic echinococcosis are caused by Echinococcus multilocularis and Echinococcus granulosus (s. s) respectively. It is endemic in several regions of the world. In this systematic review, we describe diagnosis, and the species (human, canids, livestock, and small rodents) affected by cystic (CE) and alveolar echinococcosis (AE). From 1999 to 2021, we searched the online directory through PubMed, SCOPUS, Web of Science, and google scholar. Among the 37,700 records found in the online databases, 187 publications met our eligibility requirements. The majority of investigations employed a range of diagnostic methods, such as ELISA, imaging, copro-PCR, necropsy or arecoline hydrobromide purgation, morphological cestode confirmation, and fecal sieving/flotation to detect and confirm Echinococcus infection. ELISA was the most commonly used method followed by PCR, and imaging. The research team retrieved data describing the incidence or assessment of the diagnostic test for E. multilocularis in humans (N = 99), canids (N = 63), small ruminants (N = 13), large ruminants (N= 3), camel (N= 2), pigs (N=2) and small mammals (N= 5). This study was conducted to explore the diagnostic tools applied to detect echinococcosis in humans as well as animals in prevalent countries, and to report the characteristic of new diagnostic tests for disease surveillance. This systematic review revealed that ELISA (alone or in combination) was the most common method used for disease diagnosis and diagnostic efficacy and prevalence rate increased when recombinant antigens were used. It is highly recommended to use combination protcols such as serological with molecular and imaging technique to diagnose disease. Our study identified scarcity of data of reporting echinococcosis in humans/ animals in low-income or developing countries particularly central Asian countries. Study reports in small rodents indicate their role in disease dissemination but real situation in these host is not refected due to limited number of studies. Even though echinococcosis affects both public health and the domestic animal sector, therefore, it is important to devise new and strengthe implementation of the existing monitoring, judging, and control measures in this estimate.
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Affiliation(s)
- Mughees Aizaz Alvi
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Rana Muhammad Athar Ali
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Sadiq Khan
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Warda Qamar
- Department of Parasitology, University of Agriculture, Faisalabad, Pakistan
| | - Li Li
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Bao-Quan Fu
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Hong-Bin Yan
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China.
| | - Wan-Zhong Jia
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China.
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5
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Öztürk G, Uzun MA, Özkan ÖF, Kayaalp C, Tatlı F, Eren S, Aksungur N, Çoker A, Bostancı EB, Öter V, Kaya E, Taşar P. Turkish HPB Surgery Association consensus report on hepatic cystic Echinococcosis (HCE). Turk J Surg 2022; 38:101-120. [PMID: 36483170 PMCID: PMC9714645 DOI: 10.47717/turkjsurg.2022.5757] [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: 04/30/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Cystic Echinococcosis (CE) is one of the important problems of the Eurasian region. We aimed to prepare a consensus report in order to update the treatment approaches of this disease. This study was conducted by Turkish HPB Surgery Association. MATERIAL AND METHODS This study was conducted with the modified Delphi model. For this purpose, we conducted a three-stage consensus-building approach. RESULTS Six topics, including diagnosis, medical treatment, percutaneous treatment, surgical treatment, management of complications and posttreatment follow-up and recurrences in HCE were discussed. CONCLUSION The expert panel made recommendations for every topic.
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Affiliation(s)
- Gürkan Öztürk
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Mehmet Ali Uzun
- Clinic of General Surgery, Şişli Hamidiye Etfal Education and Research Hospital, İstanbul, Türkiye
| | - Ömer Faruk Özkan
- Clinic of General Surgery, Ümraniye Education and Research Hospital, İstanbul, Türkiye
| | - Cüneyt Kayaalp
- Department of General Surgery, Yeditepe University Faculty of Medicine, İstanbul, Türkiye
| | - Faik Tatlı
- Department of General Surgery, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| | - Suat Eren
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Nurhak Aksungur
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Ahmet Çoker
- Clinic of General Surgery, Medicana International İzmir Hospital, İzmir, Türkiye
| | | | - Volkan Öter
- Clinic of Gastroenterological Surgery, Ankara State Hospital, Ankara, Türkiye
| | - Ekrem Kaya
- Department of General Surgery, Uludağ University Faculty of Medicine, Bursa, Türkiye
| | - Pınar Taşar
- Department of General Surgery, Uludağ University Faculty of Medicine, Bursa, Türkiye
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Stryiński R, Łopieńska-Biernat E, Carrera M. Proteomic Insights into the Biology of the Most Important Foodborne Parasites in Europe. Foods 2020; 9:E1403. [PMID: 33022912 PMCID: PMC7601233 DOI: 10.3390/foods9101403] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023] Open
Abstract
Foodborne parasitoses compared with bacterial and viral-caused diseases seem to be neglected, and their unrecognition is a serious issue. Parasitic diseases transmitted by food are currently becoming more common. Constantly changing eating habits, new culinary trends, and easier access to food make foodborne parasites' transmission effortless, and the increase in the diagnosis of foodborne parasitic diseases in noted worldwide. This work presents the applications of numerous proteomic methods into the studies on foodborne parasites and their possible use in targeted diagnostics. Potential directions for the future are also provided.
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Affiliation(s)
- Robert Stryiński
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Elżbieta Łopieńska-Biernat
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Mónica Carrera
- Department of Food Technology, Marine Research Institute (IIM), Spanish National Research Council (CSIC), 36-208 Vigo, Spain
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Gholami S, Tanzifi A, Sharif M, Daryani A, Rahimi MT, Mirshafiee S, Sarvi S. Demographic aspects of human hydatidosis in Iranian general population based on serology: A systematic review and meta-analysis. Vet World 2018; 11:1385-1396. [PMID: 30532491 PMCID: PMC6247888 DOI: 10.14202/vetworld.2018.1385-1396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/28/2018] [Indexed: 11/16/2022] Open
Abstract
AIM Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus cestodes, is a globally distributed chronic disease that is an important socioeconomic and public health problem in humans and livestock in developing countries, including Iran. The aim of this study was to determine the overall seroprevalence of hydatid infection in the general population of Iran. MATERIALS AND METHODS This systematic review began by searching electronic databases in English (PubMed, Science Direct, Scopus, and Google Scholar) and Persian (Magiran, Scientific Information Database, Iran Medex, and Iran Doc). RESULTS Our search resulted in a total of 40 reports published from 1995 to 2015. Of 49,460 individuals surveyed, 3090 cases of hydatidosis were reported. Community-based studies showed that the seroprevalence of CE in the Iranian general population was 6.0% (95% confidence interval: 5.0-7.0%). The age group with the highest CE seroprevalence was 20-40 years, and the lowest one was in the under 20 year's group. The seroprevalence of hydatidosis in males was significantly higher than that in females. In addition, the intended rate was significantly higher in rural regions than in urban areas. CONCLUSION Management program for developing more efficient diagnostic tests should be established. Further, cost-effective preventive approaches, including relevant research, should be considered. Finally, hydatid cyst control programs that are important for interrupting the transmission of human CE should be improved.
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Affiliation(s)
- Shirzad Gholami
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Asal Tanzifi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Sharif
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Siavash Mirshafiee
- Department of Husbandry, Ghaemshahr Branch of Islamic Azad University, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Brunetti E, Tamarozzi F, Macpherson C, Filice C, Piontek MS, Kabaalioglu A, Dong Y, Atkinson N, Richter J, Schreiber-Dietrich D, Dietrich CF. Ultrasound and Cystic Echinococcosis. Ultrasound Int Open 2018; 4:E70-E78. [PMID: 30364890 PMCID: PMC6199172 DOI: 10.1055/a-0650-3807] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 05/25/2018] [Accepted: 06/18/2018] [Indexed: 02/08/2023] Open
Abstract
The introduction of imaging techniques in clinical practice 40 years ago changed the clinical management of many diseases, including cystic echinococcosis (CE). For the first time cysts were clearly seen before surgery. Among the available imaging techniques, ultrasound (US) has unique properties that can be used to study and manage cystic echinococcosis. It is harmless, can image almost all organs and systems, can be repeated as often as required, is portable, requires no patient preparation, is relatively inexpensive and guides diagnosis, treatment and follow-up without radiation exposure and harm to the patient. US is the only imaging technique which can be used in field settings to assess CE prevalence because it can be run even on solar power or a small generator in remote field locations. Thanks to US classifications, the concept of stage-specific treatments was introduced and because US is repeatable, the scientific community has gained a clearer understanding of the natural history of the disease. This paper reviews the scope of US in CE, describes its strengths and weaknesses compared to other imaging techniques and its relationship with serodiagnosis and discusses sonographic features that may be helpful in differential diagnosis.
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Affiliation(s)
- Enrico Brunetti
- San Matteo Hospital Foundation, University of Pavia, Unit of Infectious and Tropical Diseases, Pavia, Italy
| | - Francesca Tamarozzi
- Center for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Carlo Filice
- San Matteo Hospital Foundation, University of Pavia, Unit of Infectious and Tropical Diseases, Pavia, Italy
| | - Markus Schindler Piontek
- Caritas Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Medical Clinic 2, Bad Mergentheim, Germany
| | | | - Yi Dong
- Zhongshan Hospital, Ultrasound, Shanghai, China
| | - Nathan Atkinson
- John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Department of Gastroenterology, Oxford, New Zealand
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Berlin, Germany
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Hijjawi NS, Al-Radaideh AM, Rababah EM, Al-Qaoud KM, Bani-Hani KE. Cystic echinococcosis in Jordan: A review of causative species, previous studies, serological and radiological diagnosis. Acta Trop 2018; 179:10-16. [PMID: 29246408 DOI: 10.1016/j.actatropica.2017.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/09/2017] [Accepted: 12/11/2017] [Indexed: 12/28/2022]
Abstract
Cystic echinococcosis (CE)/hydatidosis is a zoonotic disease which occur in human and herbivore animals as a result of infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato (s. l.). In human, CE is a serious public health concern in many parts of the world including Jordan. The present review will cover CE causative agent: E. granulosus species/genotypes; life cycle of E. granulosus parasite, all published previous studies on CE in Jordan (humans, intermediate hosts, definitive host) as well as its diagnostic methods in human.
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Affiliation(s)
- Nawal S Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan.
| | - Ali M Al-Radaideh
- Department of Medical Imaging, Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan
| | - Eman M Rababah
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan
| | - Khaled M Al-Qaoud
- Department of Biological Sciences, Yarmouk University, Irbid, Jordan
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Tamarozzi F, Hou A, Morales ML, Giordani MT, Vilca F, Mozo K, Bascope R, White AC, Brunetti E, Chen L, Cabada MM. Prevalence and Risk Factors for Human Cystic Echinococcosis in the Cusco Region of the Peruvian Highlands Diagnosed Using Focused Abdominal Ultrasound. Am J Trop Med Hyg 2017; 96:1472-1477. [PMID: 28719254 DOI: 10.4269/ajtmh.16-0882] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractLatin America is among the highly endemic regions for cystic echinococcosis (CE). In Peru, an estimated 1,139 disability-adjusted life years are lost annually from surgical treatment of CE. This is comparable with the combined total for Argentina, Brazil, Uruguay, and Chile. The prevalence of human infection has been investigated in the central Peruvian Andes, but there are no community-based screening data from other regions of Peru. We carried out a population survey in January 2015 using abdominal ultrasound to estimate the prevalence of abdominal CE in the Canas and Canchis provinces, in the Cusco region of Peru. Among 1,351 subjects screened, 41 (3%) had CE. There was significant variation between communities with similar socioeconomic features in a small geographical area. A history of CE was reported by 4.1% of the screened subjects, among whom 30.3% still had CE on ultrasound. Among patients reporting previous CE treatment, 14.9% had CE in active stages. Limited education, community of residence, and knowing people with CE in the community were associated with CE. These results demonstrate a significant burden of CE in the region and suggest the need for further investigations, control activities, and optimization of clinical management for CE in this area.
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Affiliation(s)
- Francesca Tamarozzi
- WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Amy Hou
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts
| | - Maria Luisa Morales
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru
| | | | - Freddy Vilca
- Hospital Alfredo Callo Rodriguez de Sicuani, Cusco, Peru
| | - Karen Mozo
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru
| | - Ruben Bascope
- Programa de Control de Enfermedades Zoonoticas, Direccion Regional de Salud Cusco, Cusco, Peru
| | - A Clinton White
- Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Enrico Brunetti
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.,Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Lin Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Miguel M Cabada
- Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas.,Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru
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11
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Baraquin A, Zait H, Grenouillet FE, Moreau E, Hamrioui B, Grenouillet F. Large-scale evaluation of a rapid diagnostic test for human cystic echinococcosis. Diagn Microbiol Infect Dis 2017. [PMID: 28647066 DOI: 10.1016/j.diagmicrobio.2017.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cystic echinococcosis (CE) is a neglected zoonotic disease, diagnosed through clinical findings, imaging techniques, and serology, for which many serological tests are available. Here we report a rapid unit assay, the immunochromatographic VIRapid® HYDATIDOSIS test (Vircell, Granada, Spain), potentially suitable for laboratories in low-prevalence or poorly equipped areas. This test was evaluated with a large retrospective cohort (224 sera), including patients suffering from CE or from other parasitic or liver diseases. The test was also assessed in routine conditions with a prospective cohort (115 sera) in areas where both cystic and alveolar echinococcoses have been diagnosed. Its performance (in terms of sensitivity, specificity, and both positive and negative likelihood ratios) was similar to an ELISA based on a crude antigen. Our study shows that this test performs adequately in the diagnostic process, when used with caution, especially regarding cross-reactivity with other parasitic diseases.
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Affiliation(s)
- Alice Baraquin
- Chrono-environnement, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne/Franche-Comté, Besançon, France
| | - Houria Zait
- Parasitology & Mycology Department, Mustapha University Hospital, Algiers, Algeria
| | - Florence-Elisabeth Grenouillet
- Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France
| | - Elise Moreau
- Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France
| | - Boussad Hamrioui
- Parasitology & Mycology Department, Mustapha University Hospital, Algiers, Algeria
| | - Frédéric Grenouillet
- Chrono-environnement, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne/Franche-Comté, Besançon, France; Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France.
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12
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Molecular Characteristics and Serodiagnostic Potential of Dihydrofolate Reductase from Echinococcus granulosus. Sci Rep 2017; 7:514. [PMID: 28364125 PMCID: PMC5428777 DOI: 10.1038/s41598-017-00643-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/07/2017] [Indexed: 02/02/2023] Open
Abstract
The larval stage of Echinococcus granulosus causes cystic echinococcosis (CE), a neglected tropical disease that leads to morbidity and mortality in humans and livestock worldwide. Here, we identified and characterized dihydrofolate reductase (Eg-DHFR) from E. granulosus, and evaluated its potential as a diagnostic antigen for sheep CE. Comparison between mammalian (host) DHFR and Eg-DHFR indicates that 45.7% of the 35 active site residues are different. Immunolocalisation analysis showed that native Eg-DHFR was widely distributed in all life-cycle stages of E. granulosus. Recombinant Eg-DHFR (rEg-DHFR) showed typical DHFR enzymatic parameters towards substrate, and was very sensitive to inhibition by methotrexate (IC50 = 27.75 ± 1.03 nM) and aminopterin (IC50 = 63.67 ± 6.76 nM). However, inhibition of DHFR exhibited little protoscolicidal effect in vitro. As there is no reliable method to monitor sheep CE, the immunogenicity of rEg-DHFR was detected, and we developed an indirect ELISA (iELISA) for CE serodiagnosis. The iELISA exhibited diagnostic specificity of 89.58%, diagnostic sensitivity of 95.83%, and the diagnostic accuracy was 91.67% compared with necropsy. Cross-reactivity assay showed analytical specificity of 85.7%. These suggest that rEg-DHFR is an effective antigen for the diagnosis of sheep CE.
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Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 258] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
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Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
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14
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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: 548] [Impact Index Per Article: 78.3] [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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Schwarz NG, Loderstaedt U, Hahn A, Hinz R, Zautner AE, Eibach D, Fischer M, Hagen RM, Frickmann H. Microbiological laboratory diagnostics of neglected zoonotic diseases (NZDs). Acta Trop 2017; 165:40-65. [PMID: 26391646 DOI: 10.1016/j.actatropica.2015.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 08/03/2015] [Accepted: 09/04/2015] [Indexed: 02/06/2023]
Abstract
This review reports on laboratory diagnostic approaches for selected, highly pathogenic neglected zoonotic diseases, i.e. anthrax, bovine tuberculosis, brucellosis, echinococcosis, leishmaniasis, rabies, Taenia solium-associated diseases (neuro-/cysticercosis & taeniasis) and trypanosomiasis. Diagnostic options, including microscopy, culture, matrix-assisted laser-desorption-ionisation time-of-flight mass spectrometry, molecular approaches and serology are introduced. These procedures are critically discussed regarding their diagnostic reliability and state of evaluation. For rare diseases reliable evaluation data are scarce due to the rarity of samples. If bio-safety level 3 is required for cultural growth, but such high standards of laboratory infrastructure are not available, serological and molecular approaches from inactivated sample material might be alternatives. Multiple subsequent testing using various test platforms in a stepwise approach may improve sensitivity and specificity. Cheap and easy to use tests, usually called "rapid diagnostic tests" (RDTs) may impact disease control measures, but should not preclude developing countries from state of the art diagnostics.
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Iraqi W. Diagnostic value of semi-purified antigens of hydatid cyst fluid in human cystic echinococcosis. Acta Parasitol 2016; 61:144-50. [PMID: 26751885 DOI: 10.1515/ap-2016-0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 10/07/2015] [Indexed: 11/15/2022]
Abstract
Cystic Echinococcosis (CE) is an infection caused by the larval stage of Echinococcus granulosus. The diagnosis of this disease has been problematic. Serological tests detecting antibodies against E. granulosus are the most popular and mainly use the crude Hydatid Cyst Fluid (HCF) or its components, Ag 5 and B. However, the diagnostic value of these tests is limited by the problems of specificity and/or sensitivity. The use of purified HCF antigens could be more helpful in the serodiagnosis of CE compared to the whole HCF. In the present study, we have evaluated the diagnostic value of semi-purified antigens using ELISA tests. Our results have shown that the 53 KDa antigen gave the best specificity (97.5%) and sensitivity (80%). We have also used Western Blot technique to analyze the serological profile against HCF. The results have confirmed that the most immunogenic component of HCF is the Ag 5.
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Arce MA, Limaylla H, Valcarcel M, Garcia HH, Santivañez SJ. Primary Giant Splenic Echinococcal Cyst Treated by Laparoscopy. Am J Trop Med Hyg 2015; 94:161-5. [PMID: 26556833 DOI: 10.4269/ajtmh.13-0505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/30/2015] [Indexed: 12/28/2022] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the dog tapeworm Echinococcus granulosus. Liver and lungs are the most commonly affected organs whereas splenic infection is rarer and its primary involvement occurs in less than 2% of abdominal CE. We report a case of primary giant splenic hydatid cyst in a 75-year-old Peruvian woman that was laparoscopically removed without any complications, perioperative prophylactic chemotherapy with albendazole 400 mg twice a day 5 days before, and 7 days after the surgical procedure was administered, postoperative recovery was uneventful, and; at her 3-month follow-up the patient remains asymptomatic and an abdominal computed tomography scan demonstrated a cystic cavity of 15 cm diameter with no daughter vesicles, neither other abdominal organ involvement. This case is in line with the existing literature on laparoscopical treatment of splenic cystic hydatid disease, suggesting that laparoscopical treatment is a safe and effective approach for large splenic hydatid cysts to be preferred to open surgical techniques.
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Affiliation(s)
- Maira A Arce
- Instituto Peruano de Parasitologia Clinica y Experimental (INPPACE), Lima, Perú; Department of Surgery, Hospital Nacional Dos de Mayo, Lima, Perú; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Center for Global Health, Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
| | - Himerón Limaylla
- Instituto Peruano de Parasitologia Clinica y Experimental (INPPACE), Lima, Perú; Department of Surgery, Hospital Nacional Dos de Mayo, Lima, Perú; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Center for Global Health, Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
| | - Maria Valcarcel
- Instituto Peruano de Parasitologia Clinica y Experimental (INPPACE), Lima, Perú; Department of Surgery, Hospital Nacional Dos de Mayo, Lima, Perú; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Center for Global Health, Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
| | - Hector H Garcia
- Instituto Peruano de Parasitologia Clinica y Experimental (INPPACE), Lima, Perú; Department of Surgery, Hospital Nacional Dos de Mayo, Lima, Perú; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Center for Global Health, Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
| | - Saul J Santivañez
- Instituto Peruano de Parasitologia Clinica y Experimental (INPPACE), Lima, Perú; Department of Surgery, Hospital Nacional Dos de Mayo, Lima, Perú; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Center for Global Health, Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
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Fotoohi S, Hashemi Tabar GR, Borji H. Serodiagnosis of human hydatidosis with an ELISA developed based on antigens derived from sheep hydatid cysts and comparison with a commercial human ELISA kit. ASIAN PAC J TROP MED 2014; 6:723-7. [PMID: 23827151 DOI: 10.1016/s1995-7645(13)60126-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/15/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To explore the serodiagnosis of hydatid cyst in human using different antigens of sheep (hydatid fluid, Somatic and Excretory/secretory antigens of protoscolex) by ELISA and compares this result with commercial human ELISA kit. METHODS One hundred blood samples from patients with history of severe abdominal pain and eosinophilia were obtained. Ten serum samples were obtained from surgically and pathologically confirmed cystic echinococcosis patients from Mashhad university hospital as positive control and 5 serum samples from infant under one year old as negative control. Blood samples were centrifuged at 3 000μg at 20 °C for 15 min and sera were stored at -20 °C. First, these samples were tested for the presence of antibody by commercial human ELISA. Then, ELISA was developed on microplates coated with hydatid fluid, Somatic and Excretory/secretory antigens of protoscolex of sheep. RESULTS The results of this study as analyzed by Kappa test showed that, hydatid fluid antigen could be used as a precise source of detection in indirect ELISA test. CONCLUSIONS Hydatid fluid in comparison with Excretory-secretory and somatic antigens showed more compatibility agreement in kappa test which can be used for further studies in development of any ELISA test for diagnosis of human hydatidosis.
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Affiliation(s)
- S Fotoohi
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
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[A case of hydatid cyst caused by Echinococcus granulosus in Puebla, Mexico, that resulted in successful surgical treatment]. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2013; 78:116-9. [PMID: 23643829 DOI: 10.1016/j.rgmx.2012.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 10/06/2012] [Accepted: 10/17/2012] [Indexed: 11/21/2022]
Abstract
We present herein the case of a 16-year-old female from the southern portion of the State of Puebla, Mexico. When gathering her past medical history, it was revealed that she had grown up with pet dogs and that her family raised sheep. Because the patient presented with few symptoms, a benign lesion was suspected, and after laparoscopic exploration, the possibility of surgical management for a non-parasitic cyst was considered. A dull pain in the right hypochondrium persisted and open surgical exploration was performed in which a 6cm young, active, uncomplicated hydatid cyst was discovered. Its surgical removal was successful and the pathologist provided the definitive diagnosis. The three layers characteristic of a parasitic cyst were present and it was histologically consistent with Echinococcus granulosus. Postoperative progression was unremarkable and the control ultrasound study revealed complete restitution of the hepatic parenchyma.
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20
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Budke CM, Carabin H, Ndimubanzi PC, Nguyen H, Rainwater E, Dickey M, Bhattarai R, Zeziulin O, Qian MB. A systematic review of the literature on cystic echinococcosis frequency worldwide and its associated clinical manifestations. Am J Trop Med Hyg 2013; 88:1011-27. [PMID: 23546806 DOI: 10.4269/ajtmh.12-0692] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence Proportion Ratio: 1.35 [95% Bayesian Credible Interval: 1.16-1.53]) and increased with age. The most common manifestations of hepatic and pulmonary CE were abdominal pain (57.3% [95% confidence interval [CI]: 37.3-76.1%]) and cough (51.3% [95% CI: 35.7-66.7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.
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Affiliation(s)
- Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.
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Barnes T, Deplazes P, Gottstein B, Jenkins D, Mathis A, Siles-Lucas M, Torgerson P, Ziadinov I, Heath D. Challenges for diagnosis and control of cystic hydatid disease. Acta Trop 2012; 123:1-7. [PMID: 22410539 DOI: 10.1016/j.actatropica.2012.02.066] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 02/14/2012] [Accepted: 02/26/2012] [Indexed: 12/12/2022]
Abstract
This paper is based on the experience of the authors, with the aim to define the challenges for Echinococcus granulosus (E.g./CE) diagnosis and control for those countries that may now or in the future be contemplating control of hydatid disease. A variety of methods are available for diagnosis in humans but a universal gold standard is lacking. Diagnosis in definitive hosts can avoid necropsy by the use of methods such as coproantigen detection but test performance is variable between populations. A sylvatic cycle adds challenges in some countries and the epidemiology of the parasite in these hosts is poorly understood. Control by solely administering praziquantel to dogs is not effective in developing countries where the disease is endemic. Additional avenues to pursue include the instigation of participatory planning, use of an existing vaccination for intermediate hosts and development of a vaccine and long-acting anthelmitic implants for definitive hosts. Promoting public acceptance of control of the dog population by humane euthanasia and reduced reproduction is also essential.
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Li Y, Xu H, Chen J, Gan W, Wu W, Wu W, Hu X. Gene cloning, expression, and localization of antigen 5 in the life cycle of Echinococcus granulosus. Parasitol Res 2011; 110:2315-23. [PMID: 22200957 DOI: 10.1007/s00436-011-2766-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 12/06/2011] [Indexed: 02/01/2023]
Abstract
Antigen 5 (Ag5) has been identified as a dominant component of cyst fluid of Echinococcus granulosus and is considered as a member of serine proteases family, which in other helminth, plays an important role in the egg hatch and larva invasion. However, whether Ag5 is expressed and secreted in all life stages is unknown. In this study, according to the sequence in GenBank, we cloned and sequenced the open reading frame (ORF) of Ag5 gene from the protoscolices of E. granulosus isolated from the sheep in Qinhai Province of China, and found several substitutions and a base insert and deletion in a short region near the stop code, leading to a frameshift mutation which is conserved with the homologue of other cestode. The ORF is 1,455 bp in length, encoding 484 amino acids with a secretory signal peptide. Bioinformatics analysis predicted several phosphorylation and myristoylation sites and a N-glycosylation site and a species-specific linear B epitope in the protein. The ORF was cloned into the plasmid pET28a(+) vector and expressed in Escherichia coli . The recombinant protein was purified by affinity chromatography. Anti-rEgAg5 antiserum was prepared in rats and used to analyze the localization of Ag5 in protoscolex and adult worm by immunofluorescence technique. Results demonstrated that the Ag5 is strongly expressed in the tegument of protoscolex and the embryonic membrane of egg and surface of oncosphere; meanwhile, it is also weakly expressed in tegument of the adult. This study showed that Ag5 is expressed in all stages of life cycle, secreted from the surface of the worm and may be anchored in membrane by its myristoylation sites; these characteristics make it a candidate antigen for diagnosis and vaccine for both intermediate and definitive hosts.
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Affiliation(s)
- Yuzhe Li
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
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Immunology and immunodiagnosis of cystic echinococcosis: an update. Clin Dev Immunol 2011; 2012:101895. [PMID: 22235225 PMCID: PMC3253442 DOI: 10.1155/2012/101895] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 09/28/2011] [Indexed: 12/24/2022]
Abstract
Cystic echinococcosis (CE) is a cosmopolitan zoonosis caused by the larval cystic stage of the dog tapeworm Echinococcus granulosus. This complex multicellular pathogen produces various antigens which modulate the host immune response and promote parasite survival and development. The recent application of modern molecular and immunological approaches has revealed novel insights on the nature of the immune responses generated during the course of a hydatid infection, although many aspects of the Echinococcus-host interplay remain unexplored. This paper summarizes recent developments in our understanding of the immunology and diagnosis of echinococcosis, indicates areas where information is lacking, and suggests possible new strategies to improve serodiagnosis for practical application.
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Post-treatment follow-up study of abdominal cystic echinococcosis in tibetan communities of northwest Sichuan Province, China. PLoS Negl Trop Dis 2011; 5:e1364. [PMID: 22039558 PMCID: PMC3201905 DOI: 10.1371/journal.pntd.0001364] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 09/02/2011] [Indexed: 12/23/2022] Open
Abstract
Background Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, with the liver as the most frequently affected organ, is known to be highly endemic in Tibetan communities of northwest Sichuan Province. Antiparasitic treatment with albendazole remains the primary choice for the great majority of patients in this resource-poor remote area, though surgery is the most common approach for CE therapy that has the potential to remove cysts and lead to complete cure. The current prospective study aimed to assess the effectiveness of community based use of cyclic albendazole treatment in Tibetan CE cases, and concurrently monitor the changes of serum specific antibody levels during treatment. Methodology/Principal Findings Ultrasonography was applied for diagnosis and follow-up of CE cases after cyclic albendazole treatment in Tibetan communities of Sichuan Province during 2006 to 2008, and serum specific IgG antibody levels against Echinococcus granulosus recombinant antigen B in ELISA was concurrently monitored in these cases. A total of 196 CE cases were identified by ultrasound, of which 37 (18.9%) showed evidence of spontaneous healing/involution of hepatic cyst(s) with CE4 or CE5 presentations. Of 49 enrolled CE cases for treatment follow-up, 32.7% (16) were considered to be cured based on B-ultrasound after 6 months to 30 months regular albendazole treatment, 49.0% (24) were improved, 14.3% (7) remained unchanged, and 4.1% (2) became aggravated. In general, patients with CE2 type cysts (daughter cysts present) needed a longer treatment course for cure (26.4 months), compared to cases with CE1 (univesicular cysts) (20.4 months) or CE3 type (detached cyst membrane or partial degeneration of daughter cysts) (9 months). In addition, the curative duration was longer in patients with large (>10 cm) cysts (22.3 months), compared to cases with medium (5–10 cm) cysts (17.3 months) or patients with small (<5 cm) cysts (6 months). At diagnosis, seven (53.8%) of 13 cases with CE1 type cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB). However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i) presenting as initial elevation followed by subsequent decline, or (ii) a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases. Conclusions This was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole. Cystic echinococcosis is a serious public health problem in Tibetan communities of northwest Sichuan Province, China. Antiparasitic treatment with albendazole remains the only choice in most cases, due to the poor socio-economy and inadequate hospital facilities in this area. A post-treatment follow-up study was carried out in community-detected 49 CE cases by application of abdominal ultrasound and serology with recombinant antigen B (rAgB) in a Tibetan region of Sichuan from 2006 to 2008. Following 6 to 30 months regular albendazole therapy, 32.7% of CE cases were considered cured at ultrasound, 49.0% were classed as improved, 14.3% remained unchanged or static, and 4.1% of cases became aggravated. The treatment course for cure was longer in patients with CE2 type cyst pathology compared to cases with CE1, CE3a or CE3b type cysts. In addition, patients with large cysts (≥10 cm) had a longer curative duration compared to those with medium cysts (5–10 cm) or small cysts (<5c m). The changes of serum specific IgG antibody levels against rAgB were not strongly associated with the viability of cystic echinococcal lesions, however, post-treatment specific IgG antibody positive sero-conversion in initially seronegative CE1 patients, was an indicator for the albendazole efficacy in specific CE patients.
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Sutherland JE, Sutphin D, Redican K, Rawlins F. Telesonography: foundations and future directions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:517-522. [PMID: 21460152 DOI: 10.7863/jum.2011.30.4.517] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The practice of telesonography has yielded promising results in several domestic and international projects aimed at providing basic sonography services. Common themes that recur within telesonography-based research include the quality of transmitted images, clinical applications, and technical and nontechnical barriers to implementation. The research base continues to grow in concert with expanding telecommunications capabilities and refinement of small portable sonographic devices. Persistent barriers to the deployment of telesonography systems include a lack of telecommunications access, a lack of standard training and operational protocols, and a paucity of research regarding the long-term health impact of telesonography within target communities. Telesonography may be used directly to improve the standard of care within a given community; however, limited resources and interest may prevent sustained operations. Future projects may use telesonography to supplement the training of health care providers in remote locations in an effort to establish permanent sonography services for their respective communities.
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Affiliation(s)
- James E Sutherland
- Edward Via Virginia College of Osteopathic Medicine, Virginia Polytechnic Institute, Blacksburg, Virginia, USA.
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Abstract
Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and reaspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective.
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Sutherland JE, Sutphin HD, Rawlins F, Redican K, Burton J. A comparison of telesonography with standard ultrasound care in a rural Dominican clinic. J Telemed Telecare 2009; 15:191-5. [PMID: 19471031 DOI: 10.1258/jtt.2009.080909] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We compared telesonography to usual patient care in a rural clinic in the Dominican Republic. A total of 108 low-income Dominican and Haitian patients volunteered to participate. The patients were randomly assigned to either telesonography or control groups. Patients in the telesonography group were scanned and sonographic images and Request for Interpretation (RFI) forms were sent by email to six volunteer radiologists in the USA. Completed RFI forms were transmitted back to the clinic at the radiologists' earliest convenience. Patients in the control group received an ordinary ultrasound referral, which required travel to a tertiary medical centre where their scans were completed by a local sonographer. Sonographic reports from the control group were hand delivered to the referring physician at patient follow-up. The telesonography system provided a four-fold increase in the proportion of patient follow-ups and a six-fold increase in the proportion of returned radiological reports. In the telemedicine group, the median total elapsed time from referral to report return was 17.8 h (interquartile range, IQR 12.2-27.1) and the median time to patient follow-up was 67.1 h (IQR 45.9-113.7). The latter was similar in the control group, where the median total elapsed time was 76.7 h (IQR 65.8-144.7). The pilot study demonstrated that store-and-forward telesonography reduced time to diagnosis and increased the continuity of care compared to the usual ultrasound referral system in the region of the Dominican Republic which was studied.
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Affiliation(s)
- James Eric Sutherland
- Department of International and Appalachian Outreach, Edward Via Virginia College of Osteopathic Medicine, Blacksburg, Virginia, USA.
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Abstract
Parasitic food-borne diseases are generally underrecognised, however they are becoming more common. Globalization of the food supply, increased international travel, increase of the population of highly susceptible persons, change in culinary habits, but also improved diagnostic tools and communication are some factors associated with the increased diagnosis of food-borne parasitic diseases worldwide. This paper reviews the most important emerging food-borne parasites, with emphasis on transmission routes. In a first part, waterborne parasites transmitted by contaminated food such as Cyclospora cayetanensis, Cryptosporidium and Giardia are discussed. Also human fasciolosis, of which the importance has only been recognised in the last decades, with total numbers of reported cases increasing from less than 3000 to 17 million, is looked at. Furthermore, fasciolopsiosis, an intestinal trematode of humans and pigs belongs to the waterborne parasites as well. A few parasites that may be transmitted through faecal contamination of foods and that have received renewed attention, such as Toxoplasma gondii, or that are (re-)emerging, such as Trypanosoma cruzi and Echinococcus spp., are briefly reviewed. In a second part, meat-borne parasite infections are reviewed. Humans get infected by eating raw or undercooked meat infected with cyst stages of these parasites. Meat inspection is the principal method applied in the control of Taenia spp. and Trichinella spp. However, it is often not very sensitive, frequently not practised, and not done for T. gondii and Sarcocystis spp. Meat of reptiles, amphibians and fish can be infected with a variety of parasites, including trematodes (Opisthorchis spp., Clonorchis sinensis, minute intestinal flukes), cestodes (Diphyllobothrium spp., Spirometra), nematodes (Gnathostoma, spp., anisakine parasites), and pentastomids that can cause zoonotic infections in humans when consumed raw or not properly cooked. Another important zoonotic food-borne trematode is the lungfluke (Paragonimus spp.). Traditionally, these parasitic zoonoses are most common in Asia because of the particular food practices and the importance of aquaculture. However, some of these parasites may emerge in other continents through aquaculture and improved transportation and distribution systems. Because of inadequate systems for routine diagnosis and monitoring or reporting for many of the zoonotic parasites, the incidence of human disease and parasite occurrence in food is underestimated. Of particular concern in industrialised countries are the highly resistant waterborne protozoal infections as well as the increased travel and immigration, which increase the exposure to exotic diseases. The increased demand for animal proteins in developing countries will lead to an intensification of the production systems in which the risk of zoonotic infections needs to be assessed. Overall, there is an urgent need for better monitoring and control of food-borne parasites using new technologies.
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Affiliation(s)
- P Dorny
- Department of Animal Health, Institute of Tropical Medicine, B-2000 Antwerp, Belgium.
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Akyildiz HY, Akcan A, Karahan I, Kucuk C, Sözüer E, Esin H. Recurrent liver hydatid disease: when does it become symptomatic and how does one diagnose it? Clin Imaging 2009; 33:55-8. [PMID: 19135931 DOI: 10.1016/j.clinimag.2008.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 05/10/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Echinococcosis is a zoonotic disease that mainly occurs in sheep-grazing areas. Recurrence of the disease and its diagnosis are relatively new areas of investigation due to the limited number of cases. The aim of this study was to evaluate the diagnosis of the symptomatic recurrent liver hydatid disease and the efficacy of abdominal ultrasonography (US). MATERIALS AND METHODS Between 1988 and 2006, 412 patients with hydatid cyst of the liver were operated at Erciyes University Medical Faculty. We have considered a growing cyst at the original operative site or at the neighboring hepatic tissue as recurrence and investigated 38 of them for the recurrence of the disease (9.2%). RESULTS The recurrence usually occurred after 2 years. The majority of the cases were Types 2 and 3 (24 cases; 8 were Type 4 and 6 were Type 1) according to Gharbi classification. In 35 patients with recurrent disease approved after surgical exploration, US was successful in preoperative diagnosis (100%). Overall, the recurrence was demonstrated correctly by means of US in 35 patients (92.1%), and 23 of 26 patients (88.4%) were correctly diagnosed with the use of computed tomography. In our study, in the first 2 years after the operation, the success rate of US examination was 72.7%. The success rate of US rose up to 100% when the frequency of recurrence is highest. CONCLUSION Beyond 2 years after surgery, US examination alone might be enough for the diagnosis of symptomatic recurrent liver hydatid disease in patients with the suspicion of recurrence. Postoperative early US profile and annual US examination must be performed for at least 5 years to prevent misinterpretation in doubtful cases.
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Affiliation(s)
- Hiizir Yakup Akyildiz
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey.
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Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis 2009; 13:125-33. [PMID: 18938096 DOI: 10.1016/j.ijid.2008.03.037] [Citation(s) in RCA: 606] [Impact Index Per Article: 40.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2007] [Revised: 02/29/2008] [Accepted: 03/03/2008] [Indexed: 12/13/2022] Open
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Gavidia CM, Gonzalez AE, Zhang W, McManus DP, Lopera L, Ninaquispe B, Garcia HH, Rodríguez S, Verastegui M, Calderon C, Pan WKY, Gilman RH. Diagnosis of cystic echinococcosis, central Peruvian Highlands. Emerg Infect Dis 2008; 14:260-6. [PMID: 18258119 PMCID: PMC2600205 DOI: 10.3201/eid1402.061101] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
High prevalence was confirmed by ultrasonography, radiography, and 2 serologic tests, although usefulness of serologic testing in the field was limited. We evaluated prevalence of cystic echinococcosis (CE) in a central Peruvian Highland district by using 4 diagnostic methods: ultrasonography for 949 persons, radiography for 829, and 2 serologic tests for 929 (2 immunoblot formats using bovine hydatid cyst fluid [IBCF] and recombinant EpC1 glutathione S-transferase [rEpC1-GST] antigens). For the IBCF and rEpC1-GST testing, prevalence of liver and pulmonary CE was 4.7% and 1.1% and seropositivity was 8.9% and 19.7%, respectively. Frequency of seropositive results for IBCF and rEpC1-GST testing was 35.7% and 16.7% (all hepatic cysts), 47.1% and 29.4% (hepatic calcifications excluded), and 22.2% and 33.3% (lung cysts), respectively. Weak immune response against lung cysts, calcified cysts, small cysts, and cysts in sites other than lung and liver might explain the poor performance of the serodiagnostic tests. We confirm that CE is highly endemic to Peru and emphasize the limited performance of available serologic assays in the field.
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Affiliation(s)
- Cesar M Gavidia
- Universidad Nacional Mayor de San Marcos, San Borja, Lima, Peru.
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Hemphill A, Spicher M, Stadelmann B, Mueller J, Naguleswaran A, Gottstein B, Walker M. Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis. Parasitology 2007; 134:1657-70. [PMID: 17631693 DOI: 10.1017/s0031182007003198] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Echinococcus granulosus and Echinococcus multilocularis are cestode parasites, of which the metacestode (larval) stages cause the diseases cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Albendazole and mebendazole are presently used for chemotherapeutical treatment. However, these benzimidazoles do not appear to be parasiticidal in vivo against AE. In addition, failures in drug treatments as well as the occurrence of side-effects have been reported. New drugs are needed to cure AE and CE, which are considered to be neglected diseases. Strategies currently being implemented to identify novel chemotherapeutical treatment options include (i) conventional primary in vitro testing of broad-spectrum anti-infective drugs, either in parallel with, or followed by, animal experimentation; (ii) studies of drugs which interfere with the proliferation of cancer cells and of Echinococcus metacestodes; (iii) exploitation of the similarities between the parasite and mammalian signalling machineries, with a special focus on targeting specific signalling receptors; (iv) in silico approaches, employing the current Echinococcus genomic database information to search for suitable targets for compounds with known modes of action. In the present article, we review the efforts toward obtaining better anti-parasitic compounds which have been undertaken to improve chemotherapeutical treatment of echinococcosis, and summarize the achievements in the field of host-parasite interactions which may also lead to new immuno-therapeutical options.
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Affiliation(s)
- A Hemphill
- Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland.
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van Doorn HR, Wentink-Bonnema E, Rentenaar RJ, van Gool T. Specific cross-reactivity in sera from cystic echinococcosis patients in an enzyme-linked immunoelectrotransfer blot for cysticercosis diagnostics. Trans R Soc Trop Med Hyg 2007; 101:948-50. [PMID: 17597175 DOI: 10.1016/j.trstmh.2007.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 04/18/2007] [Accepted: 04/18/2007] [Indexed: 11/18/2022] Open
Abstract
A commercially available enzyme-linked immunoelectrotransfer blot originally intended for diagnosis of cysticercosis was evaluated for echinococcosis diagnosis, because a characteristic band pattern--different from the specific cysticercosis pattern--was observed in sera from patients with echinococcosis. This band pattern was observed in 29 (78%) of 37 parasitologically proven cystic echinococcosis patients. Specificity of these bands was 100% for echinococcosis, when tested with 75 control sera.
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Affiliation(s)
- H Rogier van Doorn
- Section of Parasitology, Department of Medical Microbiology, Academic Medical Center, Room L1-245, University of Amsterdam, P.O. Box 22660, 1100DD Amsterdam, The Netherlands.
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Craig PS, McManus DP, Lightowlers MW, Chabalgoity JA, Garcia HH, Gavidia CM, Gilman RH, Gonzalez AE, Lorca M, Naquira C, Nieto A, Schantz PM. Prevention and control of cystic echinococcosis. THE LANCET. INFECTIOUS DISEASES 2007; 7:385-94. [PMID: 17521591 DOI: 10.1016/s1473-3099(07)70134-2] [Citation(s) in RCA: 358] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Human cystic echinococcosis (hydatid disease) continues to be a substantial cause of morbidity and mortality in many parts of the world. Elimination is difficult to obtain and it is estimated that, using current control options, achieving such a goal will take around 20 years of sustained efforts. Since the introduction of current (and past) hydatid control campaigns, there have been clear technological improvements made in the diagnosis and treatment of human and animal cystic echinococcosis, the diagnosis of canine echinococcosis, and the genetic characterisation of strains and vaccination against Echinococcus granulosus in animals. Incorporation of these new measures could increase the efficiency of hydatid control programmes, potentially reducing the time required to achieve effective prevention of disease transmission to as little as 5-10 years.
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Affiliation(s)
- Philip S Craig
- Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford, UK
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Abstract
Echinococcosis is a cosmopolitan zoonosis caused by adult or larval stages of cestodes belonging to the genus Echinococcus (family Taeniidae). The two major species of medical and public health importance are Echinococcus granulosus and Echinococcus multilocularis, which cause cystic echinococcosis and alveolar echinococcosis, respectively. Both cystic echinococcosis and alveolar echinococcosis are serious diseases, the latter especially so, with a high fatality rate and poor prognosis if managed inappropriately. This review highlights recent advances in immunity to infection and vaccination against both parasites in their intermediate and definitive hosts and procedures for diagnosis of cystic echinococcosis and alveolar echinococcosis, including the value of immunodiagnostic and DNA approaches. There is discussion also of progress in genomics and related technologies that is providing valuable insights on the functional biology of the Echinococcus organisms. These studies will underpin future research that will reveal a better understanding of the Echinococcus-host interplay, and suggest new avenues for the identification of additional targets for diagnosis, vaccination and chemotherapy.
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Affiliation(s)
- Wenbao Zhang
- Molecular Parasitology Laboratory, Australian Centre for International and Tropical Health and Nutrition, The Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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Rogan MT, Hai WY, Richardson R, Zeyhle E, Craig PS. Hydatid cysts: does every picture tell a story? Trends Parasitol 2006; 22:431-8. [PMID: 16843726 DOI: 10.1016/j.pt.2006.07.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 06/06/2006] [Accepted: 07/03/2006] [Indexed: 12/29/2022]
Abstract
Ultrasound imaging is an effective aid to the detection of abdominal cystic echinococcosis. Recently, the images produced have provided more information than just a diagnosis. Different cyst morphologies have been classified into types, and such classifications can be considered to represent a natural history of cyst development. Understanding how cyst structures alter with time is crucial to evaluating the effectiveness of different treatment regimes and to understanding natural degeneration of cysts that can occur. However, the developmental events seen in ultrasound need to be matched more closely to immunological and cellular events if we are to have a fuller appreciation of disease progression and regression. At a community level, the relative proportions of cyst types could also provide epidemiological information on disease transmission.
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Affiliation(s)
- Michael T Rogan
- Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Salford M5 4WT, UK.
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