1
|
Wang Z, Wu M, Liu Q, Wang X, Yan C, Song T. Multiclassification of Hepatic Cystic Echinococcosis by Using Multiple Kernel Learning Framework and Ultrasound Images. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1034-1044. [PMID: 38679514 DOI: 10.1016/j.ultrasmedbio.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/10/2024] [Accepted: 03/30/2024] [Indexed: 05/01/2024]
Abstract
To properly treat and care for hepatic cystic echinococcosis (HCE), it is essential to make an accurate diagnosis before treatment. OBJECTIVE The objective of this study was to assess the diagnostic accuracy of computer-aided diagnosis techniques in classifying HCE ultrasound images into five subtypes. METHODS A total of 1820 HCE ultrasound images collected from 967 patients were included in the study. A multi-kernel learning method was developed to learn the texture and depth features of the ultrasound images. Combined kernel functions were built-in Support Vector Machine (MK-SVM) for the classification work. The experimental results were evaluated using five-fold cross-validation. Finally, our approach was compared with three other machine learning algorithms: the decision tree classifier, random forest, and gradient boosting decision tree. RESULTS Among all the methods used in the study, the MK-SVM achieved the highest accuracy of 96.6% on the fused feature set. CONCLUSION The multi-kernel learning method effectively learns different image features from ultrasound images by utilizing various kernels. The MK-SVM method, which combines the learning of texture features and depth features separately, has significant application value in HCE classification tasks.
Collapse
Affiliation(s)
- Zhengye Wang
- Center for Disease Control and Prevention, Xinjiang Production and Construction Corps, Urumqi, China; Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Miao Wu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Qian Liu
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Xiaorong Wang
- Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Tao Song
- Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
| |
Collapse
|
2
|
Zhang Y, Wu J, Adili S, Wang S, Zhang H, Shi G, Zhao J. Prevalence and spatial distribution characteristics of human echinococcosis: A county-level modeling study in southern Xinjiang, China. Heliyon 2024; 10:e28812. [PMID: 38596126 PMCID: PMC11002248 DOI: 10.1016/j.heliyon.2024.e28812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives Human echinococcosis remains an important public health problem. The aim of this study was to analyze the prevalence and spatial distribution characteristics of human echinococcosis cases in southern Xinjiang, China from 2005 to 2021. Methods Human echinococcosis cases were collected from the National Infectious Disease Reporting System. Joinpoint regression analysis was performed to explore the trends. Spatial autocorrelation, hot spot analysis, as well as spatial-temporal clustering analysis were conducted to confirm the distribution and risk factors. Results A total of 4580 cases were reported in southern Xinjiang during 2005-2021, with a mean annual incidence of 2.56/100,000. Echinococcosis incidence showed an increasing trend from 2005 to 2017 (APC = 17.939, 95%CI: 13.985 to 22.029) and a decreasing trend from 2017 to 2021 (APC = -18.769, 95%CI: 28.157 to -8.154). Echinococcosis cases had a positive spatial autocorrelation in 2005-2021 (Moran's I = 0.19, P < 0.05). The disease hotspots were located in the east and west in these areas, then returned to the east clusters, including Hejing, Heshuo, Wuqia, Atushi, Aheqi, and Yanqi Hui Autonomous County. Meanwhile, spatial-temporal analysis identified the first cluster comprised of five counties (cities): Yanqi Hui Autonomous County, Korla City, Bohu County, Hejing County, and Heshuo County. And secondary clusters 1-3 are predominantly in Wushi County, Aheqi County, Keping County, Atushi City, Wuqia County and Cele County. Conclusions Our findings suggest that echinococcosis is still an important zoonotic parasitic disease in southern Xinjiang, yet it showed a certain degree of spatial clustering. It is crucial to implement comprehensive prevention and control measures to effectively combat the epidemic of echinococcosis.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Jun Wu
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Simayi Adili
- Xinjiang Autonomous Regional Center for Disease Control and Prevention, Urumqi, 830002, China
| | - Shuo Wang
- Xinjiang Autonomous Regional Center for Disease Control and Prevention, Urumqi, 830002, China
| | - Haiting Zhang
- Xinjiang Autonomous Regional Center for Disease Control and Prevention, Urumqi, 830002, China
| | - Guangzhong Shi
- Xinjiang Autonomous Regional Center for Disease Control and Prevention, Urumqi, 830002, China
| | - Jiangshan Zhao
- Xinjiang Autonomous Regional Center for Disease Control and Prevention, Urumqi, 830002, China
| |
Collapse
|
3
|
Gu H, Hu Y, Guo S, Jin Y, Chen W, Huang C, Hu Z, Li F, Liu J. China's prevention and control experience of echinococcosis: A 19-year retrospective. J Helminthol 2024; 98:e16. [PMID: 38305033 DOI: 10.1017/s0022149x24000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People's Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.
Collapse
Affiliation(s)
- H Gu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Y Hu
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - S Guo
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Y Jin
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - W Chen
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - C Huang
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - Z Hu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - F Li
- Department of Biliary Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| | - J Liu
- Laboratory of Infectious Diseases and Vaccines, West China School of Medicine, West China Hospital of Sichuan University, Chengdu610041, PR China
| |
Collapse
|
4
|
Ma T, Wang Q, Hao M, Xue C, Wang X, Han S, Wang Q, Zhao J, Ma X, Wu X, Jiang X, Cao L, Yang Y, Feng Y, Gongsang Q, Scheffran J, Fang L, Maude RJ, Zheng C, Ding F, Wu W, Jiang D. Epidemiological characteristics and risk factors for cystic and alveolar echinococcosis in China: an analysis of a national population-based field survey. Parasit Vectors 2023; 16:181. [PMID: 37270512 DOI: 10.1186/s13071-023-05788-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Human cystic and alveolar echinococcosis are neglected tropical diseases that WHO has prioritized for control in recent years. Both diseases impose substantial burdens on public health and the socio-economy in China. In this study, which is based on the national echinococcosis survey from 2012 to 2016, we aim to describe the spatial prevalence and demographic characteristics of cystic and alveolar echinococcosis infections in humans and assess the impact of environmental, biological and social factors on both types of the disease. METHODS We computed the sex-, age group-, occupation- and education level-specific prevalences of cystic and alveolar echinococcosis at national and sub-national levels. We mapped the geographical distribution of echinococcosis prevalence at the province, city and county levels. Finally, by analyzing the county-level echinococcosis cases combined with a range of associated environmental, biological and social factors, we identified and quantified the potential risk factors for echinococcosis using a generalized linear model. RESULTS A total of 1,150,723 residents were selected and included in the national echinococcosis survey between 2012 and 2016, of whom 4161 and 1055 tested positive for cystic and alveolar echinococcosis, respectively. Female gender, older age, occupation at herdsman, occupation as religious worker and illiteracy were identified as risk factors for both types of echinococcosis. The prevalence of echinococcosis was found to vary geographically, with areas of high endemicity observed in the Tibetan Plateau region. Cystic echinococcosis prevalence was positively correlated with cattle density, cattle prevalence, dog density, dog prevalence, number of livestock slaughtered, elevation and grass area, and negatively associated with temperature and gross domestic product (GDP). Alveolar echinococcosis prevalence was positively correlated with precipitation, level of awareness, elevation, rodent density and rodent prevalence, and negatively correlated with forest area, temperature and GDP. Our results also implied that drinking water sources are significantly associated with both diseases. CONCLUSIONS The results of this study provide a comprehensive understanding of geographical patterns, demographic characteristics and risk factors of cystic and alveolar echinococcosis in China. This important information will contribute towards developing targeted prevention measures and controlling diseases from the public health perspective.
Collapse
Affiliation(s)
- Tian Ma
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qian Wang
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mengmeng Hao
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chuizhao Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Xu Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Shuai Han
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Qian Wang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jiangshan Zhao
- Xingjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Xiao Ma
- Qinghai Institute for Endemic Disease Prevention and Control, Xining, Qinghai, China
| | - Xianglin Wu
- Ningxia Center for Disease Control and Prevention, Yinchuan, Ningxia, China
| | - Xiaofeng Jiang
- Inner Mongolia Autonomous Region Center for Diseases Control and Prevention, Hohhot, Inner Mongolia, China
| | - Lei Cao
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yaming Yang
- Yunnan Institute of Parasitic Diseases, Puer, Yunnan, China
| | - Yu Feng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Quzhen Gongsang
- Tibet Center for Diseases Control and Prevention, Lhasa, Tibet, China
| | - Jürgen Scheffran
- Institute of Geography, Center for Earth System Research and Sustainability, University of Hamburg, 20144, Hamburg, Germany
| | - Liqun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Richard James Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA
- The Open University, Milton Keynes, UK
| | - Canjun Zheng
- Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Fangyu Ding
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Weiping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.
| | - Dong Jiang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China.
- Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Natural Resources, Beijing, China.
| |
Collapse
|
5
|
Wang Z, Kuerban K, Zhou Z, Hailati M, Aihematiniyazi R, Wang X, Yan C. HCEs-Net: Hepatic cystic echinococcosis classification ensemble model based on tree-structured Parzen estimator and snap-shot approach. Med Phys 2023. [PMID: 37183479 DOI: 10.1002/mp.16444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Hepatic cystic echinococcosis (HCE) still has a high misdiagnosis rate, and misdiagnosis may lead to wrong treatments seriously harmful for the patients. Precise diagnosis of HCE relies heavily on the experience of clinical experts with auxiliary diagnostic tools using medical images. PURPOSE This paper intends to improve the diagnostic accuracy for HCE by employing a method which combines deep learning with ensemble method. METHODS We proposed a method, namely HCEs-Net, for classification of five HCE subtypes using ultrasound images. It takes first the snap-shot strategy to obtain sub-models from the pre-trained VGG19, ResNet18, ViT-Base, and ConvNeXt-T models, then a stacking process to ensemble those sub-models. Afterwards, it uses the tree-structured Pazren estimator (TPE) to optimize the hyperparameters. The experiments were evaluated by the five-fold cross-validation process. RESULTS A total of 3083 abdominal ultrasound images from 972 patients covering five subtypes of HCE were utilized in this study. The experiments were conducted to predict the HCE subtype, and results of modeling performance evaluation were reported in terms of precision, recall, F1-score, and AUC. The stacking model based on three ConvNeXt-T sub-models showed the best performance, with precision 85.9%, recall 85.5%, F1-score 85.7%, and AUC 0.971 which are higher than the compared state-of-the-art models. CONCLUSION The stacking model of three ConvNeXt-T sub-models shows comparable or superior performance to the other methods, including VGG19, ResNet18 and ViT-Base. It has the potential to enhance clinical diagnosis for HCE.
Collapse
Affiliation(s)
- Zhengye Wang
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Kadiliya Kuerban
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zihang Zhou
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | | | | | - Xiaorong Wang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Abdominal Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering Technology, Xinjiang Medical University, Urumqi, China
| |
Collapse
|
6
|
Dursahinhan AT, Kenkel DA, Gardner SL. Helminth and protozoan parasites of subterranean rodents (Chordata, Mammalia, Rodentia) of the world. Zookeys 2023; 1151:159-203. [DOI: 10.3897/zookeys.1151.97126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/04/2023] [Indexed: 03/05/2023] Open
Abstract
Published studies and ten new unpublished records included herein reveal that approximately 174 species of endoparasites (helminths and protozoans) are known from 65 of 163 species of rodents that occupy the subterranean ecotope globally. Of those, 94 endoparasite species were originally described from these rodents. A total of 282 host-parasite associations are summarized from four major zoogeographic regions including Ethiopian, Palearctic/Oriental, Nearctic, and Neotropical. Thirty-four parasite records from the literature have been identified to only the level of the genus. In this summary, ten new records have been added, and the most current taxonomic status of each parasite species is noted. Interestingly, there are no data on endoparasites from more than 68% of described subterranean rodents, which indicates that discovery and documentation are at an early stage and must continue.
Collapse
|
7
|
Pulmonary hydatid cyst mimicking lung tumor in a heavy smoker patient— Uniportal VATS management. Int J Surg Case Rep 2022; 95:107138. [PMID: 35576750 PMCID: PMC9112121 DOI: 10.1016/j.ijscr.2022.107138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Human infection with E. granulosus leads to the development of one or more hydatid cysts located most often in the liver and lungs. However, radiologically and clinically, analysis of atypical or complicated pulmonary hydatid cysts may resemble other types of malignancies. Case presentation Here, we present a 65-year-old man presented with chest pain, loss of appetite, and weight loss for 6 months' duration. The patient was surgically treated for a pulmonary hydatid cyst that mimicked a lung tumor clinically and radiologically. The patient underwent surgery using a uniportal video-assisted thoracoscopic surgery (UVATS) approach. The patient was put on an anti-helminthic drug (Albendazole table 400 mg twice daily for 21 days and 14 days off). He will continue for 3 cycles on this schedule. Discussion The diagnosis of pulmonary hydatid cyst depends mainly on the imaging procedures supported by appropriate serology and often histopathology. The treatment of choice for the pulmonary hydatid cyst is surgical resection. The uniportal video-assisted thoracoscopic surgery (UVATS) method has been proven to be safe and effective around globally. This includes a shorter surgery time, less pain, less chest tube drainage, and less need for painkillers after the surgery. Conclusion In this report, we present a case of a radiologically and clinically pulmonary hydatid cyst mimicking a lung tumor. In the differential diagnosis of a lung tumor, a pulmonary hydatid cyst should be considered particularly in endemic regions. Atypical or complicated pulmonary hydatid cysts may resemble other types of malignancies radiologically and clinically. In the differential diagnosis of a lung tumor, a pulmonary hydatid cyst should be considered. Uniportal VATS approach is simple, safe and feasible for removal of pulmonary hydatid cyst.
Collapse
|
8
|
Wang L, Gongsang Q, Pang H, Qin M, Wang Y, Li J, Frutos R, Gavotte L. Assessment of echinococcosis control in Tibet Autonomous Region, China. Infect Dis Poverty 2022; 11:59. [PMID: 35619124 PMCID: PMC9137097 DOI: 10.1186/s40249-022-00987-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In China the highest prevalence of echinococcosis is in Tibet Autonomous Region (TAR). The government has issued documents and implemented comprehensive prevention and control measures focusing on controlling the source of infection of echinococcosis. It was very important to understand the implementation and effect of infectious source control measures. The purpose of this study was to examine the implementation of measures to control infectious source (domestic and stray dogs) in TAR and to assess their effectiveness. METHODS We collected data on domestic dog registration and deworming and stray dog sheltering in 74 counties/districts in the TAR from 2017 to 2019. Fecal samples from domestic dogs were collected from randomly selected towns to determine Echinococcus infection in dogs using coproantigen ELISA. We analyzed the data to compare the canine rate of infection between 2016 and 2019. The data analysis was performed by SPSS statistical to compare dog infection rate in 2016 and 2019 by chi-square test, and ArcGIS was used for mapping. RESULTS From 2017 to 2019, 84 stray dog shelters were built in TAR, and accumulatively 446,660 stray or infected dogs were arrested, sheltered, or disposed of. The number of domestic dogs went downward, with an increased registration management rate of 78.4% (2017), 88.8% (2018), and 99.0% (2019). Dogs were dewormed 5 times in 2017, 12 times in 2018, and 12 times in 2019. The dog infection rate was 1.7% (252/14,584) in 2019, significantly lower than 7.3% (552/7564) from the survey of echinococcosis prevalence in Tibet in 2016 (P < 0.05). CONCLUSION Between 2017 and 2019, the number of stray dogs and infection rate of Echinococcus spp. in domestic dogs decreased significantly, indicating that dogs were effectively controlled as a source of infection in TAR and reflecting a significant decrease in the risk of echinococcosis transmission.
Collapse
Affiliation(s)
- Liying Wang
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, 200025, China. .,Tibet Center for Disease Control and Prevention, NHC Key Laboratory of Echinococcosis Prevention and Control, Lhasa, 850000, China. .,Cirad, UMR 17, Intertryp, Campus international de Baillarguet, 34398, Montpellier, France. .,Espace-Dev, UMR D-228, Université de Montpellier, 34000, Montpellier, France.
| | - Quzhen Gongsang
- Tibet Center for Disease Control and Prevention, NHC Key Laboratory of Echinococcosis Prevention and Control, Lhasa, 850000, China
| | - Huasheng Pang
- Tibet Center for Disease Control and Prevention, NHC Key Laboratory of Echinococcosis Prevention and Control, Lhasa, 850000, China
| | - Min Qin
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Ying Wang
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Jingzhong Li
- Tibet Center for Disease Control and Prevention, NHC Key Laboratory of Echinococcosis Prevention and Control, Lhasa, 850000, China.
| | - Roger Frutos
- Cirad, UMR 17, Intertryp, Campus international de Baillarguet, 34398, Montpellier, France
| | - Laurent Gavotte
- Espace-Dev, UMR D-228, Université de Montpellier, 34000, Montpellier, France
| |
Collapse
|
9
|
Kronenberg PA, Deibel A, Gottstein B, Grimm F, Müllhaupt B, Meyer zu Schwabedissen C, Aitbaev S, Omorov RA, Abdykerimov KK, Minbaeva G, Usubalieva J, Siles-Lucas M, Pepe P, Rinaldi L, Spiliotis M, Wang J, Müller N, Torgerson PR, Deplazes P. Serological Assays for Alveolar and Cystic Echinococcosis—A Comparative Multi-Test Study in Switzerland and Kyrgyzstan. Pathogens 2022; 11:pathogens11050518. [PMID: 35631039 PMCID: PMC9146094 DOI: 10.3390/pathogens11050518] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
Both alveolar (AE) and cystic echinococcosis (CE) are lacking pathognomonic clinical signs; consequently imaging technologies and serology remain the main pillars for diagnosis. The present study included 100 confirmed treatment-naïve AE and 64 CE patients that were diagnosed in Switzerland or Kyrgyzstan. Overall, 10 native Echinococcus spp. antigens, 3 recombinant antigens, and 4 commercial assays were comparatively evaluated. All native E. multilocularis antigens were produced in duplicates with a European and a Kyrgyz isolate and showed identical test values for the diagnosis of AE and CE. Native antigens and three commercial tests showed high diagnostic sensitivities (Se: 86–96%) and specificities (Sp: 96–99%) for the diagnosis of AE and CE in Swiss patients. In Kyrgyz patients, values of sensitivities and specificities were 10–20% lower as compared to the Swiss patients’ findings. For the sero-diagnosis of AE in Kyrgyzstan, a test-combination of an E. multilocularis protoscolex antigen and the recombinant antigen Em95 appears to be the most suitable test strategy (Se: 98%, Sp: 87%). For the diagnosis of CE in both countries, test performances were hampered by major cross-reactions with AE patients and other parasitic diseases as well as by limited diagnostic sensitivities (93% in Switzerland and 76% in Kyrgyzstan, respectively).
Collapse
Affiliation(s)
- Philipp A. Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
| | - Ansgar Deibel
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Bruno Gottstein
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Felix Grimm
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
| | - Beat Müllhaupt
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Cordula Meyer zu Schwabedissen
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Sezdbek Aitbaev
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Rakhatbek A. Omorov
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Kubanychbek K. Abdykerimov
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
- Life Science Zürich Graduate School, University of Zürich, 8057 Zurich, Switzerland
| | - Gulnara Minbaeva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Jumagul Usubalieva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiologia (IRNASA-CSIC), 37008 Salamanca, Spain;
| | - Paola Pepe
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Laura Rinaldi
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Markus Spiliotis
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Junhua Wang
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland;
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
| |
Collapse
|
10
|
Graeter T, Schmidberger J. Stage-Oriented CT Classification and Intermodal Evolution Model in Hepatic Alveolar Echinococcosis. ROFO-FORTSCHR RONTG 2022; 194:532-544. [PMID: 35081647 PMCID: PMC9133419 DOI: 10.1055/a-1710-3669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Alveolar echinococcosis (AE) is one of the most dangerous human parasitoses. The main site of disease manifestation is the liver (about 98 %). The Echinococcus Multilocularis Ulm Classification for Computed Tomography (EMUC-CT), presented in 2016, was the first compilation of CT morphological criteria of hepatic AE. Studies based on EMUC-CT made it possible to draw conclusions about the development of the lesions in the course of disease beyond purely diagnostic typing. Among the most important findings of these precursor studies was that EMUC-CT type IV presented as an initial lesion, whereas EMUC-CT type III lesions were mostly associated with an advanced disease constellation. An intermodal view of image morphological criteria provides further multi-layered indications for lesion evolution. Method With the “Alveolar Echinococcosis Ulm Classification” (AEUC), a revision of the previous EMUC-CT was carried out with stage-oriented reorganization of the primary morphologies. Furthermore, an intermodal classification scheme for the evolution of hepatic AE lesions based on AEUC, MRI Kodama classification, and aspects of ultrasound could be outlined. Results The first stage-oriented CT classification of hepatic AE “AEUC” is based with respect to its lesion characterization on the separate consideration of two classification pillars, the five “primary morphologies”, AEUC I–V (AEUC II–IV with subcriteria) and the five “patterns of calcification”. In addition, an intermodal classification scheme presents five stages of lesion evolution: “initial stage”, “progressive stage”, “advanced stage”, “transitional stage” and “regressive stage”. Conclusion The imaging modalities differ with respect to their visualization of lesion criteria. This underlines the need for unimodal classification systems. Staging of an AE lesion can be done more accurately by evaluating different modalities. Key Points: Citation Format
Collapse
Affiliation(s)
- Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Germany
| | | |
Collapse
|
11
|
Wang L, Quzhen G, Qin M, Liu Z, Pang H, Frutos R, Gavotte L. Geographic distribution and prevalence of human echinococcosis at the township level in the Tibet Autonomous Region. Infect Dis Poverty 2022; 11:10. [PMID: 35063031 PMCID: PMC8780799 DOI: 10.1186/s40249-022-00933-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Echinococcosis, a zoonotic parasitic disease, is caused by larval stages of cestodes in the Echinococcus genus. Echinococcosis is highly prevalent in ten provinces/autonomous regions of western and northern China. In 2016, an epidemiological survey of Tibet Autonomous Region (TAR) revealed that the prevalence of human echinococcosis was 1.66%, which was much higher than the average prevalence in China (0.24%). Therefore, to improve on the current prevention and control measures, it is important to understand the prevalence and spatial distribution characteristics of human echinococcosis at the township level in TAR. Methods Data for echinococcosis cases in 2018 were obtained from the annual report system of echinococcosis of Tibet Center for Disease Control and Prevention. Diagnosis had been performed via B-ultrasonography. The epidemic status of echinococcosis in all townships in TAR was classified according to the relevant standards of population prevalence indices as defined in the national technical plan for echinococcosis control. Spatial scan statistics were performed to establish the geographical townships that were most at risk of echinococcosis. Results In 2018, a total of 16,009 echinococcosis cases, whose prevalence was 0.53%, were recorded in 74 endemic counties in TAR. Based on the order of the epidemic degree, all the 692 townships were classified from high to low degrees. Among them, 127 townships had prevalence rates ≥ 1%. The high prevalence of human echinococcosis in TAR, which is associated with a wide geographic distribution, is a medical concern. Approximately 94.65% of the villages and towns reported echinococcosis cases. According to spatial distribution analysis, the prevalence of human echinococcosis was found to be clustered, with the specific clustering areas being identified. The cystic echinococcosis primary cluster covered 88 townships, while that of alveolar echinococcosis’s covered 38 townships. Conclusions This study shows spatial distributions of echinococcosis with different epidemic degrees in 692 townships of TAR and high-risk cluster areas at the township level. Our findings indicate that strengthening the echinococcosis prevention and control strategies in TAR should directed at townships with a high prevalence and high-risk clustering areas. Graphical Abstract ![]()
Collapse
|
12
|
Pang MQ, Lu YQ, Tang F, Wang HJ, Zhou Y, Ren L, Li RL, Zhou H, Wan CF, Liu CC, Luosang D, Yangdan C, Fan HN. Prediction and identification of epitopes in the Echinococcus multilocularis thrombospondin 3 antigen. Technol Health Care 2022; 30:799-814. [PMID: 35068426 PMCID: PMC9398089 DOI: 10.3233/thc-212983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND: Alveolar echinococcosis is an epidemic disease caused by the parasitism of Echinococcus multilocularis (Em) larvae in the intermediate or final host. OBJECTIVE: To identify and analyze B-cell and T-cell (Th1, Th2, and Th17) epitopes of the Em antigen protein thrombospondin 3 (TSP3). METHODS: The amino acid sequence of TSP3 was obtained, and the secondary structural characteristics of TSP3 were predicted using bioinformatics software to further predict its potential T-cell and B-cell epitopes. The spleen lymphocytes of BALB/c mice, which were immunized with the TSP3 protein, were collected for co-culture with B-cell and T-cell antigen small peptides. The B-cell epitopes and T-cell epitope subtypes Th1, Th2, and Th17 were identified as having good immunogenicity. RESULTS: After identification, it was found that the predominant epitopes of B cells existing in TSP3 were T18-33, T45-55, and T110-122. Furthermore, the predominant epitopes of T cells existing in TSP3 were T33-42, T45-55, T80-90, and T110-122 in the T1 subtype, T45-55, T68-77, and T92-104 in the Th2 subtype, and T53-63 and T80-90 in the Th17 subtype. CONCLUSIONS: Six T-cell and eight B-cell dominant epitopes of the TSP3 antigen were revealed; these results may be applied in the development of a dominant epitope vaccine.
Collapse
Affiliation(s)
- Ming-Quan Pang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Yue-Qing Lu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Feng Tang
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Hai-Jiu Wang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Ying Zhou
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Li Ren
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Run-Le Li
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Hu Zhou
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Chen-Fei Wan
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Chuan-Chuan Liu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Dawa Luosang
- Research Center for High Altitude Medical Sciences, Qinghai University School of Medicine, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Cairang Yangdan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| | - Hai-Ning Fan
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China
- Qinghai Provincial Research Key Laboratory for Hydatid, Xining, Qinghai, China
| |
Collapse
|
13
|
Wu M, Yan C, Wang X, Liu Q, Liu Z, Song T. Automatic Classification of Hepatic Cystic Echinococcosis Using Ultrasound Images and Deep Learning. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:163-174. [PMID: 33710638 DOI: 10.1002/jum.15691] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Hepatic cystic echinococcosis is the main form of hepatic echinococcosis, which is a life-threatening liver disease caused by parasites that requires a precise diagnosis and proper treatment. OBJECTIVE This study focuses on the automatic classification system of five different subtypes of hepatic cystic echinococcosis based on ultrasound images and deep learning algorithms. METHODS Three popular deep convolutional neural networks (VGG19, Inception-v3, and ResNet18) with and without pretrained weights were selected to test their performance on the classification task, and the experiments were followed by a 5-fold cross-validation process. RESULTS A total of 1820 abdominal ultrasound images covering five subtypes of hepatic cystic echinococcosis from 967 patients were used in the study. The classification accuracy for the models with pretrained weights (fine-tuning) ranged from 88.2 to 90.6%. The best accuracy of 90.6% was obtained by VGG19. For comparison, the models without pretrained weights (from scratch) achieved a lower accuracy, ranging from 69.4 to 75.1%. CONCLUSION Deep convolutional neural networks with pretrained weights are capable of recognizing different subtypes of hepatic cystic echinococcosis from ultrasound images, which are expected to be applied in the computer-aided diagnosis systems in future work.
Collapse
Affiliation(s)
- Miao Wu
- College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hang Zhou, China
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Xiaorong Wang
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qian Liu
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Zhihua Liu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Tao Song
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| |
Collapse
|
14
|
Cai M, Ding J, Li Y, He G, Yang J, Liu T, Guo X, Yang X, Wang X, Cho WC, Fasihi Harandi M, Zheng Y. Echinococcus multilocularis infection induces UBE2N suppression via exosomal emu-miR-4989. Acta Trop 2021; 223:106087. [PMID: 34389329 DOI: 10.1016/j.actatropica.2021.106087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/23/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022]
Abstract
Echinococcus multilocularis metacestodes mainly reside in liver in humans and animals, and cause serious damages. UBE2N was herein shown to be downregulated in response to the infection. UBE2N was further shown to be predominantly expressed in the hepatocytes, which was also significantly downregulated during the infection. UBE2N was a target of emu-miR-4989, which was loaded into the exosomes secreted by parasites. These emu-miR-4989-encapsulating exosomes were internalized by hepatocytes, and induced a significant decrease of relative luciferase activity in the cells transfected with the construct containing a wild type of UBE2N 3'-UTR compared to the control (p < 0.05). These results demonstrate that emu-miR-4989 is involved in the UBE2N inhibition in the hepatocytes during E. multilocularis through exosomes.
Collapse
Affiliation(s)
- Mengting Cai
- College of Life Science and Technology, Xinjiang University, Urumqi, China; State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Juntao Ding
- College of Life Science and Technology, Xinjiang University, Urumqi, China
| | - Yating Li
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Guitian He
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Jing Yang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Tingli Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Xiaola Guo
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China
| | - Xing Yang
- Department of Medical Microbiology and Immunology, School of Basic Medicine, Dali University, Dali 671000, Yunnan, China
| | - Xiaoqiang Wang
- School of Chemical and Biological Engineering, Lanzhou Jiaotong University, Lanzhou 730070, China
| | - William C Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Department of Parasitology, Kerman University of Medical Sciences, Kerman, Iran
| | - Yadong Zheng
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou 730046, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China.
| |
Collapse
|
15
|
Shang JY, Zhang GJ, Liao S, Yu WJ, He W, Wang Q, Huang Y, Wang Q, Long YX, Liu Y, Zhong B. Low genetic variation in Echinococcus multilocularis from the Western Sichuan Plateau of China revealed by microsatellite and mitochondrial DNA markers. Acta Trop 2021; 221:105989. [PMID: 34058159 DOI: 10.1016/j.actatropica.2021.105989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
The prevalence of E. multilocularis is a major public health problem in China. To better understand the molecular epidemiology and evolutionary patterns of E. multilocularis, an adequate dataset regarding the genetic variance of this parasite is necessary. However, for now, available genetic data of E. multilocularis is still insufficient. In the study, the EmsB microsatellite and the partial mitochondrial cox1 gene were combined to investigate the genetic diversity of 64 E. multilocularis samples from human, dogs and voles. These samples were collected in the Western Sichuan Plateau, where the highest village-based human prevalence of alveolar echinococcosis was recorded worldwide. The aim of the study is to gather more informative genetic data of E. multilocularis in the areas, especially those obtained using the EmsB marker. The microsatellite analysis revealed 7 different EmsB profiles, 1 of which was found in 90.63% of the total samples collected from all 3 hosts. This major profile was identical to the one detected in the same area 16 years ago. The rest of the 6 profiles, each represented by only 1 isolate, did not correspond to any of the profiles previously reported. All the profiles detected in the study belonged to the Asian cluster. Meanwhile, according to sequence analysis of the 758 bp cox1 region, 4 haplotypes all assigned to the Asian clade were detected among the isolates. A star-like haplotype network was exhibited with a centrally positioned haplotype found in 93.75% of the samples. The overall haplotype and nucleotide diversities were both low. These findings provided evidence for a founder event or bottleneck and subsequent population expansion in E. multilocularis. The EmsB profiles were not fully consistent with the cox1 haplotypes. The same correspondence relationship was mainly observed in samples with the major profile P5 and the main haplotype EmHa1. A total of 54 isolates assigned to profile P5 were classified to the EmHa1 haplotype. In conclusion, both the microsatellite and mtDNA markers showed low variability within the Tibetan population of E. multilocularis. An EmsB profile and a cox1 haplotype were found to be predominant in the study area, which appears to remain steady for over a decade. The results reinforce the higher potential of the microsatellite DNA marker with high discriminative power to identify the very low genetic polymorphism of E. multilocularis than that of the partial cox1 sequencing. The data obtained in the study would be helpful to enlarge the data pool to further probe the possible origins and dispersal of E. multilocularis in China.
Collapse
|
16
|
Peng J, Duan Z, Guo Y, Li X, Luo X, Han X, Luo J. Identification of candidate biomarkers of liver hydatid disease via microarray profiling, bioinformatics analysis, and machine learning. J Int Med Res 2021; 49:300060521993980. [PMID: 33787392 PMCID: PMC8020228 DOI: 10.1177/0300060521993980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives Liver echinococcosis is a severe zoonotic disease caused by
Echinococcus (tapeworm) infection, which is epidemic in
the Qinghai region of China. Here, we aimed to explore biomarkers and
establish a predictive model for the diagnosis of liver echinococcosis. Methods Microarray profiling followed by Gene Ontology and Kyoto Encyclopedia of
Genes and Genomes analysis was performed in liver tissue from patients with
liver hydatid disease and from healthy controls from the Qinghai region of
China. A protein–protein interaction (PPI) network and random forest model
were established to identify potential biomarkers and predict the occurrence
of liver echinococcosis, respectively. Results Microarray profiling identified 1152 differentially expressed genes (DEGs),
including 936 upregulated genes and 216 downregulated genes. Several
previously unreported biological processes and signaling pathways were
identified. The FCGR2B and CTLA4 proteins were identified by the PPI
networks and random forest model. The random forest model based on FCGR2B
and CTLA4 reliably predicted the occurrence of liver hydatid disease, with
an area under the receiver operator characteristic curve of 0.921. Conclusion Our findings give new insight into gene expression in patients with liver
echinococcosis from the Qinghai region of China, improving our understanding
of hepatic hydatid disease.
Collapse
Affiliation(s)
- Jinwu Peng
- Department of Pathology, Xiangya Basic Medical School, Central South University, Changsha, Hunan, China.,Department of Pathology, Xiangya Changde Hospital, Changde, Hunan, China.,Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhili Duan
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Yamin Guo
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiaona Li
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiaoqin Luo
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiumin Han
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Junming Luo
- Department of Pathology, Xiangya Changde Hospital, Changde, Hunan, China.,Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| |
Collapse
|
17
|
Mohammadi M, Mamishi S, Pourakbari B, Faraz Z, Khodabandeh M, Mahmoudi S. Cystic Echinococcosis in Children: High Frequency of Multiple Organs Involved in the North of Iran. Infect Disord Drug Targets 2021; 21:125-129. [PMID: 32108011 DOI: 10.2174/1871526520666200228104316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Echinococcosis, as an important zoonotic infection, has a major worldwide distribution. Pediatric echinococcosis has still become health concerning issue in developing countries, particularly, in the Middle East and Iran. The aim of this study was to investigate the human echinococcosis in children in northern Iran. METHODS Patients admitted to the pediatric subspecialty hospital of Amir Kala, Babol, Iran, from 2011 to 2016 with a confirmed diagnosis of echinococcosis, were reviewed. Records of the patients, including demographic data, clinical manifestations of the disease, type of cysts, and other related factors, were collected. RESULTS Sixteen pediatric patients, twelve (75%) male, and four (25%) female were evaluated. All cases had cystic echinococcosis. The results showed that fever (75%) following vomiting, nausea, and coughing (44%) were the most common clinical manifestations. The most common localizations of cases were determined as liver (n=10, 62.5%) and lung (n=9, 56%). The frequency of the involvement of more than one organ was 31% (5 cases). The co-occurrence of liver and lung was seen in 2 (12.5%) cases, and in one case, the co-occurrence of the liver and spleen was reported. In one case, lung, liver and, the pelvis was involved, while in another case, liver, sub diaphragm and kidney involvement were observed. CONCLUSION Cystic echinococcosis should be kept in mind when a cystic lesion is encountered anywhere in the body, particularly, in patients lining in the endemic regions. Since cystic echinococcosis has a considerable economic impact in Iran, the implementation of a control program and the surveillance system are highly recommended to reduce the economic burden of this disease.
Collapse
Affiliation(s)
- Mohsen Mohammadi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Setareh Mamishi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Zahra Faraz
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Mahmoud Khodabandeh
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| |
Collapse
|
18
|
Li S, Chen J, He Y, Deng Y, Chen J, Fang W, Zeren Z, Liu Y, Abdulaziz ATA, Yan B, Zhou D. Clinical Features, Radiological Characteristics, and Outcomes of Patients With Intracranial Alveolar Echinococcosis: A Case Series From Tibetan Areas of Sichuan Province, China. Front Neurol 2021; 11:537565. [PMID: 33519658 PMCID: PMC7843382 DOI: 10.3389/fneur.2020.537565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/21/2020] [Indexed: 02/05/2023] Open
Abstract
Objectives: Intracranial alveolar echinococcosis (IAE), a zoonotic disease, is a critical health problem in the Tibetan region. We aimed to describe the clinical and radiological characteristics and outcomes among patients with IAE. Methods: We screened patients diagnosed with IAE between March 2015 and May 2019 at the Ganzi Tibetan Autonomous Prefecture People's Hospital. Detailed demographics, clinical characteristics, neuroimaging features, and outcomes were recorded. Results: A total of 21 patients with an average age of 44.1 ± 12.7 years were included. Thirteen (61.9%) patients were male. The most common chief neurological complaint was headache (n = 17, 81.0%), followed by dizziness, seizure, visual disturbances, hemiparesis, disturbed consciousness, and dysphasia. All the patients had coexisting liver localizations. The typical neuroimaging features of IAE on cerebral magnetic resonance imaging scans showed obvious low-signal shadow with multiple small vesicles inside the lesions on T2-weighted images and FLAIR images. The pathological HE staining demonstrates vesicular lesions with several internal sacs. For hepatic alveolar echinococcosis (AE), the hepatic portal was invaded in six (28.6%) patients, and the portal vein (n = 5, 23.8%) was the mostly commonly involved vessel. As for treatment, 11 patients (52.4%) had poor compliance with albendazole. The duration of patients taken albendazole ranged from 2 months to 3 years. Cerebral AE surgery was performed in 11 patients, five of them underwent partial resection of AE lesions, and six patients received total resection. One patient with primary IAE underwent radical surgery. Ten patients (47.6%) died during the follow-up for a mean of 21.7 ± 11.9 (3–46) months. In total, 28.9% of the patients died within 5 years, and 71.6% died within 10 years. The median interval between the date of diagnosis as AE and death was 84 (19–144) months. Conclusion: Despite substantial advances in diagnostic and therapeutic methods, the treatment of IAE remains difficult and results in unsatisfactory outcomes. The major critical issue is surgical treatment of IAE although the disease is disseminated. Besides, lifelong albendazole would be indicated, but most patients had poor medication compliance. It is important to educate patients about the necessity of medical treatment.
Collapse
Affiliation(s)
- Sisi Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiani Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yongqiao He
- Department of Neurology, Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding, China
| | - Yongyi Deng
- Department of Neurology, Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding, China
| | - Jie Chen
- Department of Neurology, Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding, China
| | - Wenyu Fang
- Department of Neurology, Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding, China
| | - Zhamu Zeren
- Department of Neurology, Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding, China
| | - Yadong Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Bo Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
19
|
Khan A, Umhang G, Ullah Z, Boué F, Bastid V, Ullah I, Mahmood S, Afzal MS, Ahmed H. Investigation of Echinococcus multilocularis in foxes and dogs in Pakistan by detection of copro-DNA. Parasitol Res 2021; 120:731-737. [PMID: 33442815 DOI: 10.1007/s00436-020-07001-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/02/2020] [Indexed: 01/20/2023]
Abstract
Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis, a heteroxenous parasite belonging to Cestoda class. AE is currently considered an important public health issue, but epidemiological and notably molecular data from several endemic countries, including Pakistan, are sparse. Here we report the first detection of Echinococcus multilocularis in wildlife from Pakistan after real-time PCR and sequencing confirmation in the faecal samples of three foxes from northern Kaghan and Siran regions. The occurrence is estimated at 4.4% (95% CI 0.9-12.4). In order to go further in the epidemiological investigations on E. multilocularis and due to the potential presence of other Echinococcus species, we suggest the need for further epidemiological surveys targeting E. multilocularis and E. granulosus sensu lato isolates from humans and intermediate hosts as well as definitive hosts from wildlife in Pakistan.
Collapse
Affiliation(s)
- Aisha Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chakh Shahzad, Islamabad, Pakistan
| | - Gérald Umhang
- ANSES LRFSN, Wildlife Surveillance and Eco-epidemiology Unit, National Reference Laboratory for Echinococcus spp., Malzéville, France.
| | - Zaib Ullah
- Department of Zoology, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, 21120, Pakistan
| | - Franck Boué
- ANSES LRFSN, Wildlife Surveillance and Eco-epidemiology Unit, National Reference Laboratory for Echinococcus spp., Malzéville, France
| | - Vanessa Bastid
- ANSES LRFSN, Wildlife Surveillance and Eco-epidemiology Unit, National Reference Laboratory for Echinococcus spp., Malzéville, France
| | - Ikram Ullah
- Department of Zoology, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, 21120, Pakistan
| | - Sajid Mahmood
- Department of Zoology, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, 21120, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management & Technology (UMT), Lahore, Pakistan
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chakh Shahzad, Islamabad, Pakistan.
| |
Collapse
|
20
|
Yu Q, Xiao N, Han S, Tian T, Zhou XN. Progress on the national echinococcosis control programme in China: analysis of humans and dogs population intervention during 2004-2014. Infect Dis Poverty 2020; 9:137. [PMID: 33008476 PMCID: PMC7532088 DOI: 10.1186/s40249-020-00747-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background A national control program for echinococcosis has been in effect since 2005 in China. This program has applied a comprehensive strategy, and good control results have been achieved. Human echinococcosis prevalence rate decrease from 1.08% in 2004 to 0.24% in 2012. The objective of this study is focusing on assessment of the programme with two indices, including patient treatment and registered dogs deworming, in endemic areas of echincoccosis control over the period of 10 years (2004–2014) in China. Methods We established the database including demography at county and township levels with coverage for ten provinces and autonomous regions of China in this study. We using methods of epidemiological descriptive, instead the expectation-maximization for missing value filling for grouping available patients into those subjected to surgery and those receiving drug treatment after population screening and the dogs population after registered by deworming. We performed Microsoft Excel software and SPSS software on the results as percentages with the corresponding 95% confidence intervals (95% CIs). We also statistically analyzed the economics data on patient treatment and dogs deworming after the corresponding discount with annual bank interest rates (USD 1 = CNY 6.5, bank discount average changes of 2.3–3.3%). Results During 2004–2014, the grant total average rate of surgical patient (after surgical operation) treatment had increased with 32.4% and with 81.3% for medical treatment with albendazole. Meanwhile, it increased by 58.6% for the deworming of registered dog since 2007. The accumulated costs amounted to USD 27.03 million after discount for patients and registered dog treatment, which is 1/4 of the total accumulated financial inputs (USD 110.67 million from the Chinese Government). Since the implementation of the national program, it has increased 57 times with respect to the annual financial inputs (costs) and 368 times with respect to all accumulated financial inputs (costs). Conclusions This study showed that in endemic areas, patient diagnosis and management, dog management and treatment over this period helped reduce the parasite load to control the disease. More attention should be paid to controlling wild canines during the ongoing program period and sustainable follow-up evaluations are crucial for success and continued implementation of the national program.
Collapse
Affiliation(s)
- Qing Yu
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Ning Xiao
- Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Shuai Han
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Tian Tian
- Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China
| | - Xiao-Nong Zhou
- Chinese Center for Tropical Diseases Research, Shanghai, 200025, China. .,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China. .,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China. .,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China. .,National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.
| |
Collapse
|
21
|
Graeter T, Eberhardt N, Shi R, Schmidberger J, Beer AJ, Beer M, Henne-Bruns D, Hillenbrand A, Barth TFE, Grimm J, Kratzer W, Gruener B. Hepatic alveolar echinococcosis: correlation between computed tomography morphology and inflammatory activity in positron emission tomography. Sci Rep 2020; 10:11808. [PMID: 32678174 PMCID: PMC7366930 DOI: 10.1038/s41598-020-68624-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Abstract
Positron emission tomography-computed tomography (PET-CT) with 18F-fluorodesoxyglucose (FDG) is the imaging modality of choice for assessing inflammation surrounding hepatic alveolar echinococcosis (AE) lesions. This study is the first to evaluate FDG uptake in hepatic AE (n = 51) based on the standardized uptake value (SUV) and to correlate the SUVs with primary morphology and calcification patterns, based on the Echinococcus multilocularis Ulm Classification for Computed-Tomography (EMUC-CT). Our results show that the SUVs were increased for lesions with EMUC-CT types I-IV primary morphology, compared to the surrounding healthy liver tissue (SUV = 2.5 ± 0.4; p < 0.05). Type IV lesions included, by far, the highest number of PET-negative lesions. A comparison of lesions with different primary morphologies showed clear differences. The highest SUVs were found for types I and III, and the lowest was found for type IV. Type IV lesions (SUV, 3.8 ± 1.5) showed significantly lower uptake compared to type I (SUV, 6.9 ± 3.5; p = 0.030) and type III (SUV, 7.4 ± 3.9; p = 0.031) lesions. For type II lesions, the results showed only a statistical trend (SUV, 6.1 ± 3.1; p = 0.073). Due to the small number of cases, an evaluation of type V (n = 1) lesions was not possible. The different SUVs of lesions with different primary morphologies, particularly the lower FDG uptake observed in type IV lesions, suggested that these SUVs might reflect different stages of the disease.
Collapse
Affiliation(s)
- Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Nina Eberhardt
- Department of Nuclear Medicine, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Rong Shi
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Julian Schmidberger
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Ambros J Beer
- Department of Nuclear Medicine, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Doris Henne-Bruns
- Department of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Andreas Hillenbrand
- Department of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Thomas F E Barth
- Institute of Pathology, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Johannes Grimm
- Institute of Pathology, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Beate Gruener
- Department of Internal Medicine III, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| |
Collapse
|
22
|
Guo X, Zheng Y. Profiling of miRNAs in Mouse Peritoneal Macrophages Responding to Echinococcus multilocularis Infection. Front Cell Infect Microbiol 2020; 10:132. [PMID: 32309217 PMCID: PMC7145947 DOI: 10.3389/fcimb.2020.00132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/12/2020] [Indexed: 01/02/2023] Open
Abstract
Alveolar echinococcosis (AE) is a zoonotic helminthic disease caused by infection with the larval of Echinococcus multilocularis in human and animals. Here, we compared miRNA profiles of the peritoneal macrophages of E. multilocularis-infected and un-infected female BALB/c mice using high-throughput sequencing. A total of 87 known miRNAs were differentially expressed (fold change ≥ 2, p < 0.05) in peritoneal macrophages in mice 30- and 90-day post infection compared with ones in un-infected mice. An increase of mmu-miR-155-5p expression was observed in peritoneal macrophages in E. multilocularis-infected mice. Compared with the control group, the production of nitric oxide (NO) was increased in peritoneal macrophages transfected with mmu-miR-155-5p mimics at 12 h after transfection (p < 0.001). Two key genes (CD14 and NF-κB) in the LPS/TLR4 signaling pathway were also markedly altered in mmu-miR-155-5p mimics transfected cells (p < 0.05). Moreover, mmu-miR-155-5p mimics suppressed IL6 mRNA expression and promoted IL12a and IL12b mRNA expression. Luciferase assays showed that mmu-miR-155-5p was able to bind to the 3′ UTR of the IKBKE gene and decreased luciferase activity. Finally, we found the expression of IKBKE was significantly downregulated in both macrophages transfected with mmu-miR-155-5p and macrophages isolated from E. multilocularis-infected mice. These results demonstrate an immunoregulatory effect of mmu-miR-155 on macrophages, suggesting a role in regulation of host immune responses against E. multilocularis infection.
Collapse
Affiliation(s)
- Xiaola Guo
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Gansu, China
| | - Yadong Zheng
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Gansu, China.,Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, China
| |
Collapse
|
23
|
Schmidberger J, Steinbach J, Schlingeloff P, Kratzer W, Grüner B. Surgery versus conservative drug therapy in alveolar echinococcosis patients in Germany - A health-related quality of life comparison. Food Waterborne Parasitol 2019; 16:e00057. [PMID: 32095627 PMCID: PMC7034038 DOI: 10.1016/j.fawpar.2019.e00057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/29/2019] [Accepted: 05/10/2019] [Indexed: 02/07/2023] Open
Abstract
Alveolar echinococcosis (AE) is a rare zoonosis caused by the parasite Echinococcus multilocularis. Nothing is known about the health-related quality of life (HRQoL) in patients with AE receiving different types of therapy. Therefore, the aim of the study was to compare HRQoL in patients with AE in Germany depending on their therapeutic regimen namely conservative drug treatment with long-term benzimidazoles versus surgical therapy by resection of the parasitic liver lesions. The 36-Item Short Form Health Survey (SF-36) questionnaire, including other echinococcosis-related questions, was used to measure HRQoL. The SF-36 scales were evaluated according to the algorithms provided by the authors. The statistical analysis was performed with SAS version 9.2. The significance level was set at α = 0.05, p < 0.05 corresponds to statistical significance. The investigated group consisted of conservatively drug treated (n = 30) and patients with curative surgery (n = 25) with confirmed AE. The study was performed at an infectious disease outpatient department from April 2018 to October 2018. The conservatively drug treated patient group consisted of 15 men (50.0%) and 15 women (50.0%) with an average age of 55.7 ± 16.7 years (Median: 59). The surgery group consisted of nine men (36.0%) and 16 women (64.3%) with an average age of 53.3 ± 31.9 years (Median: 54). The physical quality of life of the conservatively drug treated patients did not show any significant differences to the surgical treated group (45.2 ± 11.4 vs. 47.6 ± 9.9; p = 0.4079). There was also no significant difference regarding the mental quality of life between the conservatively drug treated patients, and those treated with curative surgery (45.5 ± 10.6 vs. 47.3 ± 10.8; 0.5206). Nevertheless, there was a slight advantage in the physical and mental scores of the patients treated with surgery. Furthermore, for 13 of the 25 surgically treated patients, some aspects of the HRQoL improved significantly after surgery. The evaluation showed no statistically significant differences in HRQoL in patients with AE dependent on the applied treatment strategy (conservative drug versus curative surgical therapy).
Collapse
|
24
|
Han X, Kim JG, Wang H, Cai H, Ma X, Duong DH, Ahn CS, Kang I, Kong Y. Survey of echinococcoses in southeastern Qinghai Province, China, and serodiagnostic insights of recombinant Echinococcus granulosus antigen B isoforms. Parasit Vectors 2019; 12:323. [PMID: 31242932 PMCID: PMC6593596 DOI: 10.1186/s13071-019-3569-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background Echinococcoses, caused by metacestodes of Echinococcus granulosus (cystic echinococcosis; CE) and E. multilocularis (alveolar echinococcosis; AE), represent major emerging parasitic diseases. These enzootic helminthiases invoke significant public health concerns and social burdens in endemic areas. The diseases are prevalent in the Qinghai-Tibetan Plateau, China, while community-based epidemiological studies have been scarcely reported. We surveyed echinococcosis patients in the southeastern Qinghai Province, China, to better understand the concurrent epidemiological situation in this area. Methods During July and August of 2013 and 2014, we screened echinococcosis patients at Yushu and Golog Prefectures, Qinghai Province, China, in a diagnostic campaign. A total of 2856 people (male:female ratio, 1:1.12; mean age, 34.6 years; age range, 6–88 years) were ultrasonographically examined for the presence of hepatic echinococcal cysts. We also collected serum samples from patients and analyzed antibody reactivity against recombinant forms of diverse E. granulosus antigen Bs (rEgAgB1-5) by enzyme-linked immunosorbent assay. Results We detected 134 patients whose imaging scans were compatible with CE (115 cases) and AE (20 patients). One patient might have been infected with both CE and AE. The overall incidence was 4.7% (CE, 4.0%; AE, 0.7%). A large proportion (67.5%) of CE patients was diagnosed at active and transitional CE1-CE3 stages in their late 30s. The AE cases were generally detected at advanced stage in patients at early 20s (60%). Analysis of the receiver operating characteristic curve and Youden’s index indicated that rEgAgB2 was the most promising biomarker, followed by rEgAgB3 and rEgAgB1. Overall, sensitivity and specificity of rEgAgB1-3 were 84.5–92.7% and 91.9–94.6%, respectively. rEgAgB4 and 5 showed low sensitivity with high cross-reactivity. Conclusions Our results strongly suggest that disability-adjusted life years related to echinococcoses in Qinghai-Tibetan areas might be more serious than previously considered. Control and prevention strategy against CE and AE are highly required in these areas. In addition to ultrasonography, serological tests might provide supportive data. However, serological data should be carefully interpreted for differential diagnosis, especially in areas where both CE and AE are co-endemic. Electronic supplementary material The online version of this article (10.1186/s13071-019-3569-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xiumin Han
- Qinghai Provincial People's Hospital, Xining, 810007, China.,Qinghai Province Institute for Endemic Diseases Prevention and Control, Qinghai Centers for Disease Prevention and Control, Xining, 811602, China
| | - Jeong-Geun Kim
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Hu Wang
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Qinghai Centers for Disease Prevention and Control, Xining, 811602, China.,Endemic Disease Administration Office, Qinghai Province Health and Family Planning Commission, Xining, 811602, China
| | - Huixia Cai
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Qinghai Centers for Disease Prevention and Control, Xining, 811602, China.,Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Xiao Ma
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Qinghai Centers for Disease Prevention and Control, Xining, 811602, China
| | - Duc Hieu Duong
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Chun-Seob Ahn
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea
| | - Insug Kang
- Department of Molecular Biology and Biochemistry, Kyung Hee University College of Medicine, Seoul, 02447, Korea
| | - Yoon Kong
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, 16419, Korea.
| |
Collapse
|
25
|
Bebezov B, Mamashev N, Umetaliev T, Ziadinov I, Craig PS, Joekel DE, Deplazes P, Grimm F, Torgerson PR. Intense Focus of Alveolar Echinococcosis, South Kyrgyzstan. Emerg Infect Dis 2019; 24:1119-1122. [PMID: 29774832 PMCID: PMC6004877 DOI: 10.3201/eid2406.161641] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Human alveolar echinococcosis (AE) is a highly pathogenic zoonotic parasitic disease caused by Echinococcus multilocularis. An ultrasound study in southern Kyrgyzstan during 2012 revealed a prevalence of 4.2% probable or confirmed AE and an additional 2.2% possible AE, representing an emerging situation. The risk for probable or confirmed AE was significantly higher in dog owners.
Collapse
|
26
|
Wetscher M, Hackländer K, Faber V, Taylor N, Auer H, Duscher GG. Hunting Poses Only a Low Risk for Alveolar Echinococcosis. Front Public Health 2019; 7:7. [PMID: 30761283 PMCID: PMC6361863 DOI: 10.3389/fpubh.2019.00007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/09/2019] [Indexed: 12/28/2022] Open
Abstract
The Austrian province of Tyrol belongs to the areas where the alveolar echinococcosis (AE) caused by the fox tapeworm Echinococcus multilocularis (E. multilocularis) is highly endemic. In Central Europe and since 2011 in Austria, a growing incidence of human cases of AE has been observed, presumably linked with increasing fox populations infected by the fox tapeworm E. multilocularis. Hunting and the related activities put hunters in a high-risk group, and they are considered particularly vulnerable for the contraction of an AE. In light of this risk and the increased number of AE cases made public in Austria, the objective of the study was to investigate the prevalence of AE in hunters and to provide a possible connection to the incidence increase. In 2015 and 2016, we examined 813 serums of active hunters from all nine districts of Tyrol and serologically tested them for E. multilocularis antibodies. Twenty-one (2.58%) positive results in ELISA were detected via Western blot (WB), and only one (0.12%) serum showed a low positive reaction. No lesion in the liver parenchyma could be detected by abdominal ultrasonography in this patient so far, but the risk of developing alveolar echinococcosis remains for this WB-positive hunter. Risk factor analysis of these 813 hunters revealed that 697 (85.7%) hunted red foxes regularly and 332 (40.8%) of those skinned them as well. Three hundred and eighteen (39.1%) out of the 813 hunters were owners of hunting dogs; 89 (10.9%) and 243 (29.9%) were owners of non-hunting dogs and cats, respectively. Our results indicate that hunters do not have a greater risk of infection with E. multilocularis compared to non-hunters in Austria. The cause of the unexpected increase in AE cases in Austria remains unclear.
Collapse
Affiliation(s)
- Monika Wetscher
- Department of Integrative Biology and Biodiversity Research, Institute of Wildlife Biology and Game Management, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Klaus Hackländer
- Department of Integrative Biology and Biodiversity Research, Institute of Wildlife Biology and Game Management, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Viktoria Faber
- Third Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectious Diseases and Rheumathology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - Ninon Taylor
- Third Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectious Diseases and Rheumathology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - Herbert Auer
- Department of Medical Parasitology, Center of Pathophysiology, Infectiology and Immunology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University Vienna, Vienna, Austria
| | - Georg G Duscher
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
27
|
Li Z, Ding S, Li Y. Study on the immunity protection of 14-3-3–MPLA–liposome vaccine against cystic echinococcosis in mice. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.flm.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
28
|
Schmidberger J, Weimer H, Schlingeloff P, Kratzer W, Grüner B. Health-related quality of life in patients with alveolar echinococcosis: a cross-sectional study. Infection 2018; 47:67-75. [PMID: 30225656 DOI: 10.1007/s15010-018-1219-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 09/11/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE The Alveolar echinococcosis (AE) is a rare zoonosis caused by the parasite Echinococcus multilocularis. To date, nothing is known about the health-related quality of life (HRQoL) in patients with AE. The aim of the study was to evaluate the HRQoL in patients with AE in comparison of the healthy population. METHODS We used the 36-Item Short Form Health Survey (SF-36) questionnaire to evaluate the HRQoL. The SF-36 scales have a range of 0-100 (0 represents the worst and 100 the most favourable state of health). SAS Version 9.2 was used for the statistical analysis of AE-cases (n = 30) and the healthy control group (n = 35). RESULTS The analysis showed that the HRQoL in people with AE is reduced in comparison with the control population. The study group consisted of 15 (50.0%) men and 15 (50.0%) women; the control group of 16 (45.7%) men and 19 (54.3%) women. The mean age was 55.73 ± 16.65 years, while that of the control group was 54.57 ± 15.34 years. The physical quality of life in patients with AE (45.21 ± 11.42) was not significantly less than that of the control group (50.54 ± 10.52); p = 0.0568. Nevertheless, AE-patients show lower SF-36 scores for the physical quality of life. For the mental quality of life, patients with AE had a significantly lower score (45.46 ± 10.57) than the control group (51.57 ± 9.04); p = 0.0154. CONCLUSIONS The HRQoL in people with AE is reduced in comparison with a control population. Assessment of the physical and mental quality of life in patients with AE may help to evaluate the patient outcome.
Collapse
Affiliation(s)
- Julian Schmidberger
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Henriette Weimer
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Patrycja Schlingeloff
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Beate Grüner
- Department of Internal Medicine III, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | | |
Collapse
|
29
|
Wang X, Liu J, Zuo Q, Mu Z, Weng X, Sun X, Wang J, Boufana B, Craig PS, Giraudoux P, Raoul F, Wang Z. Echinococcus multilocularis and Echinococcus shiquicus in a small mammal community on the eastern Tibetan Plateau: host species composition, molecular prevalence, and epidemiological implications. Parasit Vectors 2018; 11:302. [PMID: 29769131 PMCID: PMC5956848 DOI: 10.1186/s13071-018-2873-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/25/2018] [Indexed: 12/04/2022] Open
Abstract
Background The eastern part of the Tibetan Plateau is now recognized as an endemic region with the highest reported human infection rates in the world of human alveolar echinococcosis (AE) caused by Echinococcus multilocularis. Existing epidemiological studies on AE have mainly focused on the synanthropic environment, while basic parasitological and ecological aspects in wildlife host species remain largely unknown, especially for small mammal hosts. Therefore, we examined small mammal host species composition, occurrence, and the prevalence of both E. multilocularis and E. shiquicus in Shiqu County (Sichuan Province, China), eastern Tibetan Plateau. Results In total, 346 small mammals from five rodent and one pika species were trapped from four randomly set 0.25 ha square plots. Two vole species, Lasiopodomys fuscus (n = 144) and Microtus limnophilus (n = 44), and the plateau pika (Ochotona curzoniae) (n = 135), were the three most-dominant species trapped. Although protoscoleces of E. multilocularis and E. shiquicus were only observed in L. fuscus and O. curzoniae, respectively, cox1 and nad1 gene DNA of E. shiquicus was detected in all the small mammal species except for Neodon irene, whereas E. multilocularis was detected in the three most-dominant species. The overall molecular prevalence of Echinococcus species was 5.8 (95% CI: 3.3–8.2%) ~ 10.7% (95% CI: 7.4–14.0%) (the conservative prevalence to the maximum prevalence with 95% CI in parentheses), whereas for E. multilocularis it was 4.3 (95% CI: 2.2–6.5%) ~ 6.7% (95% CI: 4.0–9.3%), and 1.5 (95% CI: 0.2–2.7%) ~ 4.1% (95% CI: 2.0–6.1%) for E. shiquicus. The prevalence of both E. multilocularis and E. shiquicus, was significantly higher in rodents (mainly voles) than in pikas. Phylogenetic analyses revealed that Echinococcus haplotypes of cox1 from small mammal hosts were actively involved in the sylvatic and anthropogenic transmission cycles of E. multilocularis in the eastern Tibetan Plateau. Conclusions In contrast to previous studies, the current results indicated that rodent species, rather than pikas, are probably more important natural intermediate hosts of E. multilocularis and E. shiquicus in the eastern Tibetan Plateau. Thus, understanding interspecific dynamics between rodents and pikas is essential to studies of the echinococcosis transmission mechanism and human echinococcosis prevention in local communities. Electronic supplementary material The online version of this article (10.1186/s13071-018-2873-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xu Wang
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Jiayu Liu
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Qingqiu Zuo
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Zhiqiang Mu
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Xiaodong Weng
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Xiaohui Sun
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Junyao Wang
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Belgees Boufana
- Department of Infectious, Parasitic and Immuno-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Philip S Craig
- School of Environment and Life Sciences, University of Salford, Greater Manchester, UK
| | - Patrick Giraudoux
- Chrono-Environment Lab, University of Bourgogne-Franche-Comté and CNRS, Besançon, France
| | - Francis Raoul
- Chrono-Environment Lab, University of Bourgogne-Franche-Comté and CNRS, Besançon, France
| | - Zhenghuan Wang
- School of Life Sciences, East China Normal University, Shanghai, China.
| |
Collapse
|
30
|
Ito A, Budke CM. The echinococcoses in Asia: The present situation. Acta Trop 2017; 176:11-21. [PMID: 28728830 DOI: 10.1016/j.actatropica.2017.07.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022]
Abstract
Human alveolar and cystic echinococcosis, caused by the accidental ingestion of eggs of the tapeworms Echinococcus multilocularis and Echinococcus granulosus sensu lato, respectively, are endemic in Asia. Various Echinococcus species are maintained in domesticated and/or wild mammals through predator-prey interactions. Molecular analysis is used to help differentiate infecting parasite species and genotypes, with the goal of better understanding parasite life cycles in order to aid in the planning and implementation of control programs. This paper discusses the various echinococcoses in Asia, with limited reference to neighboring areas, including parts of Central Asia, Russia, Europe and North America.
Collapse
|
31
|
Alveolar echinococcosis in Germany, 1992-2016. An update based on the newly established national AE database. Infection 2017; 46:197-206. [PMID: 29090421 DOI: 10.1007/s15010-017-1094-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/26/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Alveolar echinococcosis is a rare disease caused by the parasite Echinococcus multilocularis. The newly established national database should enable us to determine high-risk areas and evaluate the endemic levels. METHODS The national database was implemented using SQL Workbench. We used EpiInfo™ software to display the prevalence of disease. Moran's I geodata analysis according to cluster and high risk areas was performed with GeoDa™. SAS Version 9.2 was used for the statistical analysis of the cases (n = 523). RESULTS The analysis showed a concentration of cases in Baden-Württemberg and Bavaria. Moran's I showed a heterogeneous case distribution throughout Germany (I = 0.208815, Z = 32.6175, p < 0.001). In the period from 1992 to 2016, the prevalence was 0.64/100,000 inhabitants in the whole of Germany, 2.18/100,000 inhabitants in Baden-Württemberg and 1.48/100,000 inhabitants in Bavaria. The analysis also revealed a difference between men and women, with a prevalence of 0.58/100,000 and 0.69/100,000, respectively. The analysis of spatial autocorrelation and possible risk areas showed that the southeast regions of Baden-Württemberg (I = 0.188514, Z = 11.3197, p < 0.001) and the southwest part of Bavaria (I = 0.176953, Z = 13.5144, p < 0.001) constitute the high risk areas. CONCLUSIONS The prevalence of disease is noticeably high in the Swabian Jura, the Bavarian Alps and the Alpine foothills. Raising awareness and educating doctors in high risk areas may prevent new cases and assist in earlier diagnosis.
Collapse
|
32
|
Ahmed H, Ali S, Afzal MS, Khan AA, Raza H, Shah ZH, Simsek S. Why more research needs to be done on echinococcosis in Pakistan. Infect Dis Poverty 2017; 6:90. [PMID: 28669350 PMCID: PMC5494903 DOI: 10.1186/s40249-017-0309-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
Background Echinococcosis has a worldwide geographical distribution with endemic foci on every inhabited continent. Due to the frequent outbreaks in different parts of Pakistan in the recent past, echinococcosis is being described as a neglected tropical disease and is considered one of the most neglected parasitic diseases in the country. In endemic regions, predominantly settings with limited resources, there are high numbers of echinococcosis patients, as these communities do not have access to appropriate treatment. In Pakistan, there are limited reports on echinococcosis. The disease is prevalent in human and livestock, but this has not been sufficiently explored yet. Pakistan is an agricultural country and due to the disease’s zoonotic mode of transmission, there is a dire need of future research on it. The present paper is an effort to highlight the importance of echinococcosis in Pakistan. Discussion There is a dire need for future research on echinococcosis in Pakistan as very few investigations had been carried out on this topic thus far. The prevalence of the disease in neighbouring countries highlights that Pakistan might be at severe risk of this zoonotic infection and further supports the need for more research. In Pakistan, the majority of the population lives in rural areas with limited acess to proper hygienic/sanitary facilities. These conditions favour the outbreak of diseases such as echinococcosis. The limited available data could result in higher outbreaks in the future, and thus cause the already weak healthcare system to overburden. The country has a meagre annual budget for health, which is being spent on known infections such as polio, dengue fever and hepatic viral infections. A proper surveillance system for echinococcosis is required across the country as treatment is usually expensive, complicated and may require extensive surgery and/or prolonged drug therapy. Development of new/novel drugs and other treatment modalities receives very little, if any, attention. Prognostic awareness programmes against this infection involve deworming of the infected animals, improved food inspection and slaughterhouse hygiene, and public education campaigns. Conclusion Future research on echinococcosis is anticipated to demonstrate whether the epidemiology, diagnosis and recombinant vaccines/antibodies relating to echinococcosis can meet the quality standards (purity, potency, safety and efficacy) defined by the World Health Organization. Research work should be carried out on the epidemiology and serodiagnosis of echinocossis in the different areas of Pakistan, which will be useful for the proper eradication of echinococcosis in this region. The health department should implement awareness-raising campaigns for the general public in order to reduce the burden of disease. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0309-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Haroon Ahmed
- Department of Biosciences, COMSATS Institute of Information Technology (CIIT), Park Road, Chak Shahzad, Islamabad, Pakistan.,Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, 23119, Elazig, Turkey
| | - Shahzad Ali
- Department of Wildlife and Ecology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Sohail Afzal
- Department of Chemistry, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Abid Ali Khan
- Department of Biosciences, COMSATS Institute of Information Technology (CIIT), Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Hamid Raza
- Department of Chemistry, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Zaheer Hussain Shah
- School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, 23119, Elazig, Turkey.
| |
Collapse
|
33
|
Yu Q, Xiao N, Yang SJ, Han S. Deworming of stray dogs and wild canines with praziquantel-laced baits delivered by an unmanned aerial vehicle in areas highly endemic for echinococcosis in China. Infect Dis Poverty 2017; 6:117. [PMID: 28655333 PMCID: PMC5488432 DOI: 10.1186/s40249-017-0329-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/19/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Canines, the definitive hosts for the parasites causing alveolar (AE) and cystic echinococcosis (CE), are the main source of this infections playing the key role in the transmission. The ten-year mortality rate of AE is extremely high (94%) if the patients are not given sustained treatment. The aim of this field study is to explore the possibility of delivery of praziquantel-laced baits using unmanned aerial vehicles (UAVs) aimed at deworming wild canines in the endemic areas. METHODS UAVs were compared to manual bait delivery in the 1-km2 test areas followed by testing of canine faeces using an Echinococcus coproantigen ELISA test in the ensuing year. The outcomes of the two approaches were compared with respect to time of delivery and overall cost. FINDINGS Compared to manual bait delivery, delivery by UAVs saved up to 67% of the overall cost. Three times more staff was needed for the former approach compared to the latter and, time wise, UAV bait delivery saved 350% compared to manual bait delivery on average. With regard to investment needed, the use of UAVs showed an efficiency 2.5 times better than manual bait delivery. Compared to the area served by UAVs, the average positive rate for the canine faecal samples was more than 38% higher in the area served manually. CONCLUSION The technique of bait delivery with praziquantel using UAVs for canine deworming has a strong potential with regard to savings of manpower, time and overall cost in areas highly endemic for echinococcosis.
Collapse
Affiliation(s)
- Qing Yu
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai, 200025, China. .,Key Laboratory of Parasite and Vector Biology, National health and Family Planning Commission, Shanghai, China. .,WHO Collaborating Center for Tropical Diseases, Shanghai, China.
| | - Ning Xiao
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, National health and Family Planning Commission, Shanghai, China.,WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Shi-Jie Yang
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, National health and Family Planning Commission, Shanghai, China.,WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Shuai Han
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, National health and Family Planning Commission, Shanghai, China.,WHO Collaborating Center for Tropical Diseases, Shanghai, China
| |
Collapse
|
34
|
Grüner B, Schmidberger J, Drews O, Kratzer W, Gräter T. Imaging in alveolar echinococcosis (AE): Comparison of Echinococcus multilocularis classification for computed-tomography (EMUC-CT) and ultrasonography (EMUC-US). ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jrid.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
35
|
Genetic variation of mitochondrial genes among Echinococcus multilocularis isolates collected in western China. Parasit Vectors 2017; 10:265. [PMID: 28558809 PMCID: PMC5450100 DOI: 10.1186/s13071-017-2172-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/03/2017] [Indexed: 11/16/2022] Open
Abstract
Background Alveolar echinococcosis (AE) is a life-threatening human disease caused by Echinococcus multilocularis transmitted between rodents and dogs/foxes in the Northern Hemisphere. The study aims to identify the genetic variation of the parasite in AE patients from China. Methods E. multilocularis isolates were collected from wild small mammals (n = 6) and AE patients (n = 56) from western China. Genomic DNA was extracted from different tissue samples including paraffin tissue blocks, ethanol fixed tissues and frozen tissues surgically removed. Two mitochondrial gene fragments (526 bp for cob and 474 bp for nad2) of E. multilocularis were amplified and sequenced. Results The parasite fragment sequences of cob fragments from AE patients showed two haplotypes, and nad2 gene fragment sequences had four haplotypes. The gene sequences from Microtus sp. were 100% identical to the sequences of some isolates from AE patients. These haplotypes were distributed in both Qinghai and Xinjiang provinces. Alignment analysis with the sequences from the GenBank databases showed five genotypes including three Asian genotypes, one from Europe and one from North America. Conclusions Most AE patients harbored the Asian genotype 1 which may be an indication of its relative frequency in the definitive hosts and the environment or of its pathogenicity to humans, which calls for further research.
Collapse
|
36
|
Cai H, Guan Y, Ma X, Wang L, Wang H, Su G, Zhang X, Han X, Ma J, Liu YF, Li J, Zhang J, Wang Y, Wang W, Du R, Lei W, Wu W. Epidemiology of Echinococcosis Among Schoolchildren in Golog Tibetan Autonomous Prefecture, Qinghai, China. Am J Trop Med Hyg 2017; 96:674-679. [PMID: 28070013 PMCID: PMC5361544 DOI: 10.4269/ajtmh.16-0479] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Echinococcosis is a serious zoonotic parasitic disease that is highly endemic in Qinghai Province. The present study aimed to investigate the prevalence of echinococcosis among schoolchildren in Golog Tibetan Autonomous Prefecture to improve early diagnosis and treatment of patients and to provide information for echinococcosis prevention and control. A total of 11,260 schoolchildren from five counties (Maqin, Gander, Dari, Jiuzhi, and Banma) in Golog Tibetan Autonomous Prefecture, Qinghai Province, were screened for echinococcosis. Screening involved ultrasound imaging combined with serologic examination as an auxiliary diagnostic test. The prevalence of echinococcosis in the schoolchildren was 2.1% (235/11,260), with a rate of 0.8% for cystic echinococcosis (CE; 89/11,260) and 1.3% for alveolar echinococcosis (AE; 146/11,260). Additionally, one child had a mixed infection. The prevalence ranged between 1.1% and 4.1% among the five investigated counties, and was highest in Dari County (4.1%). The prevalence of echinococcosis was higher in girls than in boys and gradually increased with age. In addition, children with CE mainly had type 1 (CE1) and type 3 (CE3) lesions, and children with AE mainly had small-diameter calcified lesions, suggesting that they were in the early asymptomatic stage of echinococcosis. In conclusion, children of Golog Tibetan Autonomous Prefecture appear to exhibit the highest recorded prevalence of CE and AE globally. Ultrasound is useful for screening populations in regions where both CE and AE are endemic.
Collapse
Affiliation(s)
- Huixia Cai
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China.,National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center of Malaria, Schistosomiasis and Filariasis, Shanghai, China
| | - Yayi Guan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center of Malaria, Schistosomiasis and Filariasis, Shanghai, China
| | - Xiao Ma
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Liying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center of Malaria, Schistosomiasis and Filariasis, Shanghai, China
| | - Hu Wang
- Endemic Disease Administration Office, Qinghai Province Health and Family Planning Commission, Xining, China
| | - Guoming Su
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Xuefei Zhang
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Xiumin Han
- Clinical Medical Research Institute, Qinghai Provincial People's Hospital, Xining, China
| | - Junying Ma
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Yu Fang Liu
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Jun Li
- Department of Science and Education, Shanghai Pulmonary Hospital, Shanghai, China
| | - Jingxiao Zhang
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Yongshun Wang
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Wei Wang
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Rui Du
- Endemic Disease Administration Office, Qinghai Province Health and Family Planning Commission, Xining, China
| | - Wen Lei
- Department of Parasite Control, Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, China
| | - Weiping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center of Malaria, Schistosomiasis and Filariasis, Shanghai, China
| |
Collapse
|
37
|
Abstract
Human cystic echinococcosis (CE) has been eliminated or significantly reduced as a public health problem in several previously highly endemic regions. This has been achieved by the long-term application of prevention and control measures primarily targeted to deworming dogs, health education, meat inspection, and effective surveillance in livestock and human populations. Human CE, however, remains a serious neglected zoonotic disease in many resource-poor pastoral regions. The incidence of human alveolar echinococcosis (AE) has increased in continental Europe and is a major public health problem in parts of Eurasia. Better understanding of wildlife ecology for fox and small mammal hosts has enabled targeted anthelmintic baiting of fox populations and development of spatially explicit models to predict population dynamics for key intermediate host species and human AE risk in endemic landscapes. Challenges that remain for echinococcosis control include effective intervention in resource-poor communities, better availability of surveillance tools, optimal application of livestock vaccination, and management and ecology of dog and wildlife host populations.
Collapse
|
38
|
Vuitton DA, Azizi A, Richou C, Vuitton L, Blagosklonov O, Delabrousse E, Mantion GA, Bresson-Hadni S. Current interventional strategy for the treatment of hepatic alveolar echinococcosis. Expert Rev Anti Infect Ther 2016; 14:1179-1194. [DOI: 10.1080/14787210.2016.1240030] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
39
|
Chamai M, Omadang L, Erume J, Ocaido M, Oba P, Othieno E, Bonaventure S, Kitibwa A. Identification of <i>Echinococcus granulosus</i> strains using polymerase chain reaction-restriction fragment length polymorphism amongst livestock in Moroto district, Uganda. ACTA ACUST UNITED AC 2016; 83:e1-7. [PMID: 27543147 PMCID: PMC6238788 DOI: 10.4102/ojvr.v83i1.1068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/29/2015] [Accepted: 12/31/2015] [Indexed: 11/13/2022]
Abstract
A descriptive study was conducted to identify the different strains of Echinococcus granulosus occurring in livestock in Moroto district, Uganda. Echinococcus cysts from 104 domestic animals, including cattle, sheep, goats and camels, were taken and examined by microscopy, polymerase chain reaction with restriction fragment length polymorphism and Sanger DNA sequencing. Echinococcus granulosus genotypes or strains were identified through use of Bioinformatics tools: BioEdit, BLAST and MEGA6. The major finding of this study was the existence of a limited number of E. granulosus genotypes from cattle, goats, sheep and camels. The most predominant genotype was G1 (96.05%), corresponding to the common sheep strain. To a limited extent (3.95%), the study revealed the existence of Echinococcus canadensis G6/7 in three (n = 3) of the E. granulosus–positive samples. No other strains of E. granulosus were identified. It was concluded that the common sheep strain of Echinococcus sensu stricto and G6/7 of E. canadensis were responsible for echinococcal disease in Moroto district, Uganda.
Collapse
Affiliation(s)
- Martin Chamai
- Department of Biomolecular Resources and Biolaboratory Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Zhu M, Gao F, Li Z, Wang X, Wang H, Wang Z, Zhao J, Zhao W. Immunoprotection of recombinant Eg.myophilin against Echinococcus granulosus infection in sheep. Exp Ther Med 2016; 12:1585-1590. [PMID: 27602078 DOI: 10.3892/etm.2016.3501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 02/25/2016] [Indexed: 12/22/2022] Open
Abstract
The aims of the present study were to investigate the immunoprotection of recombinant Echinococcus granulosus myophilin (rEg.myophilin) against the establishment of a challenge oral infection with E. granulosus eggs, as well as to determine the mechanisms underlying this protection. Sheep were subcutaneously immunized two times with rEg.myophilin, followed by the challenge with E. granulosus eggs orally. The animals were sacrificed 44 weeks after infection and the immunoglobulin (Ig) and cytokine levels were analyzed using ELISA. The results identified significant changes in several indexes of animal immune response subsequent to immunization with rEg.myophilin. These changes included reduced number of formed cysts, as well as elevated levels of IgG, IgA and cytokines. The present data suggest that immunization with rEg.myophilin in sheep can successfully reduce the formation of cysts caused by challenge E. granulosus infection and stimulate immune response, suggesting that rEg.myophilin a has potential value as a candidate vaccine against E. granulosus.
Collapse
Affiliation(s)
- Mingxing Zhu
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Key Laboratory of Hydatid Disease, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Fu Gao
- Institute of Clinical Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Xi'an Traditional Chinese Medicine Hospital, Xi'an, Shannxi 710021, P.R. China
| | - Zihua Li
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Key Laboratory of Hydatid Disease, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Xiuqing Wang
- Institute of Clinical Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Hao Wang
- Key Laboratory of Hydatid Disease, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Department of Pathogenic Biology and Medical Immunology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Zhisheng Wang
- Experimental Animal Center, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Jiaqing Zhao
- Key Laboratory of Hydatid Disease, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Department of Pathogenic Biology and Medical Immunology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Wei Zhao
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China; Key Laboratory of Hydatid Disease, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| |
Collapse
|
41
|
Graeter T, Kratzer W, Oeztuerk S, Haenle MM, Mason RA, Hillenbrand A, Kull T, Barth TF, Kern P, Gruener B. Proposal of a computed tomography classification for hepatic alveolar echinococcosis. World J Gastroenterol 2016; 22:3621-3631. [PMID: 27053854 PMCID: PMC4814648 DOI: 10.3748/wjg.v22.i13.3621] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/30/2015] [Accepted: 12/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To establish a computed tomography (CT)-morphological classification for hepatic alveolar echinococcosis was the aim of the study.
METHODS: The CT morphology of hepatic lesions in 228 patients with confirmed alveolar echinococcosis (AE) drawn from the Echinococcus Databank of the University Hospital of Ulm was reviewed retrospectively. For this reason, CT datasets of combined positron emission tomography (PET)-CT examinations were evaluated. The diagnosis of AE was made in patients with unequivocal seropositivity; positive histological findings following diagnostic puncture or partial resection of the liver; and/or findings typical for AE at either ultrasonography, CT, magnetic resonance imaging or PET-CT. The CT-morphological findings were grouped into the new classification scheme.
RESULTS: Within the classification a lesion was dedicated to one out of five “primary morphologies” as well as to one out of six “patterns of calcification”. “primary morphology” and “pattern of calcification” are primarily focussed on separately from each other and combined, whereas the “primary morphology” V is not further characterized by a “pattern of calcification”. Based on the five primary morphologies, further descriptive sub-criteria were appended to types I-III. An analysis of the calcification pattern in relation to the primary morphology revealed the exclusive association of the central calcification with type IV primary morphology. Similarly, certain calcification patterns exhibited a clear predominance for other primary morphologies, which underscores the delimitation of the individual primary morphological types from each other. These relationships in terms of calcification patterns extend into the primary morphological sub-criteria, demonstrating the clear subordination of those criteria.
CONCLUSION: The proposed CT-morphological classification (EMUC-CT) is intended to facilitate the recognition and interpretation of lesions in hepatic alveolar echinococcosis. This could help to interpret different clinical courses better and shall assist in the context of scientific studies to improve the comparability of CT findings.
Collapse
|
42
|
Wen H, Dong JH, Zhang JH, Duan WD, Zhao JM, Liang YR, Shao YM, Ji XW, Tai QW, Li T, Gu H, Tuxun T, He YB, Huang JF. Ex Vivo Liver Resection and Autotransplantation for End-Stage Alveolar Echinococcosis: A Case Series. Am J Transplant 2016; 16:615-24. [PMID: 26460900 DOI: 10.1111/ajt.13465] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 01/25/2023]
Abstract
The role of autotransplantation in end-stage hepatic alveolar echinococcosis (AE) is unclear. We aimed to present our 15-case experience and propose selection criteria for autotransplantation. All patients were considered to have unresectable hepatic AE by conventional resection due to critical invasion to retrohepatic vena cava, hepatocaval region along with three hepatic veins, and the tertiary portal and arterial branches. All patients successfully underwent ex vivo extended right hepatectomy and autotransplantation without intraoperative mortality. The median autograft weight was 706 g (380-1000 g); operative time was 15.5 hours (11.5-20.5 hours); and anhepatic time was 283.8 minutes (180-435 min). Postoperative hospital stay was 32.3 days (12-60 days). Postoperative complication Clavien-Dindo grade IIIa or higher occurred in three patients including one death that occurred 12 days after the surgery due to acute liver failure. One patient was lost to follow-up after the sixth month. Thirteen patients were followed for a median of 21.6 months with no relapse. This is the largest reported series of patients with end-stage hepatic AE treated with liver autotransplantation. The technique requires neither organ donor nor postoperative immunosuppressant. The early postoperative mortality was low with acceptable morbidity. Preoperative precise assessment and strict patient selection are of utmost importance.
Collapse
Affiliation(s)
- H Wen
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - J-H Dong
- Department of Hepatobiliary Surgery, Beijing Tsinghua Chang Gung Hospital, Beijing, P.R. China
| | - J-H Zhang
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - W-D Duan
- Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, P.R. China
| | - J-M Zhao
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Y-R Liang
- Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, P.R. China
| | - Y-M Shao
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - X-W Ji
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Q-W Tai
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - T Li
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - H Gu
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - T Tuxun
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Y-B He
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - J-F Huang
- Department of Hepatobiliary Surgery, Peking Union Medical College Hospital, Beijing, P.R. China
| |
Collapse
|
43
|
Torgerson PR, Devleesschauwer B, Praet N, Speybroeck N, Willingham AL, Kasuga F, Rokni MB, Zhou XN, Fèvre EM, Sripa B, Gargouri N, Fürst T, Budke CM, Carabin H, Kirk MD, Angulo FJ, Havelaar A, de Silva N. World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010: A Data Synthesis. PLoS Med 2015; 12:e1001920. [PMID: 26633705 PMCID: PMC4668834 DOI: 10.1371/journal.pmed.1001920] [Citation(s) in RCA: 443] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/02/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Foodborne diseases are globally important, resulting in considerable morbidity and mortality. Parasitic diseases often result in high burdens of disease in low and middle income countries and are frequently transmitted to humans via contaminated food. This study presents the first estimates of the global and regional human disease burden of 10 helminth diseases and toxoplasmosis that may be attributed to contaminated food. METHODS AND FINDINGS Data were abstracted from 16 systematic reviews or similar studies published between 2010 and 2015; from 5 disease data bases accessed in 2015; and from 79 reports, 73 of which have been published since 2000, 4 published between 1995 and 2000 and 2 published in 1986 and 1981. These included reports from national surveillance systems, journal articles, and national estimates of foodborne diseases. These data were used to estimate the number of infections, sequelae, deaths, and Disability Adjusted Life Years (DALYs), by age and region for 2010. These parasitic diseases, resulted in 48.4 million cases (95% Uncertainty intervals [UI] of 43.4-79.0 million) and 59,724 (95% UI 48,017-83,616) deaths annually resulting in 8.78 million (95% UI 7.62-12.51 million) DALYs. We estimated that 48% (95% UI 38%-56%) of cases of these parasitic diseases were foodborne, resulting in 76% (95% UI 65%-81%) of the DALYs attributable to these diseases. Overall, foodborne parasitic disease, excluding enteric protozoa, caused an estimated 23.2 million (95% UI 18.2-38.1 million) cases and 45,927 (95% UI 34,763-59,933) deaths annually resulting in an estimated 6.64 million (95% UI 5.61-8.41 million) DALYs. Foodborne Ascaris infection (12.3 million cases, 95% UI 8.29-22.0 million) and foodborne toxoplasmosis (10.3 million cases, 95% UI 7.40-14.9 million) were the most common foodborne parasitic diseases. Human cysticercosis with 2.78 million DALYs (95% UI 2.14-3.61 million), foodborne trematodosis with 2.02 million DALYs (95% UI 1.65-2.48 million) and foodborne toxoplasmosis with 825,000 DALYs (95% UI 561,000-1.26 million) resulted in the highest burdens in terms of DALYs, mainly due to years lived with disability. Foodborne enteric protozoa, reported elsewhere, resulted in an additional 67.2 million illnesses or 492,000 DALYs. Major limitations of our study include often substantial data gaps that had to be filled by imputation and suffer from the uncertainties that surround such models. Due to resource limitations it was also not possible to consider all potentially foodborne parasites (for example Trypanosoma cruzi). CONCLUSIONS Parasites are frequently transmitted to humans through contaminated food. These estimates represent an important step forward in understanding the impact of foodborne diseases globally and regionally. The disease burden due to most foodborne parasites is highly focal and results in significant morbidity and mortality among vulnerable populations.
Collapse
Affiliation(s)
| | - Brecht Devleesschauwer
- Ghent University, Ghent, Belgium.,Université catholique de Louvain, Brussels, Belgium.,Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | | | | | | | - Xiao-Nong Zhou
- Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Eric M Fèvre
- University of Liverpool, Liverpool, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | | | | | | | - Christine M Budke
- Texas A&M University, College Station, Texas, United States of America
| | - Hélène Carabin
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Martyn D Kirk
- The Australian National University, Canberra, Australia
| | - Frederick J Angulo
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Arie Havelaar
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Utrecht University, Utrecht, The Netherlands.,University of Florida, Gainesville, Gainesville, Florida, United States of America
| | | |
Collapse
|
44
|
Abulaihaiti M, Wu XW, Qiao L, Lv HL, Zhang HW, Aduwayi N, Wang YJ, Wang XC, Peng XY. Efficacy of Albendazole-Chitosan Microsphere-based Treatment for Alveolar Echinococcosis in Mice. PLoS Negl Trop Dis 2015; 9:e0003950. [PMID: 26352932 PMCID: PMC4564103 DOI: 10.1371/journal.pntd.0003950] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 07/03/2015] [Indexed: 12/23/2022] Open
Abstract
This study aimed to investigate the pharmacology and anti-parasitic efficacy of albendazole–chitosan microspheres (ABZ-CS-MPs) for established intraperitoneal infections of Echinococcus multilocularis metacestodes in an experimental murine model. Male outbred Kunming mice infected with E. multilocularis Metacestodes were administered with three ABZ formulations, namely, ABZ-CS-MPs, Liposome–Albendazole (L-ABZ), and albendazole tablet (ABZ-T). Each of the ABZ formulations was given orally at three different doses of 37.5, 75, and 150mg/kg, three times a week for 12 weeks postinfection. After administering the drugs, we monitored the pharmacological performance and anti-parasitic efficacy of ABZ-CS-MPs compared with L-ABZ, and ABZ-T treated mice. ABZ-CS-MPs reduced the weight of tissues containing E. multilocularis metacestodes most effectively compared with the ABZ-T group and untreated controls. Metacestode grown was Highly suppressed during treatment with ABZ-CS-MPs. Significantly higher plasma levels of ABZ metabolites were measured in mice treated with ABZ-CS-MPs or L-ABZ compared with ABZ-T. In particular, enhanced ABZ-sulfoxide concentration profiles were observed in the mice given 150mg/kg of ABZ-CS-MPs, but not in the mice treated with L-ABZ. Histological examination showed that damages caused disorganization of both the germinal and laminated layers of liver hyatid cysts, demolishing their characteristic structures after treatment with ABZ-CS-MPs or L-ABZ. Over time, ABZ-CS-MPs treatment induced a shift from Th2-dominant to Th1-dominant immune response. CS-MPs As a new carrier exhibited improved absorption and increased bioavailability of ABZ in the treatment of E. multilocularis infections in mice. Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis and is a rare but life-threatening disease. Albendazole is the most frequently used anti-parasitic drugs in patients infected with AE. However, ABZ has only limited water solubility, and small differences in drug solubility may have a major influence on their absorption and resultant pharmacokinetic behavior. Chitosan microspheres as a new carrier increased ABZ absorption and bioavailability. The anti-parasitic efficacy of albendazole–chitosan microspheres (ABZ-CS-MPs) in mice infected with Echinococcus multilocularis was assessed. ABZ-loaded CS-MPs exhibited improved absorption and increased bioavailability in the treatment of E. multilocularis infections in mice compared with those treated with liposome–albendazole and albendazole tablet. ABZ-CS-MPs are in solid form that can be manufactured in capsules or tablets, which can be easily delivered to those in need, particularly those who are nomadic. Therefore, given the merits of low cost, portability, and simple manufacturing, ABZ-CS-MPs are a promising drug to treat alveolar echinococcosis.
Collapse
Affiliation(s)
- Maitiseyiti Abulaihaiti
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Xiang-Wei Wu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Lei Qiao
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Hai-Long Lv
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Hong-Wei Zhang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Nasrul Aduwayi
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yan-Jie Wang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Xin-Chun Wang
- Department of Pharmacy, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
- * E-mail: (XCW); (XYP)
| | - Xin-Yu Peng
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
- * E-mail: (XCW); (XYP)
| |
Collapse
|
45
|
Abstract
AbstractThis review presents the historical and current situation of echinococcoses in Mongolia. Since the collapse of the Soviet Union in 1991, Mongolia's health surveillance infrastructure has been very poor, especially as it pertains to chronic diseases, including neglected zoonotic diseases (NZDs). Although there is anecdotal evidence of people dying from hepatic disease due to infection with the larval stage of Echinococcus spp., there are very few published reports. All confirmed cases of echinococcoses in Mongolia are from hospitals located in the capital city of Ulaanbaatar. Cases of cystic echinococcosis (CE), caused by either Echinococcus granulosus sensu stricto or Echinococcus canadensis are believed to be relatively common throughout Mongolia. In contrast, cases of alveolar echinococcosis (AE), caused by Echinococcus multilocularis, are believed to be rare. Recent wild-animal surveys have revealed that wolves (Canis lupus) are the major definitive hosts of E. canadensis, whereas both wolves and red foxes (Vulpes vulpes) are the primary definitive hosts of E. multilocularis. Although wild-animal surveys have begun to elucidate the transmission of Echinococcus spp. in Mongolia, there have yet to be large-scale studies conducted in domestic dogs and livestock. Therefore, further epidemiological studies, in addition to education-based control campaigns, are needed to help combat this NZD.
Collapse
|
46
|
Han J, Bao G, Zhang D, Gao P, Wu T, Craig P, Giraudoux P, Chen X, Xin Q, He L, Chen G, Jing T. A Newly Discovered Epidemic Area of Echinococcus multilocularis in West Gansu Province in China. PLoS One 2015; 10:e0132731. [PMID: 26186219 PMCID: PMC4505874 DOI: 10.1371/journal.pone.0132731] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 06/17/2015] [Indexed: 12/28/2022] Open
Abstract
Alveolar echinococcosis (AE) is a lethal parasitic disease. In Gansu Province of China, all AE cases reported in literature were from Zhang and Min Counties, the southern part of the province. Here, we report the discovery of nine AE cases and one cystic echinococcosis (CE) case from Nanfeng Town of Minle County, in the middle of Hexi Corridor in west Gansu Province. The diagnosis of these cases were confirmed by serology, histopathology, computed tomography, B-ultrasound, immunohistochemistry method, DNA polymerase chain reaction and sequencing analysis. Because eight of nine AE cases came from First Zhanglianzhuang (FZLZ) village, we conducted preliminary epidemiological analyses of 730 persons on domestic water, community and ecology such as 356 dogs’ faeces of FZLZ, in comparison with those of other five villages surrounding FZLZ. Our studies indicate that Nanfeng Town of Minle County is a newly discovered focus of AE in China as a CE and AE co-epidemic area. Further research of Echinococcus multilocularis transmission pattern in the area should be carried for prevention of this parasitic disease.
Collapse
Affiliation(s)
- Jian Han
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- The Research Institute of Biomedical Nanotechnology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Genshu Bao
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Duoqiang Zhang
- Department of Hepatobiliary Surgery, Ningxia People’s Hospital, Yinchuan, China
| | - Pengcheng Gao
- Department of General Surgery, Zhangye People’s Hospital, Zhangye, China
| | - Tinjun Wu
- Center for Disease Control of Minle County, Minle, China
| | - Philip Craig
- Cestode Zoonoses Research Group, School of Environment and Life Sciences, University of Salford, Manchester, United Kingdom
| | - Patrick Giraudoux
- Chrono-environment lab, University of Franche-Comté, Besançon, France
| | - Xiao Chen
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Qi Xin
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Lili He
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Gen Chen
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Tao Jing
- Department of Pathogenic Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- The Research Institute of Biomedical Nanotechnology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- * E-mail:
| |
Collapse
|
47
|
Richter PJ, Holtfreter M, Orhun A, Müller-Stöver I, Kubitz R, Hillenbrand A, Kratzer W, Gräter T, Grüner B. Echinokokkose-Erkrankungen. MMW Fortschr Med 2015; 157:56-63. [PMID: 26099410 DOI: 10.1007/s15006-015-2727-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pisa Joachim Richter
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Unversität, Moorenstr. 5, D-40225, Düsseldorf, Deutschland,
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Zhu M, Wang X, Wang H, Wang Z, Zhao J, Wang Y, Zhao W. Mechanism of protective immunity by vaccination with recombinant Echinococcus granulosus glutathione S-transferase (Chinese strain) in mice. Exp Ther Med 2015; 10:1127-1132. [PMID: 26622451 DOI: 10.3892/etm.2015.2582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 05/06/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to investigate the immunoprotective effects of recombinant Echinococcus granulosus glutathione S-transferase (rEgGST) against the development of protoscolices (PSCs), and to determine the mechanisms underlying this protection. ICR mice were subcutaneously immunized three times with rEgGST at weeks 0, 2 and 4, followed by the intraperitoneal administration of E. granulosus PSCs at week 10. Six mice in each group were sacrificed at 0, 2, 4, 6, 10, 18 and 30 weeks following the initial vaccination in order to observe the macroscopic and microscopic effects of parasite development. Various analyses were subsequently conducted, including determination of the levels of immunoglobulins (Igs) and cytokines. Significant differences were observed a number of indices of immune response following immunization with rEgGST. These included reduced cyst formation and elevated levels of IgG1, IgG2a, IgG3, IL-2, IL-4, IL-10 and IFN-γ, which indicated an increased percentage of immune helper cells. The results of the present study suggest that immunization with rEgGST in mice is able to successfully reduce the PSC-induced formation of cysts and to stimulate an immune response, suggesting that rEgGST possesses potential value as a candidate vaccine for PSC infection.
Collapse
Affiliation(s)
- Mingxing Zhu
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Xiuqing Wang
- Institute of Clinical Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Hao Wang
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Zhisheng Wang
- Experimental Animal Center, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Jiaqing Zhao
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Yana Wang
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| | - Wei Zhao
- Center of Scientific Technology, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
| |
Collapse
|
49
|
Hegglin D, Bontadina F, Deplazes P. Human–wildlife interactions and zoonotic transmission of Echinococcus multilocularis. Trends Parasitol 2015; 31:167-73. [DOI: 10.1016/j.pt.2014.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/03/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
|
50
|
Zhang W, Zhang Z, Wu W, Shi B, Li J, Zhou X, Wen H, McManus DP. Epidemiology and control of echinococcosis in central Asia, with particular reference to the People's Republic of China. Acta Trop 2015; 141:235-43. [PMID: 24686096 DOI: 10.1016/j.actatropica.2014.03.014] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 03/17/2014] [Accepted: 03/19/2014] [Indexed: 12/22/2022]
Abstract
At least 270 million people (58% of the total population) are at risk of cystic echinococcosis (CE) in Central Asia including areas of Mongolia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Afghanistan, Iran, Pakistan and western China. The annual surgical incidence rate in Uzbekistan and Tadjikistan has been estimated to be as high as 25-27 cases/100,000 with the highest prevalence reaching 10% (range from 0.8 to 11.9%) in some Tibetan communities in western China. Echinococcus transmission in the region is largely associated with social factors including limited community knowledge of echinococcosis, small-scale household animal production, home killing of livestock, and the feeding of dogs with uncooked offal. Alveolar echinococcosis (AE) is also endemic in Central Asia and is recognized as a major problem in some Tibetan communities with up to 6% of villagers infected in some villages. In western China, 5-30% of the population are seropositive against E. granulosus antigens, indicating that a large number of individuals have been exposed to the parasite. Although echinococcosis control programs have been initiated in some countries in Central Asia, control efforts are generally fragmented and uncoordinated. Monthly deworming of dogs with praziquantel (PZQ), as a key measure to control the Echinococcus parasites, has been used in western China. However, the approach has proven difficult in local semi-nomadic communities. Additional control measures including health education, domestic livestock animal treatment/vaccination and dog vaccination are needed in CE-endemic areas to accelerate progress.
Collapse
|