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Santucciu C, Bozzi E, Profili S, Porcu A, Masala G, Babudieri S, Mastrandrea S. Investigation of patients with new infection of echinococcal cyst in Sardinia, Italy. Diagn Microbiol Infect Dis 2024; 109:116224. [PMID: 38382287 DOI: 10.1016/j.diagmicrobio.2024.116224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
Cystic Echinococcosis (CE) is a zoonotic disease caused by the larval stage of a tapeworm of Taeniidae family, genus Echinococcus and species Echinococcus granulosus sensu lato (s.l.). CE is a worldwide public health problem and is highly incident in all Mediterranean areas. Following clinical, image techniques and serological investigations all 83 subjects involved in the study were diagnosed for CE. General and clinical data were entered into a database and evaluated. The 43.37% were female and 56.63% male, mean age was 50.71 while the range most represented (22.7%) was between 61->70 years. The purposes of our survey were to investigate these 83 patients enrolled in the study and to deeply examine 20 (24.10%) patients that developed a new echinococcal cyst. Moreover, the causes at the basis of the onset of a new cyst were analysed, together with a possible correlation with different treatments related to primary infection corresponding to surgery (n=7), albendazole (n=6), PAIR (n=3) and watch and wait (n=4). A possible link with medical treatments of the primary infection was observed in the subjects who underwent surgery or PAIR and a likely correlation attributable to high environmental contamination in subjects managed with drugs or watch and wait was detected. Moreover, our analysis evidenced that patients with a new infection presented a more severe diagnosis along with a major mortality rate. Finally, these data may have an important contribution for an epidemiological point of view concerning the percentage of CE in a specific geographical endemic area, such as Sardinia.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, Sassari 07100, Italy.
| | - Elena Bozzi
- U.O.C. di Malattie Infettive, A.O.U., Sassari 07100, Italy
| | | | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, Sassari 07100, Italy
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Santucciu C, Peruzzu A, Fara AM, Cossu A, Kronenberg PA, Deplazes P, Masala G. Immunohistochemistry as a Reliable Tool for the Diagnosis of Cystic Echinococcosis in Patients from Sardinia, Italy-A Confirmatory Study. Diseases 2024; 12:84. [PMID: 38785739 PMCID: PMC11119186 DOI: 10.3390/diseases12050084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Cystic Echinococcosis (CE) is a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato (s.l.). This study aims to investigate the use of two monoclonal antibodies (mAbEmG3 and mAbEm2G11) by immunohistochemistry (IHC) to confirm the diagnosis of CE in human patients, in particular in those cases in which other techniques fail to provide a correct or conclusive diagnosis. For this purpose, a survey on 13 patients was performed. These subjects were referred to Sardinian hospitals (Italy) from 2017 to 2022 and were suspected to be affected by CE. Our findings from these 13 patients showed the detection of E. granulosus sensu stricto by IHC in 12 of 13 echinococcal cysts, as one sample was of a non-parasitological origin. The results confirmed that IHC, by means of the mAbEmG3 and mAbEm2G11, is a reliable diagnostic tool that showed a very high performances when tested on strain of E. granulosus s.l. from Sardinia.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and National Reference Laboratory for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, 07100 Sassari, Italy; (A.P.); (G.M.)
| | - Angela Peruzzu
- WOAH and National Reference Laboratory for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, 07100 Sassari, Italy; (A.P.); (G.M.)
| | - Antonella Maria Fara
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy; (A.M.F.); (A.C.)
| | - Antonio Cossu
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy; (A.M.F.); (A.C.)
| | - Philipp A. Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8091 Zurich, Switzerland; (P.A.K.); (P.D.)
- Medical Micro- and Molecular Biology, Institute of Chemistry and Biotechnology, Zurich University of Applied Sciences (ZHAW), 8820 Wädenswil, Switzerland
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8091 Zurich, Switzerland; (P.A.K.); (P.D.)
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Giovanna Masala
- WOAH and National Reference Laboratory for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, 07100 Sassari, Italy; (A.P.); (G.M.)
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Bonelli P, Serra E, Dei Giudici S, Peruzzu A, Crotti S, Danesi P, Carvelli A, Piseddu T, Masala G. Molecular phylogenetic analysis of Echinococcus granulosus sensu lato infecting sheep in Italy. Acta Trop 2024; 252:107151. [PMID: 38367944 DOI: 10.1016/j.actatropica.2024.107151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/27/2024] [Accepted: 02/15/2024] [Indexed: 02/19/2024]
Abstract
Cystic Echinococcosis (CE), caused by the larval form of Echinococcus granulosus sensu lato, is a neglected zoonosis still threatening public health worldwide. In Italy different epidemiological scenarios were reported depending on the geographical area and associated socio-economic activities. Although in northern Italy the occurrence of E. granulosus is considered sporadic, in the southern regions and, particularly in Sardinia, CE prevalence reaches high levels. We analysed CE cysts collected from infected sheep from various areas of mainland Italy and the Sardinia island, with the main objective to investigate intergenotypic and intragenotypic variations at national level. CE cysts were collected from slaughtered sheep following post mortem inspection at local abattoirs. Total genomic DNA was extracted and amplification and sequencing of the partial mitochondrial genes nad5 and cox1 were performed. A Bayesian phylogenetic tree was estimated on a nad5 dataset (n = 260) composed of E. granulosus samples from this study (n = 126) and all the nad5 haplotypes available in GenBank (n = 134). In addition, haplotype network, diversity and neutrality analysis were performed on nad5 and cox1 sequences of Italian origin obtained in this study. E. granulosus sensu stricto (s.s.) was found to be the only Echinococcus species infecting sheep in Italy, mainly represented by G1 genotype (76 %) and, to a lower extent, by G3 genotype (24 %). Phylogenetic analyses revealed 40 nad5 and 33 cox 1 haplotypes, and the presence of two founder haplotypes, belonging to G1 and G3 genotype, showing 100 % similarity with DNA sequences from different geographic regions. The lack of geographical segregation, high haplotype and low nucleotide diversity coupled with significant negative values of Tajima's D and Fu's Fs observed in this study indicated high genetic variation and demographic expansion of E. granulosus s.s. in Italy.
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Affiliation(s)
- Piero Bonelli
- Istituto Zooprofilattico Sperimentale della Sardegna, WOAH Reference Laboratory for Echinococcosis, National Reference Laboratory of Echinococcosis (CeNRE), Via Vienna 2, Sassari, 07100, Italy.
| | - Elisa Serra
- Istituto Zooprofilattico Sperimentale della Sardegna, WOAH Reference Laboratory for Echinococcosis, National Reference Laboratory of Echinococcosis (CeNRE), Via Vienna 2, Sassari, 07100, Italy
| | - Silvia Dei Giudici
- Istituto Zooprofilattico Sperimentale della Sardegna, Diagnostica virologica, Sassari, 07100, Italy
| | - Angela Peruzzu
- Istituto Zooprofilattico Sperimentale della Sardegna, WOAH Reference Laboratory for Echinococcosis, National Reference Laboratory of Echinococcosis (CeNRE), Via Vienna 2, Sassari, 07100, Italy
| | - Silvia Crotti
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Perugia, 06126, Italy
| | - Patrizia Danesi
- Istituto Zooprofilattico Sperimentale della Venezie, Legnaro, 35020, Italy
| | - Andrea Carvelli
- Istituto Zooprofilattico Sperimentale del Lazio della Toscana, Roma, 00178, Italy
| | - Toni Piseddu
- Istituto Zooprofilattico Sperimentale della Sardegna, WOAH Reference Laboratory for Echinococcosis, National Reference Laboratory of Echinococcosis (CeNRE), Via Vienna 2, Sassari, 07100, Italy
| | - Giovanna Masala
- Istituto Zooprofilattico Sperimentale della Sardegna, WOAH Reference Laboratory for Echinococcosis, National Reference Laboratory of Echinococcosis (CeNRE), Via Vienna 2, Sassari, 07100, Italy
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Drocchi G, Santucciu C, Mastrandrea S, Sanguedolce F, Madonia M. Diagnosis and treatment of unusual multiorgan Echinococcus hydatid cysts. Curr Urol 2024; 18:75-77. [PMID: 38505159 PMCID: PMC10946642 DOI: 10.1097/cu9.0000000000000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background Echinococcosis is a zoonotic disease caused by Echinococcus granulosus. Usually, the liver is the most affected organ, accounting for approximately 70% to 85% of cases. The lungs represent 20% of the cases. Fewer than 10% are found in other sites, including the bone, brain, spleen, and kidneys. Case presentation A young man was referred to a local hospital for dull pain in the right flank, fever, and mild cough. Computed tomography showed 2 large cysts: the first involved the left lung and measured 130 × 90.5 × 120 mm, whereas the second cyst was located in the right kidney and measured 130 × 100 × 120 mm. Surgery was performed to remove both lesions in 2 separate surgical sessions. Conclusions Echinococcosis is a compulsorily notifiable disease. Collaboration between medical doctors from different specializations is necessary. A multidisciplinary approach is important for the correct therapeutic management of the disease. Furthermore, the high possibility of recurrence makes the long-term follow-up mandatory.
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Affiliation(s)
- Giovanni Drocchi
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
| | - Cinzia Santucciu
- OIE and National Reference Laboratory for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Sassari, Italy
| | - Scilla Mastrandrea
- Department of Infectious disease, Sassari University Hospital, Sassari, Italy
| | - Francesco Sanguedolce
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
| | - Massimo Madonia
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
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Casulli A, Antinori S, Bartoloni A, D'Amelio S, Gabrielli AF, Gazzoli G, Rinaldi L, Bruschi F. Neglected Tropical Diseases in Italy: introducing IN-NTD, the Italian network for NTDs. Parasitology 2023; 150:1082-1088. [PMID: 37264942 PMCID: PMC10801374 DOI: 10.1017/s0031182023000422] [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] [Received: 01/27/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 06/03/2023]
Abstract
The World Health Organization (WHO) defines neglected tropical diseases (NTDs) as a diverse group of primarily infectious diseases, which disproportionately affect poor and marginalized populations worldwide. In this context, NTDs are responsible for important morbidity and mortality and justify a global response. Moreover, NTDs are relatively neglected by research and development as well as by funding, if compared with the magnitude of the public health problem they represent. This happens even though, unlike other infectious diseases, they can be prevented, controlled and eliminated by targeted public health interventions. NTDs are mainly prevalent in communities from low-income countries in tropical and sub-tropical areas but are also present in upper–middle-income countries, including several in Europe. Here, we provide an update on the most relevant parasitic endemic or imported NTDs in Italy and illustrate the rationale for the establishment of the Italian network on NTDs, an alliance of scientific societies, institutes, foundations, universities and non-profit organizations united to fight NTDs.
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Affiliation(s)
- Adriano Casulli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- European Union Reference Laboratory for Parasites (EURLP), Istituto Superiore di Sanità, Rome, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
- Italian Society for Infectious and Tropical Diseases (SIMIT), Prato, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Stefano D'Amelio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Albis Francesco Gabrielli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Giovanni Gazzoli
- Italian Association Amici di Raoul Follereau (AIFO), Bologna, Italy
| | - Laura Rinaldi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Fabrizio Bruschi
- Department of Translational Research, N.T.M.S., School of Medicine, University of Pisa, Pisa, Italy
- Italian Society of Parasitology (SoIPa), c/o Department of Public Health, Sapienza Università di Roma, Rome, Italy
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Khosravi M, Mohammad Rahimi H, Nazari A, Baghaei K, Asadzadeh Aghdaei H, Shahrokh S, Sharifdini M, Torrecilhas AC, Mehryab F, Mirjalali H, Shekari F, Zali MR. Characterisation of extracellular vesicles isolated from hydatid cyst fluid and evaluation of immunomodulatory effects on human monocytes. J Cell Mol Med 2023; 27:2614-2625. [PMID: 37530547 PMCID: PMC10468670 DOI: 10.1111/jcmm.17894] [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] [Received: 07/27/2022] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023] Open
Abstract
Hydatidosis is a disease caused by the larval stage of Echinococcus granulosus, which involves several organs of intermediate hosts. Evidence suggests a communication between hydatid cyst (HC) and hosts via extracellular vesicles. However, a little is known about the communication between EVs derived from HC fluid (HCF) and host cells. In the current study, EVs were isolated using differential centrifugation from sheep HCF and characterized by western blot, electron microscope and size distribution analysis. The uptake of EVs by human monocyte cell line (THP-1) was evaluated. The effects of EVs on the expression levels of pro- and anti-inflammatory cytokines were investigated using quantitative real-time PCR (RT-PCR), 3 and 24 h after incubation. Moreover, the cytokine level of IL-10 was evaluated in supernatant of THP-1 cell line at 3 and 24 h. EVs were successfully isolated and showed spherical shape with size distribution at 130.6 nm. After 3 h, the expression levels of pro-inflammatory cytokine genes (IL1Β, IL15 and IL8) were upregulated, while after 24 h, the expression levels of pro-inflammatory cytokines were decreased and IL13 gene expression showed upregulation. A statistically significant increase was seen in the levels of IL-10 after 24 h. The main mechanism of the communication between EVs derived from HCF and their host remains unclear; however, time-dependent anti-inflammatory effects in our study suggest that HC may modulate the immune responses via EVs.
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Affiliation(s)
- Mojdeh Khosravi
- Department of Pharmacy and Pharmaceutical Technology and ParasitologyUniversity of ValenciaValenciaSpain
| | - Hanieh Mohammad Rahimi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Abdoreza Nazari
- Department of Molecular Systems Biology at Cell Science Research CenterRoyan Institute for Stem Cell Biology and TechnologyTehranIran
| | - Kaveh Baghaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Shabnam Shahrokh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Ana Claudia Torrecilhas
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências FarmacêuticasUniversidade Federal de São Paulo (UNIFESP)DiademaBrazil
| | - Fatemeh Mehryab
- Department of Molecular Systems Biology at Cell Science Research CenterRoyan Institute for Stem Cell Biology and TechnologyTehranIran
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Faezeh Shekari
- Department of Molecular Systems Biology at Cell Science Research CenterRoyan Institute for Stem Cell Biology and TechnologyTehranIran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver DiseasesShahid Beheshti University of Medical SciencesTehranIran
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7
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San-José A, Mayor P, Carvalho B, El Bizri HR, Antunes AP, Antunez Correa M, Aquino R, Bodmer RE, Boubli JP, Carvalho EAR, Campos-Silva JV, Constantino PAL, de Paula MJ, Desbiez ALJ, Fang T, Gómez-Puerta LA, Knoop SB, Longin G, Morcatty TQ, Maranhão L, Massocato GF, Munari DP, Nunes AV, Puertas P, Oliveira MA, Pezzuti JCB, Richard-Hansen C, Santos G, Valsecchi J, von Mühlen EM, Bosmediano J, Rodó X. Climate determines transmission hotspots of Polycystic Echinococcosis, a life-threatening zoonotic disease, across Pan-Amazonia. Proc Natl Acad Sci U S A 2023; 120:e2302661120. [PMID: 37549288 PMCID: PMC10438396 DOI: 10.1073/pnas.2302661120] [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] [Received: 02/22/2023] [Accepted: 06/28/2023] [Indexed: 08/09/2023] Open
Abstract
Polycystic Echinococcosis (PE), a neglected life-threatening zoonotic disease caused by the cestode Echinococcus vogeli, is endemic in the Amazon. Despite being treatable, PE reaches a case fatality rate of around 29% due to late or missed diagnosis. PE is sustained in Pan-Amazonia by a complex sylvatic cycle. The hunting of its infected intermediate hosts (especially the lowland paca Cuniculus paca) enables the disease to further transmit to humans, when their viscera are improperly handled. In this study, we compiled a unique dataset of host occurrences (~86000 records) and disease infections (~400 cases) covering the entire Pan-Amazonia and employed different modeling and statistical tools to unveil the spatial distribution of PE's key animal hosts. Subsequently, we derived a set of ecological, environmental, climatic, and hunting covariates that potentially act as transmission risk factors and used them as predictors of two independent Maximum Entropy models, one for animal infections and one for human infections. Our findings indicate that temperature stability promotes the sylvatic circulation of the disease. Additionally, we show how El Niño-Southern Oscillation (ENSO) extreme events disrupt hunting patterns throughout Pan-Amazonia, ultimately affecting the probability of spillover. In a scenario where climate extremes are projected to intensify, climate change at regional level appears to be indirectly driving the spillover of E. vogeli. These results hold substantial implications for a wide range of zoonoses acquired at the wildlife-human interface for which transmission is related to the manipulation and consumption of wild meat, underscoring the pressing need for enhanced awareness and intervention strategies.
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Affiliation(s)
- Adrià San-José
- Climate and Health Program, ISGlobal, Barcelona08003, Spain
| | - Pedro Mayor
- Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona, Bellaterra08193, España
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
| | - Bruno Carvalho
- Climate and Health Program, ISGlobal, Barcelona08003, Spain
| | - Hani R. El Bizri
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- School of Science, Engineering and Environment, University of Salford, SalfordM5 4WT, United Kingdom
| | - André Pinassi Antunes
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Instituto Nacional de Pesquisas da Amazônia, Manaus, Amazonas69067-375, Brazil
| | - Miguel Antunez Correa
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
- Programa Putumayo Amazonas, Instituto del Bien Común, Loreto15072, Perú
| | - Rolando Aquino
- Instituto de Investigaciones de Trópico y de Altura, Universidad Nacional Mayor de San Marcos, Iquitos575, Peru
| | - Richard E. Bodmer
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
| | - Jean P. Boubli
- School of Science, Engineering and Environment, University of Salford, SalfordM5 4WT, United Kingdom
| | - Elildo A. R. Carvalho
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Centro Nacional de Pesquisa e Conservação de Mamíferos Carnívoros, Instituto Chico Mendes de Conservação da Biodiversidade, Atibaia, SP12952-011, Brazil
| | | | - Pedro A. L. Constantino
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- US Forest Service - International Programs1 Thomas Circle NW, Suite 400, Washington, DC20005
| | - Milton José de Paula
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Instituto Federal de Educação Ciência e Tecnologia do Pará, Altamira, Pará68377-630, Brazil
| | - Arnauld L. J. Desbiez
- Instituto de Conservação de Animais Silvestres, Campo Grande, Mato Grosso do Sul79040-290, Brazil
| | - Tula Fang
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
| | - Luis A. Gómez-Puerta
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima01, Peru
| | - Simon B. Knoop
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
| | - Guillaume Longin
- Parc Amazonien de Guyane, Maripasoula, French Guiana97370, France
| | - Thais Q. Morcatty
- Oxford Wildlife Trade Research Group, Oxford Brookes University, OxfordOX3 0BP, United Kingdom
| | - Louise Maranhão
- Research Group on Terrestrial Vertebrate Ecology, Mamirauá Sustainable Development Institute, Tefé, Amazonas69553-225, Brasil
| | - Gabriel Favero Massocato
- Instituto Federal de Educação Ciência e Tecnologia do Pará, Altamira, Pará68377-630, Brazil
- Instituto de Conservação de Animais Silvestres, Campo Grande, Mato Grosso do Sul79040-290, Brazil
| | - Daniel P. Munari
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
| | - André Valle Nunes
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Laboratory of Biodiversity Monitoring and Food Security, Knowledge Center on Biodiversity, Belo Horizonte31270-901, Brazil
| | - Pablo Puertas
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
| | - Marcela A. Oliveira
- Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, Iquitos16002, Peru
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Centro Universitário Aparício Carvalho, Porto Velho76811-678, Brasil
- Programa de Pós-Graduação em Conservação e Uso de Recursos Naturais, Universidade Federal de Rondônia, Porto Velho76800-000, Brasil
| | - Juarez C. B. Pezzuti
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Núcleo de Altos Estudos Amazônicos, Universidade Federal do Pará, Belém66075110, Brasil
| | - Cécile Richard-Hansen
- Service Espèces à Enjeux, Direction de la Recherche et Appui Scientifique, Office Français de la Biodiversité/Unité Mixte de Recherche Ecologie des Forêts de Guyane, Kourou, French Guiana97310, France
| | - Geovanna Santos
- Centro Universitário São Lucas, Porto Velho, Rondônia76805-846, Brazil
| | - João Valsecchi
- Rede de Pesquisa em Biodiversidade, Conservação e Uso da Fauna da Amazônia, Manaus69067-375, Brasil
- Research Group on Terrestrial Vertebrate Ecology, Mamirauá Sustainable Development Institute, Tefé, Amazonas69553-225, Brasil
| | | | - John Bosmediano
- Departamento de Ciencias e Ingeniería, Universidad Científica de Perú, Iquitos16007, Peru
| | - Xavier Rodó
- Climate and Health Program, ISGlobal, Barcelona08003, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona08010, Spain
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Maggioni G, Bonis A, Schiavon M, Giraudo C, Lunardi F, Pezzuto F, Calabrese F. An unexpected guest: Pulmonary echinococcosis diagnosed by intraoperative frozen section examination. A case report and literature review. Pathol Res Pract 2023; 248:154615. [PMID: 37343377 DOI: 10.1016/j.prp.2023.154615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/23/2023]
Abstract
Echinococcosis is caused by tapeworms belonging to the Echinococcus genus. The most common site of infection is the liver although it may involve almost any organ. Symptoms of pulmonary echinococcosis vary depending on the location and structure of the cyst. While uncomplicated cysts usually appear at imaging as well-defined homogeneous lesions with fluid content and smooth walls of variable thickness, complicated lesions may have a more heterogeneous content with higher density making more difficult the distinction from malignancies or other infections. Hereby we describe the case of a 61-year-old Northern African male admitted to our tertiary center for left upper chest pain who then underwent a chest computed tomography (CT) scan which demonstrated a large hypodense lesion, with smooth and thick walls, in the upper left lobe. The following magnetic resonance confirmed the homogeneous fluid content, and the 18 F- fluorodeoxyglucose-positron emission tomography/CT demonstrated a mild uptake of the walls. According to these findings, the main differential diagnoses at imaging included bronchogenic cyst, synovial sarcoma, and pulmonary hematoma although the patient denied any recent trauma. Given the large size and clinical symptoms he underwent surgery. Intra-operative frozen section, supported by imprint cytology, excluded the presence of malignancy while suggested an echinococcal laminar exocyst. The final pathological examination confirmed the diagnosis of echinococcosis (i.e., Echinococcus Granulosus protoscolex). After surgery he was treated with albendazole and at the six-month follow-up he was in good clinical conditions. Our case highlights the importance of considering rare infections, particularly in individuals from endemic areas. Frozen tissue analyses can be a diagnostic challenge and often require ancillary tools such as imprint cytology and serial sections for more sensitive and accurate diagnosis.
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Affiliation(s)
- Giuseppe Maggioni
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Alessandro Bonis
- Thoracic Surgery Unit, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35121 Padua, Italy
| | - Marco Schiavon
- Thoracic Surgery Unit, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35121 Padua, Italy
| | - Chiara Giraudo
- Radiology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Francesca Lunardi
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Federica Pezzuto
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Fiorella Calabrese
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy.
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Colpani A, Achilova O, D’Alessandro GL, Budke C, Mariconti M, Muratov T, Vola A, Mamedov A, Giordani MT, Suvonkulov U, Brunetti E, Manciulli T. Ultrasound-Based Prevalence of Cystic Echinococcosis in the Samarkand Region of Uzbekistan: Results from a Field Survey. Am J Trop Med Hyg 2023; 109:153-158. [PMID: 37277104 PMCID: PMC10324010 DOI: 10.4269/ajtmh.22-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/25/2023] [Indexed: 06/07/2023] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis caused by Echinococcus granulosus. Uzbekistan is endemic for CE, but estimates of disease burden are lacking. We present findings from a cross-sectional, ultrasound-based survey evaluating the prevalence of human CE in the Samarkand region, Uzbekistan. The survey was conducted between September and October 2019 in the Payariq district, Samarkand. Study villages were selected based on sheep breeding and reported human CE. Residents aged 5-90 years were invited to receive a free abdominal ultrasound examination. The WHO Informal Working Group on Echinococcosis classification was used for cyst staging. Information regarding CE diagnosis and treatment was collected. Of 2,057 screened subjects, 498 (24.2%) were male. Twelve (0.58%) had detectable abdominal CE cysts. In total, five active/transitional (N = 1 CE1, N = 1 CE2, N = 3 CE3b) and 10 inactive cysts (N = 8 CE4, N = 2 CE5) were identified. Two participants had cystic lesions with no pathognomonic features of CE and were given a 1-month course of albendazole for diagnostic purposes. Twenty-three additional individuals reported previous surgery for CE in the liver (65.2%), lungs (21.6%), spleen (4.4%), liver and lungs (4.4%), and brain (4.4%). Our findings confirm the presence of CE in the Samarkand region, Uzbekistan. Additional studies are needed to assess the burden of human CE in the country. All patients with a history of CE reported surgery, even though most cysts found during the current study were inactive. Therefore, it appears there is a lack of awareness by the local medical community of the currently accepted stage-specific management of CE.
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Affiliation(s)
- Agnese Colpani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Olesya Achilova
- Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan
| | - Gian Luca D’Alessandro
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Mara Mariconti
- Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Timur Muratov
- Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan
| | - Ambra Vola
- Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Arzu Mamedov
- Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan
| | | | | | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Tommaso Manciulli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
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Santucciu C, Bonelli P, Peruzzu A, Fancellu A, Farà A, Mastrandrea S, Drocchi G, Cossu A, Profili S, Porcu A, Masala G. Genetic Characterization of Echinococcus granulosus sensu stricto Isolated from Human Cysts from Sardinia, Italy. Diseases 2023; 11:91. [PMID: 37489443 PMCID: PMC10366878 DOI: 10.3390/diseases11030091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/26/2023] Open
Abstract
This study involved 20 patients affected by cystic echinococcosis (CE) who were referred to different hospitals of Sardinia (Italy) from 2017 to 2022. By means of a multidisciplinary approach, diagnosis was confirmed for CE in 18 patients and for different aetiologies in two subjects. Moreover, serology was positive for 15 subjects. Since multiple CE cysts were found in five patients, a total of 27 lesions were collected; however, only one for each patient was investigated for genetic characterization of E. granulosus s.s. DNA isolates. Our results included 15 fertile cysts that underwent DNA extraction and amplification by three different PCRs targeting nuclear (calreticulin) and mitochondrial genes (cox1 and nad5). DNA was sequenced, and by neighbour-joining phylogenetic trees we determined 10 G1 and five G3 genotypes previously reported in Sardinia. These sequences were used to construct a network, along with those circulating in Mediterranean areas. The haplotype network calculated on cox1 evidenced seven different haplotypes of the 15 isolates, with SAR2 the most represented, carried by seven cysts, and SAR17 never described in the Mediterranean area. Meanwhile, the nad5 sequences showed the most common haplotype as nd5SAR7, as well as two new haplotypes not previously described, nd5SAR13, isolated from a Sardinian patient, and nd5SAR14, isolated from a Romanian patient.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Piero Bonelli
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Angela Peruzzu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Antonella Farà
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy
| | - Scilla Mastrandrea
- Unità Operativa Complessa di Malattie Infettive, Azienda Ospedaliero-Universitaria, 07100 Sassari, Italy
| | - Giovanni Drocchi
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16132 Genova, Italy
| | - Antonio Cossu
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy
| | - Stefano Profili
- Unità Operativa Complessa di Radiologia, Azienda Ospedaliero-Universitaria, 07100 Sassari, Italy
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
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Alvi MA, Ali RMA, Khan S, Saqib M, Qamar W, Li L, Fu BQ, Yan HB, Jia WZ. Past and Present of Diagnosis of Echinococcosis: A Review (1999-2021). Acta Trop 2023; 243:106925. [PMID: 37080264 DOI: 10.1016/j.actatropica.2023.106925] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
The larval forms of taeniid cestodes belonging to the genus Echinococcus are the source of the zoonotic infection known as echinococcosis. Alveolar and cystic echinococcosis are caused by Echinococcus multilocularis and Echinococcus granulosus (s. s) respectively. It is endemic in several regions of the world. In this systematic review, we describe diagnosis, and the species (human, canids, livestock, and small rodents) affected by cystic (CE) and alveolar echinococcosis (AE). From 1999 to 2021, we searched the online directory through PubMed, SCOPUS, Web of Science, and google scholar. Among the 37,700 records found in the online databases, 187 publications met our eligibility requirements. The majority of investigations employed a range of diagnostic methods, such as ELISA, imaging, copro-PCR, necropsy or arecoline hydrobromide purgation, morphological cestode confirmation, and fecal sieving/flotation to detect and confirm Echinococcus infection. ELISA was the most commonly used method followed by PCR, and imaging. The research team retrieved data describing the incidence or assessment of the diagnostic test for E. multilocularis in humans (N = 99), canids (N = 63), small ruminants (N = 13), large ruminants (N= 3), camel (N= 2), pigs (N=2) and small mammals (N= 5). This study was conducted to explore the diagnostic tools applied to detect echinococcosis in humans as well as animals in prevalent countries, and to report the characteristic of new diagnostic tests for disease surveillance. This systematic review revealed that ELISA (alone or in combination) was the most common method used for disease diagnosis and diagnostic efficacy and prevalence rate increased when recombinant antigens were used. It is highly recommended to use combination protcols such as serological with molecular and imaging technique to diagnose disease. Our study identified scarcity of data of reporting echinococcosis in humans/ animals in low-income or developing countries particularly central Asian countries. Study reports in small rodents indicate their role in disease dissemination but real situation in these host is not refected due to limited number of studies. Even though echinococcosis affects both public health and the domestic animal sector, therefore, it is important to devise new and strengthe implementation of the existing monitoring, judging, and control measures in this estimate.
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Affiliation(s)
- Mughees Aizaz Alvi
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Rana Muhammad Athar Ali
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Sadiq Khan
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Warda Qamar
- Department of Parasitology, University of Agriculture, Faisalabad, Pakistan
| | - Li Li
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Bao-Quan Fu
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Hong-Bin Yan
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China.
| | - Wan-Zhong Jia
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China.
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12
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Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project. THE LANCET. INFECTIOUS DISEASES 2023; 23:e95-e107. [PMID: 36427513 DOI: 10.1016/s1473-3099(22)00638-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/24/2022]
Abstract
The neglected zoonosis cystic echinococcosis affects mainly pastoral and rural communities in both low-income and upper-middle-income countries. In Europe, it should be regarded as an orphan and rare disease. Although human cystic echinococcosis is a notifiable parasitic infectious disease in most European countries, in practice it is largely under-reported by national health systems. To fill this gap, we extracted data on the number, incidence, and trend of human cases in Europe through a systematic review approach, using both the scientific and grey literature and accounting for the period of publication from 1997 to 2021. The highest number of possible human cases at the national level was calculated from various data sources to generate a descriptive model of human cystic echinococcosis in Europe. We identified 64 745 human cystic echinococcosis cases from 40 European countries. The mean annual incidence from 1997 to 2020 throughout Europe was 0·64 cases per 100 000 people and in EU member states was 0·50 cases per 100 000 people. Based on incidence rates and trends detected in this study, the current epicentre of cystic echinococcosis in Europe is in the southeastern European countries, whereas historical endemic European Mediterranean countries have recorded a decrease in the number of cases over the time.
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13
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Entezami M, Nocerino M, Widdicombe J, Bosco A, Cringoli G, Casulli A, Iacono GL, Rinaldi L, Prada JM. The spatial distribution of cystic echinococcosis in Italian ruminant farms from routine surveillance data. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.1034572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IntroductionCystic echinococcosis (CE) is a zoonotic parasite caused by the cestode Echinococcus granulosus sensu lato (s.l.) which predominantly affects livestock. The disease is endemic in central-southern and insular Italy, with CE particularly infecting sheep, goats, cattle, and water buffalo. The spatial distribution of CE in endemic regions is not widely understood, with surveillance efforts varying across the region.MethodsIn this study, we investigated the spatial distribution of CE in livestock using samples from farms across different livestock species using a Stochastic Partial Differential Equations (SPDE) model. Samples were collected during a survey conducted in the area of central-southern and insular Italy between the years 2019 – 2021.ResultsA total of 3141 animal samples (126 goats, 601 sheep and 2414 cattle and water buffalo) were inspected for Echinococcus s.l. cysts through routine surveillance in abattoirs by postmortem visual examination, palpation and incision of target organs. The geographic location of the farm of origin (a total of 2,878) for each sample was recorded. CE prevalence of 46.0% (1,323/2,878) was estimated at the farm level with 78.3% (462/590) of farms with sheep, 28.6% (36/126) of farms with goats, 36.5% (747/2,049) of farms with cattle, and 23.5% (102/434) of farms with water buffalo infected.DiscussionThe spatial model evaluated the probability of infection in farms across the sampled regions, with the distribution of CE showing high clustering of infected cattle farms in Sardinia and Sicily regions, and sheep farms in Salerno province (Campania region). The output of this study can be used to identify CE hot-spots and to improve surveillance and control programs in endemic areas of Italy.
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Parandin F, Hanafi-Bojd AA, Heydarpour F, Mohebali M, Zeinali M, Akbari Sari A, Rezaei M, Rokni MB. Risk Mapping and Spatial Modeling of Human Cystic Echinococcosis in Iran from 2009 to 2018: A GIS-Based Survey. IRANIAN JOURNAL OF PARASITOLOGY 2022; 17:306-316. [PMID: 36466033 PMCID: PMC9682367 DOI: 10.18502/ijpa.v17i3.10620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/25/2021] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis. METHODS The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test. RESULTS Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001). CONCLUSION The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis.
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Affiliation(s)
- Fatemeh Parandin
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Heydarpour
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zeinali
- Center of Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaei
- Department of Forestry and Landscape Architecture, Konkuk University, Seoul, South Korea
| | - Mohammad Bagher Rokni
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
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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).
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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.)
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Molecular Study Of Hydatid Disease In Iraqi Goats By using The Mitochondrial Cytochrome C Oxidase Subunit 1 Gene. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the present study was to identify and recognize the genotype for cystic Echinococcosis that infects goats (n=19) in Iraq. The hydatid cyst was collected from different parts of the body, i.e. lungs, liver, heart, spleen and peritoneal cavity. The current study was conducted in five different regions of Iraq (Anbar, Baghdad, Saladdin, Karkuk, Babylon during October 2018 to July 2019. The mitochondria DNA was extracted and screened for the presence of (CO1) cytochrome C oxidase subunit 1 gene using polymer chain reactions (PCR). Amplification size was around 450bp. The amplicon was isolated and purified. The isolated CO1 amplicon was sequenced. The CO1 putative sequence was BLAST with available sequence from NCBI. The genetic tree was deduced. The genotype G1 is the most frequently spread strains and considered as a key source for infection in goats of Iraq.
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Comparison and evaluation of analytic and diagnostic performances of four commercial kits for the detection of antibodies against Echinococcus granulosus and multilocularis in human sera. Comp Immunol Microbiol Infect Dis 2022; 86:101816. [PMID: 35472655 DOI: 10.1016/j.cimid.2022.101816] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 02/08/2023]
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Casulli A, Massolo A, Saarma U, Umhang G, Santolamazza F, Santoro A. Species and genotypes belonging to Echinococcus granulosus sensu lato complex causing human cystic echinococcosis in Europe (2000-2021): a systematic review. Parasit Vectors 2022; 15:109. [PMID: 35346335 PMCID: PMC8962544 DOI: 10.1186/s13071-022-05197-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study aimed to fill a gap of knowledge by providing a quantitative measure of molecularly identified species and genotypes belonging to Echinococcus granulosus sensu lato (s.l.) causing human cystic echinococcosis (CE) in Europe during the period 2000-2021. As these species and genotypes are characterized by genetic, animal host and geographical differences, studying the E. granulosus s.l. complex is epidemiologically relevant. METHODS A systematic review (SR) was conducted on the basis of both scientific and grey literature considering primary studies between 2000 and 2021 in four databases. From a total of 1643 scientific papers, 51 records were included in the SR. The main inclusion criterion for this study was the molecular confirmation of E. granulosus s.l. at the genotype/species level as a causative agent of human CE cases in selected European countries. RESULTS Relevant data were obtained from 29 out of 39 eligible European countries. This SR identified 599 human molecularly confirmed echinococcal cysts: 460 (76.8%) identified as E. granulosus sensu stricto (s.s.), 130 (21.7%) as E. canadensis cluster (G6/7 and G10), 7 (1.2%) as E. ortleppi (G5), and 2 as E. vogeli (0.3%). Three geographical hotspots of human CE caused by different species of the E. granulosus s.l. complex were identified: (1) E. granulosus s.s. in Southern and South-eastern Europe (European-Mediterranean and Balkan countries); (2) E. canadensis (G6/7) in Central and Eastern Europe; (3) E. ortleppi in Central and Western Europe. This SR also identified data gaps that prevented a better definition of the geographical distribution of the Echinococcus granulosus s.l. species complex in Europe: western Balkan countries, part of Central Europe, and Baltic countries. CONCLUSIONS These results mandate longitudinal, multi-centre, intersectoral and transdisciplinary studies which consider both molecular and clinical epidemiology in animals and humans. Such studies would be valuable for a better understanding of the transmission of the E. granulosus s.l. species complex and their potential clinical impact on humans.
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Affiliation(s)
- Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy.
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy.
| | - Alessandro Massolo
- Department of Biology, Ethology Unit, University of Pisa, Pisa, Italy
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- UMR CNRS 6249 Chrono-Environnement, Université Bourgogne Franche-Comté, Besancon, France
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Gérald Umhang
- Anses LRFSN, National Reference Laboratory for Echinococcus Spp, Malzéville, France
| | - Federica Santolamazza
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Azzurra Santoro
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
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Serra E, Masu G, Chisu V, Cappai S, Masala G, Loi F, Piseddu T. Environmental Contamination by Echinococcus spp. Eggs as a Risk for Human Health in Educational Farms of Sardinia, Italy. Vet Sci 2022; 9:vetsci9030143. [PMID: 35324871 PMCID: PMC8953574 DOI: 10.3390/vetsci9030143] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023] Open
Abstract
Cystic Echinococcosis (CE) is a severe zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus. These parasites are naturally transmitted between canid definitive hosts that harbour the adult stage in the intestine, and mainly ungulate intermediate hosts, with larval cysts developing in their internal organs. The close coexistence between dog and sheep with incorrect hygiene management are the most important factors for the persistence of this parasitic pathology. The Educational Farms (EF) are farms and agritourisms suitably equipped to carry out training activities for people interested in farm practices and agricultural processing, in particular student groups. Public attendance of farms represents a new potential risk factor for the zoonoses transmission. Consumption of contaminated food and water in combination with contact or playing with domestic dogs (Canis familiaris) are possible routes of zoonoses human infection. In fact, Echinococcus spp. eggs may persist in the environment up to several months at low temperatures and moist conditions, having the chance of contaminating different matrices and surfaces. The aim of this investigation was to study environmental contamination by parasitic elements as a risk for zoonoses, such as Echinococcus spp. A total of 116 samples (35 of water, 33 of soil, 23 of vegetables, 25 of dog faeces) were collected in 30 EF in Sardinia. Samples were subjected to biomolecular investigation for the research of specific gene sequences of Echinococcus granulosus, Echinococcus multilocularis and Taenia spp. The study allowed to identify eight positive EF due to the presence of Echinococcusgranulosus in eight dog faeces samples and one positive EF due to the presence of Taenia spp. in a water sample. The work has allowed to develop and harmonise the diagnostic methods and operating protocols essential for controlling the spread of the CE to create “One Health” intervention plans in high endemic areas through the implementation of SOP (standard operating procedures) for monitoring the pathology in animals, humans and environment.
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Affiliation(s)
- Elisa Serra
- OIE-National Reference Laboratory of Echinococcosis, Istituto Zooprofilattico Sperimentale della Sardegna, Via Vienna, 07100 Sassari, Italy; (E.S.); (G.M.); (G.M.); (T.P.)
| | - Gabriella Masu
- OIE-National Reference Laboratory of Echinococcosis, Istituto Zooprofilattico Sperimentale della Sardegna, Via Vienna, 07100 Sassari, Italy; (E.S.); (G.M.); (G.M.); (T.P.)
| | - Valentina Chisu
- OIE-National Reference Laboratory of Echinococcosis, Istituto Zooprofilattico Sperimentale della Sardegna, Via Vienna, 07100 Sassari, Italy; (E.S.); (G.M.); (G.M.); (T.P.)
- Correspondence: (V.C.); (F.L.)
| | - Stefano Cappai
- Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Istituto Zooprofilattico Sperimentale della Sardegna, Via XX Settembre, 09125 Cagliari, Italy;
| | - Giovanna Masala
- OIE-National Reference Laboratory of Echinococcosis, Istituto Zooprofilattico Sperimentale della Sardegna, Via Vienna, 07100 Sassari, Italy; (E.S.); (G.M.); (G.M.); (T.P.)
| | - Federica Loi
- Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Istituto Zooprofilattico Sperimentale della Sardegna, Via XX Settembre, 09125 Cagliari, Italy;
- Correspondence: (V.C.); (F.L.)
| | - Toni Piseddu
- OIE-National Reference Laboratory of Echinococcosis, Istituto Zooprofilattico Sperimentale della Sardegna, Via Vienna, 07100 Sassari, Italy; (E.S.); (G.M.); (G.M.); (T.P.)
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20
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Human Cystic Echinococcosis in Lebanon: A Retrospective Study and Molecular Epidemiology. Acta Parasitol 2022; 67:186-195. [PMID: 34264443 PMCID: PMC8938340 DOI: 10.1007/s11686-021-00453-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/06/2021] [Indexed: 11/26/2022]
Abstract
Purpose Human cystic echinococcosis (CE) is a zoonotic parasitic disease that constitutes a public health challenge and a socio-economic burden in endemic areas worldwide. No specific surveillance system of CE infections in humans exists in Lebanon. The incidence and trends over time have not been documented. The current study aimed to assess the demographic and epidemiologic features of human CE surgical cases over a 14-year period in the five main regions of Lebanon. Methods From 2005 to 2018, a total of 894 surgically confirmed cases of hydatidosis were recorded from five anatomy and pathology laboratories. Results The mean annual surgical incidence was 1.23/100,000 inhabitants. Over the span of these years, the incidence increased from 0.53 to 1.94 cases/100,000 inhabitants in 2005 and 2018, respectively. CE is present in Lebanon with an uneven distribution from one region to the other with higher prevalence in Bekaa (29.0%), a rural area where sheep raising is widespread. Human CE cases were more common in females (60.1%) than in males (39.9%) and a high burden of infection was reported for the age group of 30–39 years. Besides, 66.7% of the cases expressed only liver complications whereas, 20.5% showed predilection towards lungs. The 7.8% of cases presented cysts in other organs, and 1.3% showed multiple localizations. Additionally, predominant involvement of Echinococcus granulosus sensu stricto was recorded in human infections. Comparison of Echinococcus granulosus s.s. populations from different Mediterranean countries also revealed high gene flow among this region and sharing of alleles. Conclusion The current study is a step forward to fill the gap of knowledge for the hydatidosis in Lebanon where the lack of epidemiological data and control measures have resulted in higher incidence of human CE. Graphic Abstract ![]()
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Basinger SC, Khan A, Ahmed H, Afzal MS, Simsek S, Budke CM. Estimation of the monetary burden of treated human cystic echinococcosis in Pakistan. Acta Trop 2021; 222:106026. [PMID: 34186020 DOI: 10.1016/j.actatropica.2021.106026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/22/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus sensu lato tapeworms, continues to be a public health problem in many endemic countries, including Pakistan. Patient level data, including age, sex, and cyst(s) location for surgically managed CE patients for the years 2013-2016 from hospitals located in Punjab and Khyber Pakhtunkhwa provinces were obtained from medical charts. Direct and indirect costs associated with surgically managed CE patients treated in private and public hospitals were then estimated and applied to country-level case numbers estimated through the Global Burden of Disease Study. A total cost of US$4,068,666 (95% CI: US$3,097,684 - US$5,295,702) was estimated for the year 2017, with US$3,951,853 (95% CI: US$2,981,400 - US$5,177,610) attributable to direct diagnosis and treatment-related costs and US$117,137 (95% CI: US$91,841 - US$146, 979) attributable to wage losses during the treatment period. Mean direct cost per patient (US$1,056) was approximately 72% of the country's per capita gross domestic product (GDP). Surgical management continues to be the treatment of choice for CE patients in Pakistan. If physicians were to adhere to World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) cyst stage-specific treatment guidelines, it is likely that the number of surgical interventions would decrease as would treatment costs.
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Vola A, Mariconti M, Lissandrin R, Cuzzocrea F, Bortolotto C, Sammarchi L, Vercelli A, Rinaldi P, Maestri M, Manciulli T, Brunetti E. Prospective collection of clinical data on cystic echinococcosis: experience with the European Registry of Cystic Echinococcosis in Pavia, Italy. Trans R Soc Trop Med Hyg 2021; 116:157-162. [PMID: 34323274 DOI: 10.1093/trstmh/trab097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/28/2021] [Accepted: 06/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a chronic, complex and neglected infection that may cause serious disease in humans. Given its peculiar epidemiologic and clinical features, collection of clinical data is challenging. Notification systems, when available, fail to record important clinical features, available data are mostly retrospectively collected and no prospectively enrolled uniform surveillance systems exist. The European Register of Cystic Echinococcosis database (ERCE) is the first systematic attempt to address these issues. METHODS Here, we describe the demographics and clinical characteristics of 436 patients who accessed the CE clinic at the University of Pavia-San Matteo Hospital Foundation, in Pavia, Italy, from March 2012 to February 2020. RESULTS Overall, 436 patients, consisting of 204 (46.8%) males and 232 (53.2%) females were enrolled; the mean age at enrollment was 50 (range 4-88) y. Of the 436 patients, 248 (56.9%) were born in Italy while 188 (43.1%) were foreign-born. In total, 638 CE cysts were counted, most of them in the CE4 (230; 36.1%) and CE3b (131; 20.5%) stages. CONCLUSIONS This is the largest cohort of CE patients with detailed clinical and demographic data published to date. We strongly encourage colleagues caring for CE patients in the European Union to join the ERCE.
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Affiliation(s)
- Ambra Vola
- Unit of Molecular Virology, Microbiology and Virology Department, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Mara Mariconti
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Raffaella Lissandrin
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy
| | - Fabrizio Cuzzocrea
- Unit of Orthopedic Surgery and Traumatology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Chandra Bortolotto
- Unit of Orthopedic Surgery and Traumatology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Luigi Sammarchi
- Unit of Radiology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Alessandro Vercelli
- Department of Radiology, Istituto di Cura, Città di Pavia, Via Parco Vecchio, 27, 27100 Pavia, Italy
| | - Pietro Rinaldi
- Unit of Thoracic Surgery, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Marcello Maestri
- Unit of General Surgery, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Tommaso Manciulli
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy.,Unit of Radiology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Enrico Brunetti
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy
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23
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Khan A, Ahmed H, Amjad S, Afzal MS, Haider W, Simsek S, Khawaja MR, Khan DH, Naz S, Durrance-Bagale A, Shabbir RMK, Arfeen RZU, Ali S, Cao J. Community Based Assessment of Behavior and Awareness of Risk Factors of Cystic Echinococcosis in Major Cities of Pakistan: A One Health Perspective. Front Public Health 2021; 9:648900. [PMID: 34150699 PMCID: PMC8213035 DOI: 10.3389/fpubh.2021.648900] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The parasitic disease, cystic echinococcosis (CE), is a serious health problem in Pakistan. Risk of disease transmission is increased by economic and political instability, poor living conditions, and limited awareness of hygienic practices. The current study aimed to investigate the community perception and awareness regarding the risk factors of CE in Pakistan, from a One Health perspective. Methods: We conducted a community-based survey involving 454 participants in the major cities of Pakistan. Quantitative data based on knowledge, attitude, and practices (KAP), the One Health concept, risk factors, and community perception of CE among the general population of the major cities of Pakistan were collected. The questions included those related to knowledge, attitude, practices, One Health concept, risk factors, and community perception. The Chi-squared test was applied to determine the associations regarding KAPs across socio-demographic parameters. Results: KAPs had no significant associations with sociodemographic aspects such as age, sex, religion, ethnicity, education, marital status, occupation, or financial status of the participants. The findings indicated a lack of awareness about CE among the participants. Respondents were unaware of the risk factors and the One Health concept of CE. However, the community attitude and perception were positive toward the control of CE. Conclusion: Illiteracy, deficient sanitation systems and lack of awareness are the contributing factors to CE in Pakistan. It is necessary to make the community aware regarding CE and its importance. Increasing this awareness represents an important step toward the eradication and control of CE.
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Affiliation(s)
- Aisha Khan
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan.,Key Laboratory of Parasite and Vector Biology, National Health Commission of the People's Republic of China, Shanghai, China
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Shaheera Amjad
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Muhammad Sohail Afzal
- Department of Lifesciences, School of Science, University of Management and Technology, Lahore, Pakistan
| | - Waseem Haider
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sami Simsek
- Department of Parasitology, Firat University, Elâziğ, Turkey
| | | | - Danish Hassan Khan
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Anna Durrance-Bagale
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Raja Zoq Ul Arfeen
- School of Food and Agricultural Sciences, University of Management and Technology (UMT), Lahore, Pakistan
| | - Shahzad Ali
- Department of Wildlife and Ecology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Jianping Cao
- Key Laboratory of Parasite and Vector Biology, National Health Commission of the People's Republic of China, Shanghai, China.,National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.,The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, China
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24
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Al-Saeedi M, Ramouz A, Khajeh E, El Rafidi A, Ghamarnejad O, Shafiei S, Ali-Hasan-Al-Saegh S, Probst P, Stojkovic M, Weber TF, Hoffmann K, Mehrabi A. Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009365. [PMID: 33979343 PMCID: PMC8143402 DOI: 10.1371/journal.pntd.0009365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/24/2021] [Accepted: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In patients with hepatic cystic echinococcosis (CE), treatment effectiveness, outcomes, complications, and recurrence rate are controversial. Endocystectomy is a conservative surgical approach that adequately removes cyst contents without loss of parenchyma. This conservative procedure has been modified in several ways to prevent complications and to improve surgical outcomes. This systematic review aimed to evaluate the intraoperative and postoperative complications of endocysectomy for hepatic CE as well as the hepatic CE recurrence rate following endocystectomy. METHODS A systematic search was made for all studies reporting endocystectomy to manage hepatic CE in PubMed, Web of Science, and Cochrane CENTRAL databases. Study quality was assessed using the methodological index for non-randomized studies (MINORS) criteria and the Cochrane revised tool to assess risk of bias in randomized trials (RoB2). The random-effects model was used for meta-analysis and the arscine-transformed proportions were used to determine complication-, mortality-, and recurrence rates. This study is registered with PROSPERO (number CRD42020181732). RESULTS Of 3,930 retrieved articles, 54 studies reporting on 4,058 patients were included. Among studies reporting preoperative anthelmintic treatment (31 studies), albendazole was administered in all of them. Complications were reported in 19.4% (95% CI: 15.9-23.2; I2 = 84%; p-value <0.001) of the patients; biliary leakage (10.1%; 95% CI: 7.5-13.1; I2 = 81%; p-value <0.001) and wound infection (6.6%; 95% CI: 4.6-9; I2 = 27%; p-value = 0.17) were the most common complications. The post-endocystectomy mortality rate was 1.2% (95% CI: 0.8-1.8; I2 = 21%; p-value = 0.15) and the recurrence rate was 4.8% (95% CI: 3.1-6.8; I2 = 87%; p-value <0.001). Thirty-nine studies (88.7%) had a mean follow-up of more than one year after endocystectomy, and only 14 studies (31.8%) had a follow-up of more than five years. CONCLUSION Endocystectomy is a conservative and feasible surgical approach. Despite previous disencouraging experiences, our results suggest that endocystectomy is associated with low mortality and recurrence.
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Affiliation(s)
- Mohammad Al-Saeedi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ali Ramouz
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Elias Khajeh
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ahmad El Rafidi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Omid Ghamarnejad
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Saeed Shafiei
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sadeq Ali-Hasan-Al-Saegh
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Pascal Probst
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marija Stojkovic
- Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Tim Frederik Weber
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Katrin Hoffmann
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
- Liver Cancer Center Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
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25
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van der Giessen J, Deksne G, Gómez-Morales MA, Troell K, Gomes J, Sotiraki S, Rozycki M, Kucsera I, Djurković-Djaković O, Robertson LJ. Surveillance of foodborne parasitic diseases in Europe in a One Health approach. Parasite Epidemiol Control 2021; 13:e00205. [PMID: 33665388 PMCID: PMC7900597 DOI: 10.1016/j.parepi.2021.e00205] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/10/2020] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
In 2012, WHO/FAO ranked 24 foodborne parasites (FBP) using multicriteria decision analysis (MCDA) to provide risk assessors with a basis for prioritising control of highly ranked FBP on the global level. One conclusion was that ranking may differ substantially per region. In Europe, the same methodology was used to rank FBP of relevance for Europe. Of the 24 FBP, the top-five prioritised FBP were identified for Europe as Echinococcus multilocularis, Toxoplasma gondii, Trichinella spiralis, E. granulosus, and Cryptosporidium spp., all of which are zoonotic. The objective of the present study was to provide an overview of surveillance and reporting systems in Europe for these top five prioritised FBP in the human and animal populations, to identify gaps, and give recommendations for improvement. Information on the surveillance systems was collected from 35 European countries and analysed according to the five different regions. For most FBP, human surveillance is passive in most countries and regions in Europe and notification differs between countries and regions. Adequate surveillance programmes for these FBP are lacking, except for T. spiralis, which is notifiable in 34 countries with active surveillance in susceptible animals under EU directive. Although human and animal surveillance data are available for the five prioritised FBP, we identified a lack of consistency in surveillance and reporting requirements between national experts and European bodies. Recommendations for improved surveillance systems are discussed.
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Affiliation(s)
- Joke van der Giessen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, P.O. Box 1, Bilthoven 3720 BA, Netherlands
| | - Gunita Deksne
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Str. 3, Riga LV-1076, Latvia.,Faculty of Biology, University of Latvia, Jelgavas Str. 1, Riga LV-1004, Latvia
| | - Maria Angeles Gómez-Morales
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy
| | - Karin Troell
- National Veterinary Institute, Ulls väg 2B, Uppsala SE-751 89, Sweden
| | - Jacinto Gomes
- National Institute for Agrarian and Veterinary Research, Av. da República, Quinta do Marquês, Oeiras 2780-157, Portugal
| | - Smaragda Sotiraki
- Veterinary Research Institute, Hellenic Agricultural Organisation-Demeter, Thermi, Thessaloniki 57001, Greece
| | - Miroslaw Rozycki
- National Veterinary Research Institute, Aleja Partyzantów 57, Puławy 24-100, Poland
| | - István Kucsera
- National Public Health Center, Albert Flórián út 2-6, Budapest 1097, Hungary
| | - Olgica Djurković-Djaković
- Centre of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, University of Belgrade, Dr. Subotića 4, Belgrade 11129, Serbia
| | - Lucy J Robertson
- Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, Ullevålsveien 72, Oslo 0454, Norway
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Cringoli G, Pepe P, Bosco A, Maurelli MP, Baldi L, Ciaramella P, Musella V, Buonanno ML, Capuano F, Corrado F, Ianniello D, Alves LC, Sarnelli P, Rinaldi L. An integrated approach to control Cystic Echinococcosis in southern Italy. Vet Parasitol 2021; 290:109347. [PMID: 33444910 DOI: 10.1016/j.vetpar.2021.109347] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/13/2020] [Accepted: 12/19/2020] [Indexed: 12/13/2022]
Abstract
Cystic echinococcosis (CE) is a severe zoonosis, caused by the larval stage of the tapeworm Echinococcus granulosus. This helminth infection is of increasing public health and socio-economic concern due to the considerable morbidity rates that cause economic losses both in the public health sector and in the livestock industry. Control programmes against E. granulosus are considered long-term actions which require an integrated approach and high expenditure of time and financial resources. Since 2010, an integrated approach to control CE has been implemented in a highly endemic area of continental southern Italy (Campania region). Innovative procedures and tools have been developed and exploited during the control programme based on the following strategies: i) active and passive surveillance in livestock (using geospatial tools for georeferencing), ii) diagnosis in dogs (using the FLOTAC techniques and molecular analysis), iii) targeted treatment of farm dogs (using purpose-built confinement cages), iv) early diagnosis in livestock (by ultrasonography), v) surveillance in humans (through hospital discharge records analysis), vi) monitoring the food chain (analysing raw vegetables), vii) outreach activities to the general public (through dissemination material, e.g. brochures, gadgets, videos, virtual reality). Over eight years, the integrated approach and the new strategies developed have resulted in a noteworthy reduction of the parasite infection rates in livestock (e.g. up to 30 % in sheep). The results obtained so far highlight that using a one health multidisciplinary and multi-institution effort is of pivotal importance in preparing CE control programmes at regional level and could be extended to other endemic Mediterranean areas.
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Affiliation(s)
- G Cringoli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy; Centro di Riferimento Regionale per le Malattie degli Animali Domestici (CReSan), Regione Campania, Naples, Italy
| | - P Pepe
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy
| | - A Bosco
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy
| | - M P Maurelli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy
| | - L Baldi
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - P Ciaramella
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - V Musella
- Department of Health Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - M L Buonanno
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - F Capuano
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - F Corrado
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - D Ianniello
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy
| | - L C Alves
- Department of Veterinary Medicine, Federal Rural University of Pernambuco, Recife, Brazil
| | - P Sarnelli
- Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy; UOD Prevenzione e Sanità Pubblica Veterinaria Regione Campania, Naples, Italy
| | - L Rinaldi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy; Centro Regionale per il Monitoraggio delle Parassitosi (CREMOPAR), Regione Campania, Eboli, SA, Italy; Centro di Riferimento Regionale per le Malattie degli Animali Domestici (CReSan), Regione Campania, Naples, Italy.
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Balog T, Nagy G, Halász T, Csányi E, Zomborszky Z, Csivincsik Á. The occurrence of Echinococcus spp. in golden jackal (Canis aureus) in southwestern Hungary: Should we need to rethink its expansion? Parasitol Int 2020; 80:102214. [PMID: 33137507 DOI: 10.1016/j.parint.2020.102214] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 01/28/2023]
Abstract
Alveolar echinococcosis and cystic echinococcosis are severe zoonotic diseases caused by Echinococcus multilocularis and Echinococcus granulosus s.l. in Europe. To present knowledge, in the European continent, the most important definitive hosts of these parasites belong to the Canidae family. The golden jackal as an opportunistic mesopredator frequently preys on rodents including arvicolids and other easily available food resources, such as viscera and other carrion. By these reasons, the golden jackal can promote the maintenance of both Echinococcus multilocularis and Echinococcus granulosus s.l. Our investigation was conducted in the southwestern part of Hungary where one of the densest golden jackal populations exists. We examined altogether 173 golden jackal small intestines to determine the presence of Echinococcus multilocularis and Echinococcus granulosus s.l. After the molecular diagnostic procedure, we found 27 Echinococcus multilocularis-positive (prevalence: 15.6%; mean intensity: 664 worms) and three Echinococcus granulosus s.l. infected hosts (prevalence: 1.7%; mean intensity: 554.3 worms). We suggest the invasion of the golden jackal in Europe can enhance the spread of both Echinococcus multilocularis and Echinococcus granulosus s.l. This novel epidemiological situation can influence the geographical distribution of these helminths and the characteristics of their endemic in different host species, as well as in humans.
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Affiliation(s)
- Tamás Balog
- SEFAG Forest Management and Wood Industry Share Co., Department of Game Management, Kaposvár, Hungary
| | - Gábor Nagy
- Kaposvár University, Department of Physiology and Animal Hygiene, Kaposvár, Hungary.
| | - Tibor Halász
- SEFAG Forest Management and Wood Industry Share Co., Department of Game Management, Kaposvár, Hungary; Kaposvár University, Department of Physiology and Animal Hygiene, Kaposvár, Hungary
| | - Erika Csányi
- 'Fauna' South Transdanubian Hunting Party, Nagybajom, Hungary
| | - Zoltán Zomborszky
- Kaposvár University, Department of Physiology and Animal Hygiene, Kaposvár, Hungary
| | - Ágnes Csivincsik
- Kaposvár University, Department of Physiology and Animal Hygiene, Kaposvár, Hungary
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Santucciu C, Bonelli P, Peruzzu A, Fancellu A, Marras V, Carta A, Mastrandrea S, Bagella G, Piseddu T, Profili S, Porcu A, Masala G. Cystic Echinococcosis: Clinical, Immunological, and Biomolecular Evaluation of Patients from Sardinia (Italy). Pathogens 2020; 9:E907. [PMID: 33143032 PMCID: PMC7693143 DOI: 10.3390/pathogens9110907] [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: 08/20/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Cystic echinococcosis (CE), a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato (s.l.), is a worldwide public health problem. Echinococcus granulosus sensu stricto (s.s.), associated with G1 and G3 genotypes, is endemic with high prevalence in the Mediterranean basin. The parasite's life cycle comprises definitive hosts (canids) and intermediate hosts (ruminants) and can occasionally involve humans. The main aim of this research was to confirm the diagnosis of 13 patients suspected of CE who presented different complications and needed the surgical removal of the cysts. We also wanted to understand and clarify more the diagnosis of echinococcosis in humans. For this purpose, the patients first underwent cyst evaluation by ultrasound (US), immunological analysis, and then total pericystectomy, followed by parasitological, histopathological, and molecular biology examinations of the cysts. US stadiated one CE1, one CE2, eight CE3b, one CE4, and two CE5; immunology evidenced nine positives; histopathology confirmed 11 CE cysts, of which 8 fertile presenting protoscoleces were identified as E. granulosus s.s. by molecular biology, genotyped as three G1 and four G3 by neighbor-joining (NJ) phylogenetic tree. In conclusion, the results showed that 11 patients were affected by E. granulosus s.s. G1 orG3, and 2 cystic neoformations were of non-parasitic origin.
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Affiliation(s)
- Cinzia Santucciu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Piero Bonelli
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Angela Peruzzu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.F.); (A.P.)
| | - Vincenzo Marras
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy;
| | - Antonello Carta
- U.O.C. di Radiologia, A.O.U., 07100 Sassari, Italy; (A.C.); (S.P.)
| | - Scilla Mastrandrea
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
- U.O.C. di Malattie Infettive, A.O.U., 07100 Sassari, Italy
| | - Giorgio Bagella
- Radiology Unit, University Hospital of Sassari, 07100 Sassari, Italy;
| | - Toni Piseddu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Stefano Profili
- U.O.C. di Radiologia, A.O.U., 07100 Sassari, Italy; (A.C.); (S.P.)
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.F.); (A.P.)
| | - Giovanna Masala
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
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Tilli M, Botta A, Bartoloni A, Corti G, Zammarchi L. Hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, and Taenia solium taeniasis/cysticercosis, Italy, 2011-2016. Infection 2020; 48:695-713. [PMID: 32418191 DOI: 10.1007/s15010-020-01443-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To analyze epidemiology and burden of Neglected Tropical Diseases (NTDs) in Italy. METHODS We used Hospital Discharge Records and number of residents in Italy to calculate number and rate of hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, Taenia solium taeniasis, and cysticercosis by sex, citizenship group, and region in the period 2011-2016. RESULTS 7195 hospitalizations for NTDs were retrieved, accounting for 7375 diagnoses, 60% in Italians and 40% in foreigners. Male-to-female ratio was 2; the age group more commonly affected was 25-44 years (32.5%). The most common diagnoses were leishmaniasis (34%), schistosomiasis (29%), strongyloidiasis (12%), Chagas disease (8%), and dengue (8%). Average yearly hospitalization rate per 100,000 residents for all NTDs was 2.05, 1.33, and 10.39 in general population, Italians, and foreign citizens, respectively. Hospitalization rates higher than 100 per 100,000 subjects were found in citizens from Sub-Saharan Africa (SSA) and Bolivia. CONCLUSIONS NTDs have a not negligible burden in Italy. The most clinically relevant NTDs in Italy are leishmaniasis and schistosomiasis, followed by strongyloidiasis, Chagas disease, and dengue. Cystic echinococcosis, that was not included in the analysis since a similar study on this disease was recently published, should also be listed among the leading NTD in Italy. While schistosomiasis has its highest burden on population coming from highly endemic areas such as SSA, leishmaniasis is especially relevant in Italian-born residents of southern regions. Education at university and post-graduate levels, to increase the awareness of healthcare professionals on these topics, as well as targeted public health interventions (such as screening or presumptive treatment in high-risk groups), are an asset to improve clinical management and control of these diseases.
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Affiliation(s)
- Marta Tilli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Annarita Botta
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Largo Brambilla 3, 50134, Florence, Italy
- Referral Center for Tropical Diseases of Tuscany Region, Careggi University and Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giampaolo Corti
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Largo Brambilla 3, 50134, Florence, Italy.
- Referral Center for Tropical Diseases of Tuscany Region, Careggi University and Hospital, Largo Brambilla 3, 50134, Florence, Italy.
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Tamarozzi F, Legnardi M, Fittipaldo A, Drigo M, Cassini R. Epidemiological distribution of Echinococcus granulosus s.l. infection in human and domestic animal hosts in European Mediterranean and Balkan countries: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008519. [PMID: 32776936 PMCID: PMC7440662 DOI: 10.1371/journal.pntd.0008519] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/20/2020] [Accepted: 06/25/2020] [Indexed: 12/22/2022] Open
Abstract
Cystic echinococcosis (CE) is a neglected zoonosis caused by infection with the cestode Echinococcus granulosus sensu lato. We carried out a systematic literature review on E. granulosus s.l. human and animal (cattle, sheep, dog) infection in European Mediterranean and Balkan countries in 2000–2019, to provide a picture of its recent epidemiology in this endemic area. MEDLINE, EMBASE, Scopus, Google Scholar and Open Grey databases were searched. Included cases were: i) for humans, data from hospital records and imaging studies; ii) for dogs, data from necropsy and coprological studies; iii) for ruminants, cases based on slaughter inspection. The NUTS (Nomenclature of Territorial Units for Statistics) classification was used to categorize extracted data in epidemiological units, defined as data referred to one NUTS2 (basic region) in one year time. Data were then aggregated to NUTS1 level (major regions), calculating the average incidence value of included epidemiological units. For prevalence studies covering different epidemiological units, the pooled prevalence was estimated. Data were extracted from 79 publications, 25 on human infection (covering 437 epidemiological units), and 54 on animal infection (52 epidemiological units for cattle, 35 for sheep and 25 for dogs). At NUTS1 level, average annual incidence rates of human CE ranged from 0.10–7.74/100,000; pooled prevalence values ranged from 0.003–64.09% in cattle, 0.004–68.73% in sheep, and 0–31.86% in dogs. Southern and insular Italy, central Spain, Romania and Bulgaria reported the highest values. Bovine data showed a more similar pattern to human data compared to sheep and dogs. Limitation of evidence included the paucity of human prevalence studies, data heterogeneity, and the patchy geographical coverage, with lack of data especially for the Balkans. Our results confirm Italy, Spain, and Eastern Europe being the most affected areas, but data are extremely heterogeneous, geographical coverage very patchy, and human prevalence studies extremely scant. Results also highlight the notorious problem of underreporting of E. granulosus s.l. infection in both humans and animals. Cystic echinococcosis (CE) is a neglected zoonosis caused by infection with the parasite Echinococcus granulosus sensu lato, naturally transmitted between canids and livestock; CE in humans can be a serious condition. In endemic areas, CE is responsible for significant health and economic losses, but its real burden is difficult to estimate. E. granulosus s.l. is especially present in areas where livestock breeding is practiced, including European Mediterranean and Balkan countries. We carried out a systematic literature review on the epidemiology of E. granulosus s.l. human and animal infection in this area in 2000–2019. Data were extracted from 79 publications, and referred to Nomenclature of Territorial Units for Statistics (NUTS) levels per year. Average annual incidence rates of human CE ranged from 0.10–7.74/100,000; pooled prevalences ranged from 0.003–64.09% in cattle, 0.004–68.73% in sheep, and 0–31.86% in dogs. Bovine data showed a more similar pattern to human data compared to sheep and dogs. Our results confirm that Italy, Spain, and Eastern Europe are the most affected areas, but data are extremely heterogeneous, geographical coverage very patchy, and human prevalence studies extremely scant. Results also highlight the well-known problem of underreporting of E. granulosus s.l. infection in both humans and animals.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy
| | - Matteo Legnardi
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (Padova), Italy
| | - Andrea Fittipaldo
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy
| | - Michele Drigo
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (Padova), Italy
| | - Rudi Cassini
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (Padova), Italy
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Canali M, Aragrande M, Angheben A, Capelli G, Drigo M, Gobbi F, Tamarozzi F, Cassini R. Epidemiologic-economic models and the One Health paradigm: echinococcosis and leishmaniasis, case studies in Veneto region, Northeastern Italy. One Health 2020; 9:100115. [PMID: 32021898 PMCID: PMC6995255 DOI: 10.1016/j.onehlt.2019.100115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 01/18/2023] Open
Abstract
Epidemiology and health economics have systemic interdependencies. The identification of the economic outcomes of any disease is operated by overlapping its epidemiology with the economic functions of the impacted entities. This communication presents two epidemiologic-economic models designed to evaluate the economic burden of cystic echinococcosis and leishmaniasis in Veneto (Northeastern Italy). Following a One Health approach, the research integrates expertise from different disciplines and institutions and fulfilled its first stage by defining the relevant cost categories and the data collection strategy for the two diseases in the study area. The two models identify the relevant epidemiological factors and the economic outcomes of infections in both animals and humans. The results, visualized in flow charts indicating the types of costs associated with these zoonoses, will guide data collection and the epidemiologic and economic assessment in the next research stages. This experience shows that One Health methods, although still innovative or unusual in many scientific and professional contexts, can be applied by using relatively limited resources and already available professional skills.
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Affiliation(s)
- Massimo Canali
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Aragrande
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Andrea Angheben
- Infectious and Tropical Diseases, IRCCS Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - Gioia Capelli
- National reference centre/OIE collaborating centre for diseases at the animal-human interface, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro (PD), Italy
| | - Michele Drigo
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - Federico Gobbi
- Infectious and Tropical Diseases, IRCCS Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - Francesca Tamarozzi
- WHO Collaborating Centre for Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Rudi Cassini
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
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Varcasia A, Dessì G, Lattanzio S, Marongiu D, Cuccuru C, Carta S, Meloni MP, Tamponi C, Scala A. Cystic echinococcosis in the endemic island of Sardinia (Italy): has something changed? Parasitol Res 2020; 119:2207-2215. [PMID: 32447517 DOI: 10.1007/s00436-020-06717-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
Cystic echinococcosis (CE) is a disease of livestock and humans caused by the larval stage of the Echinococcus granulosus sensu lato (s.l.) species complex and occurs especially in areas where sheep breeding is widespread. This survey evaluates, after more than a decade since the last epidemiological survey, the current situation and trend of CE in sheep of the highly endemic island of Sardinia (Italy). From 2012 to 2018, out of a total of 1416 sheep, 65.3% were found positive for CE. Cyst fertility has increased slightly from 10.3% in 2006 (Scala et al. 2006) to 11.7% in the present survey (χ2 = 1.07; P = 0.30018) with a peak of 14.0% in the province of Sassari. Overall, 6815 hydatids were found and classified as sterile (26.2%), fertile (14.4%), caseous (5.3%), or calcified (54.1%) based on their morphology. All isolates were identified as E. granulosus sensu stricto (former G1/G3, strains). Results shown as the implementation of new European Council Regulations and in particular of 21/2004 that established a system for the individual identification and tracking of sheep could be a step forward towards a better control of animal movement, preventing illegal slaughtering on the island as well as in other countries experiencing similar problems. Even if at first sight the general situation of Sardinia regarding CE seems a little better compared with the past, our findings indicate that in some Provinces the epidemiological situation is not improved since 2006.
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Affiliation(s)
- Antonio Varcasia
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy.
| | - Giorgia Dessì
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Silvia Lattanzio
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | | | - Cesare Cuccuru
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Silvia Carta
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Maria Pina Meloni
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Claudia Tamponi
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Antonio Scala
- Laboratory of Parasitology, Veterinary Teaching Hospital, Department of Veterinary Medicine, University of Sassari, Sassari, Italy
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Pavia G, De Gori F, Ciambrone L, De Gori N, Musarella R, Casalinuovo F. Dispersal and molecular characterisation of the Echinococcus granulosus (Batsch, 1786) complex isolated from various intermediate hosts in the Calabria region, southern Italy. Folia Parasitol (Praha) 2020; 67. [PMID: 32458816 DOI: 10.14411/fp.2020.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/05/2020] [Indexed: 11/19/2022]
Abstract
Cystic echinococcosis (CE) is a zoonotic disease caused by the tapeworms of the Echinococcus granulosus sensu lato complex, which have worldwide distribution. No data on the circulation of genotypes of the E. granulosus complex in intermediate hosts in endemic areas in Calabria are available. The aims of our study were to evaluate the dispersal of genotypes of the E. granulosus complex in Calabria and to characterise parasite isolates by Sanger sequencing and phylogenetic analysis. We collected 71 animal samples from pigs, wild boars, sheep, cattle and goats. The first PCR screening analysis targeted three partial genomic regions: the cytochrome c oxidase subunit 1 (cox1), calreticulin protein (cal) and NADH dehydrogenase subunit 1 (nad1); this identified 28 parasitic cysts. Bidirectional sequencing of cox1 amplicons and phylogenetic analysis allowed us to characterise all isolates. Molecular analyses of 28 newly generated cox1 sequences revealed that most wild boars (n = 16) and three pigs were parasitised by the larval stage of Taenia hydatidena Pallas, 1766, called cysticercus tenuicollis. Two isolates from wild boars were identified as Echinococcus canadensis Webster and Cameron, 1961 (G7), while five sheep and two goats were infected with E. granulosus G1 (sheep strain) and G1 microvariant (previously reported as G2 genotype or Tasmanian sheep strain), respectively. These molecular findings should prompt further and more extensive studies, to elucidate regional transmission patterns and to guide control programs.
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Affiliation(s)
- Grazia Pavia
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Section of Catanzaro, Italy
| | - Federica De Gori
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Section of Catanzaro, Italy
| | - Lucia Ciambrone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Section of Catanzaro, Italy
| | | | - Rosanna Musarella
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Section of Catanzaro, Italy
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Rossi P, Tamarozzi F, Galati F, Akhan O, Cretu CM, Vutova K, Siles-Lucas M, Brunetti E, Casulli A. The European Register of Cystic Echinococcosis, ERCE: state-of-the-art five years after its launch. Parasit Vectors 2020; 13:236. [PMID: 32381109 PMCID: PMC7206799 DOI: 10.1186/s13071-020-04101-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The real burden of human cystic echinococcosis (CE) remains elusive, due to the peculiar characteristics of the disease and the heterogeneous and incomplete data recording of clinical cases. Furthermore, official notification systems do not collect pivotal clinical information, which would allow the comparison of different treatment outcomes, and thus circumvent the difficulty of implementing clinical trials for CE. The Italian Register of CE (RIEC) was launched in 2012 and expanded in 2014 into the European Register of CE (ERCE). The primary aim of the ERCE was to highlight the magnitude of CE underreporting, through the recording of cases that were not captured by official records. We present an overview of data collated in the ERCE and discuss its future, five years after its inception. METHODS The ERCE database was explored on March 31st 2019; data concerning participating centres and registered cases were descriptively analysed. RESULTS Forty-four centres from 15 countries (7 non-European) were affiliated to the ERCE. Thirty-four centres (77%) registered at least one patient; of these, 18 (53%) recorded at least one visit within the past 18 months. A total of 2097 patients were registered, 19.9% of whom were immigrants. Cyst characteristics were reported for at least one cyst at least in one visit in 1643 (78.3%) patients, and cyst staging was used by 27 centres. In total, 3386 cysts were recorded at first registration; mostly located in the liver (75.5%). Data concerning clinical management could be analysed for 920 "cyst stage-location-management" observations, showing great heterogeneity in the implementation of the stage-specific management approach recommended by the WHO. CONCLUSIONS The ERCE achieved its goal in showing that CE is a relevant but neglected public health problem in Europe and beyond, since a proportion of patients reaching medical attention are not captured by official notification systems. The ERCE may provide a valuable starting platform to complement hospital-derived data, to obtain a better picture of the epidemiology of clinical CE, and to collect clinical data for the issue of evidence-based recommendations. The ERCE will be expanded into the International Register of CE (IRCE) and restructured aiming to overcome its current criticalities and fulfil these aims.
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Affiliation(s)
- Patrizia Rossi
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Tamarozzi
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Galati
- DG-INF - Information Technology Service, Istituto Superiore di Sanità, Rome, Italy
| | - Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Carmen Michaela Cretu
- C. Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - Kamenna Vutova
- Specialised Hospital of Infectious and Parasitic Diseases “Prof. Ivan Kirov”, Department of Infectious, Parasitic and Tropical Diseases, Medical University, Sofia, Bulgaria
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca, CSIC, Salamanca, Spain
| | - Enrico Brunetti
- Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Division of Tropical and Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Adriano Casulli
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Manenti G, Censi M, Pizzicannella G, Pucci N, Pitocchi F, Calcagni A, Amico A, Collura A, Ryan CP. Vertebral hydatid cyst infection. A case report. Radiol Case Rep 2020; 15:523-527. [PMID: 32153692 PMCID: PMC7057157 DOI: 10.1016/j.radcr.2020.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/09/2020] [Accepted: 01/21/2020] [Indexed: 12/02/2022] Open
Abstract
Hydatidosis is a common parasitic zoonosis in Middle Eastern, African, and Mediterranean populations whit primarily and well known involve of liver and lungs, but some complications are extremely rare and underrated. Particularly Hydatid cystic disease of the skeletal is one of the rarest clinical manifestations and when occurs involve in almost 50% of cases the spine. This manifestation is extremely debilitating, hard to correctly identify and manage. We want to underline this rare involve of spine to avoid misdiagnosis and complications.
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Affiliation(s)
| | | | | | | | | | - Antonello Calcagni
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy
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Bonelli P, Dei Giudici S, Peruzzu A, Piseddu T, Santucciu C, Masu G, Mastrandrea S, Delogu ML, Masala G. Genetic diversity of Echinococcus granulosus sensu stricto in Sardinia (Italy). Parasitol Int 2020; 77:102120. [PMID: 32259586 DOI: 10.1016/j.parint.2020.102120] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
Cystic echinococcosis (CE) is a severe parasitic zoonosis caused by the metacestode of the tapeworm Echinococcus granulosus sensu lato (s.l.). The disease has a global distribution representing a significant public health concern. Based on mitochondrial DNA analysis E. granulosus s.l. has been subdivided into five species: E. granulosus sensu stricto (s.s.) (G1, G3 genotype), E. equinus (G4 genotype), E. ortleppi (G5 genotype), E. canadensis (G6-G8, G10 genotype) and E. felidis. E. granulosus s.s., and in particular G1, is the most widespread genotype and the major responsible of human CE cases worldwide. In Italy G1 genotype is higly represented with larger percentages in some hyperendemic areas such as Sardinia. Molecular studies represent a valuable tool to improve our understanding of the E. granulosus epidemiology and CE control strategies. In the present study we investigated genetic variability of E. granulosus s.s. in Sardinia. To this purpose 83 hydatid cysts were collected from different animal species including humans and the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was partially sequenced (720 bp). Nucleotide sequences from Mediterranean basin were also analyzed for comparison. The phylogenetic network revealed 30 haplotypes grouped around a predominant isolate that had been already reported from other world regions. Haplotype diversity (0.8495 ± 0.0336) and nucleotide diversity (0.003305 ± 0.002014) were similar in Sardinia respect to other Mediterranean countries. Neutrality indices obtained by Tajima's D and Fu's Fs test were significantly negative (p ≤ .01) suggesting expansion of Sardinian population. Low Fixation indices (Fst), ranging from negative values (Algeria, Greece, Spain, other part of Italy) to 0.089 (Albania, France), indicated absence of genetic differentiation, and gene flow between Sardinia and other Mediterranean countries.
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Affiliation(s)
- Piero Bonelli
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy.
| | - Silvia Dei Giudici
- Laboratory of Diagnostic Virology, Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Angela Peruzzu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Toni Piseddu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Cinzia Santucciu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Gabriella Masu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Scilla Mastrandrea
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | | | - Giovanna Masala
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
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Saghafipour A, Divband M, Farahani LZ, Parsa HH, Fard HG. Epidemiology, burden, and geographical distribution of cystic echinococcosis in Central Iran. INTERNATIONAL JOURNAL OF ONE HEALTH 2020. [DOI: 10.14202/ijoh.2020.17-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background and Aim: Human cystic echinococcosis (CE) is an important, neglected zoonotic disease with worldwide distribution which has been reported in different regions of Iran, including the central areas (e.g. Qom Province). The disease is caused by the Echinococcus granulosus parasite living in the intestine of dogs and other canids as definitive hosts. This study aimed to investigate the epidemiology, burden, and geographical distribution of CE in Qom Province, Central Iran.
Materials and Methods: In this descriptive-analytic study, the data of patients with diagnosed CE during 2011-2018 were collected from all urban and rural areas of Qom Province. The data of the epidemiological status of CE cases were extracted from the CE surveillance system in the Centers for Disease Control and Prevention in the Qom University of Medical Sciences which is owned and run by Iran's Ministry of Health and Medical Education. In addition, the economic burden of the disease was evaluated by Azarakhsh and Roozamad financial software; the geographical distribution of CE was obtained by ArcGIS 10.3 software (IBM Corp., Chicago, USA).
Results: The results reveal that the incidence rate of CE was 6.81/100,000 people over the 8-year period of the study. More than half of the cases were females (57.95%), housewives (57.47%), and residents (89.77%). The majority of the cases were Iranian (88.77%) and the rest were from the two neighboring countries: Afghanistan and Pakistan. The economic burden of the human CE in the 8 years was estimated to be 3,761,352,526 rials (75,227 $). In terms of spatial distribution, the highest incidence rate of CE was observed in Salafchegan District in the southwest of Qom Province.
Conclusion: The economic burden of human CE infection provided by governmental health-care systems or as out-of-pocket expenses is relatively high, and housewives, especially those living in Salafchegan District, are more likely to be affected. More studies are recommended on different epidemiological aspects and the definitive hosts of the parasite; besides, people at risk need to be warned and educated so that the incidence rate of the disease is reduced.
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Affiliation(s)
- Abedin Saghafipour
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Masoumeh Divband
- Student Research Committee, Qom University of Medical Sciences, Qom, Iran
| | - Leyli Zanjirani Farahani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Hamidi Parsa
- Master of Sciences in Medical Economics, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Golabchi Fard
- Master of Sciences in Medical Economics, Qom University of Medical Sciences, Qom, Iran
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Zammarchi L, Gobbi F, Angheben A, Spinicci M, Buonfrate D, Calleri G, De Paola M, Bevilacqua N, Carrara S, Attard L, Vanino E, Gulletta M, Festa E, Iacovazzi T, Grimaldi A, Sepe A, Salomone Megna A, Gaiera G, Castagna A, Parodi P, Albonico M, Bisoffi Z, Castelli F, Olliaro P, Bartoloni A. Schistosomiasis, strongyloidiasis and Chagas disease: the leading imported neglected tropical diseases in Italy. J Travel Med 2020; 27:5678667. [PMID: 31840757 DOI: 10.1093/jtm/taz100] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/28/2019] [Accepted: 12/03/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND In recent years, an increasing number of individuals affected by neglected tropical diseases (NTDs) have been observed in Italy, due to migration, international travels and climate changes. Reliable data on the current NTD epidemiology in Italy and the health system preparedness on this issue are not available. METHODS We report the results of a survey on selected NTDs (schistosomiasis, strongyloidiasis, echinococcosis, Chagas disease, leishmaniasis, cysticercosis, filariasis and scabies) in nine Italian sentinel centres, in order to investigate their occurrence throughout the country and identify which ones are a priority for public health interventions, development of protocols for case management, and training activities. To explore the preparedness of the centres, we investigate the availability of specific diagnostic tools and drugs, needed for the management of the most common NTDs. We also reviewed and summarized the available national policies, recommendations and guidelines on NTDs in Italy. RESULTS Overall, 4123 NTDs cases were diagnosed in nine Italian centres within a 7-year period (2011-2017). Schistosomiasis and strongyloidiasis were the most common NTDs, accounting for about one-third each of all the diagnosed cases, followed by Chagas disease. The number of cases showed a significant trend to increase over time, mainly due to foreign-born subjects. Serology for Schistosoma spp. and Strongyloides stercoralis was available in seven and five centres, respectively. Agar plate stool culture for S. stercoralis was available in three sites. Ivermectin and praziquantel were always available in six centres. Six national policies, recommendations and guidelines documents were available, but for the most part, they are not fully implemented yet. CONCLUSIONS This survey showed how some NTDs, such as schistosomiasis and strongyloidiasis, are becoming more common in Italy, due to multiple components. A list of seven key actions was proposed, in order to improve diagnosis, management and control of NTDs in Italy.
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Affiliation(s)
- Lorenzo Zammarchi
- Department of Experimental & Clinical Medicine, University of Florence, Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, 37024, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona 37024, Italy
| | - Andrea Angheben
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona 37024, Italy
| | - Michele Spinicci
- Department of Experimental & Clinical Medicine, University of Florence, Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, 37024, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona 37024, Italy
| | - Guido Calleri
- Ospedale Amedeo di Savoia, ASL Città di Torino, Turin, 10149, Italy
| | - Mirella De Paola
- Ospedale Amedeo di Savoia, ASL Città di Torino, Turin, 10149, Italy
| | - Nazario Bevilacqua
- National Institute for Infectious Diseases I.R.C.C.S. L. Spallanzani, Rome 00149, Italy
| | - Stefania Carrara
- National Institute for Infectious Diseases I.R.C.C.S. L. Spallanzani, Rome 00149, Italy
| | - Luciano Attard
- Infectious Disease Unit, Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, 40138, Italy
| | - Elisa Vanino
- Infectious Disease Unit, Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, 40138, Italy
| | - Maurizio Gulletta
- University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, 25123, Italy
| | - Elena Festa
- University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, 25123, Italy
| | - Tiziana Iacovazzi
- U.O.C. Malattie Infettive ASL BA, P.O. Fallacara, Triggiano, Bari 70019, Italy
| | - Anna Grimaldi
- U.O.C. Laboratorio di Ricerche Chimico-Cliniche e Microbiologiche ASL BA, P.O. Fallacara, Triggiano, Bari 70019, Italy
| | | | - Angelo Salomone Megna
- Infectious Diseases Unit, Department of Medical Sciences, Gaetano Rummo Hospital, Benevento, 82100, Italy
| | - Giovanni Gaiera
- Department of Infectious Diseases, S. Raffaele Hospital, Milano, 00144, Italy
| | - Antonella Castagna
- Department of Infectious Diseases, S. Raffaele Hospital, Milano, 00144, Italy
| | | | - Marco Albonico
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona 37024, Italy.,Department of Life Sciences and Systems Biology, University of Turin, Turin, 10123, Italy
| | - Zeno Bisoffi
- Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona 37024, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, 37134, Italy
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, 25123, Italy
| | - Piero Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, OX3 7LG, UK
| | - Alessandro Bartoloni
- Department of Experimental & Clinical Medicine, University of Florence, Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, 37024, Italy
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Cystic and alveolar echinococcosis are two completely different diseases caused by two different species of Echinococcus parasites. comment ON: Disseminated cystic echinococcosis of Ferdinando II de' Medici, Grand Duke of Tuscany (1610–1670) by Gaeta R, Giuffra V. J infect. 2019 Sep 4. J Infect 2020; 80:121-142. [DOI: 10.1016/j.jinf.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/15/2019] [Indexed: 11/24/2022]
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Abstract
This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2018 in 36 European countries (28 Member States (MS) and 8 non‐MS). The first and second most commonly reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The European Union (EU) trend for confirmed human cases of these two diseases was stable during 2014–2018. The proportion of human salmonellosis cases due to Salmonella Enteritidis was at the same level in 2018 as in 2017. Of the 27 reporting MS, 16 met all Salmonella reduction targets for poultry, whereas 11 MS failed meeting at least one. The EU flock prevalence of target Salmonella serovars in breeding hens, laying hens, broilers and fattening turkeys decreased during recent years but stalled in breeding turkeys. Salmonella results from Competent Authorities for pig carcasses and for poultry tested through National Control Programmes were more frequently positive compared with food business operators. Shiga toxin‐producing Escherichia coli (STEC) infections in humans were the third most commonly reported zoonosis in the EU and increased from 2014 to 2018. Yersiniosis was the fourth most frequently reported zoonosis in humans in 2018 with a stable trend in 2014–2018. The number of reported confirmed listeriosis cases further increased in 2018, despite Listeria rarely exceeding the EU food safety limit tested in ready‐to‐eat food. In total, 5,146 food‐ and waterborne outbreaks were reported. Salmonella was the most commonly detected agent with S. Enteritidis causing one in five outbreaks. Salmonella in eggs and egg products was the highest risk agent/food pair. A large increase of human West Nile virus infections was reported in 2018. The report further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever) and tularaemia.
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Trevisan C, Torgerson PR, Robertson LJ. Foodborne Parasites in Europe: Present Status and Future Trends. Trends Parasitol 2019; 35:695-703. [PMID: 31358427 DOI: 10.1016/j.pt.2019.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 02/05/2023]
Abstract
Although foodborne parasites (FBPs) are becoming recognized as important foodborne pathogens, they remain neglected compared with bacterial and viral foodborne pathogens. As drivers for infection with FBPs are variable, it is often unclear for funding bodies where research should be prioritized. Through a COST Action (Euro-FBP; FA1408), we harnessed Europe-wide expertise to address these questions, using an Expert Knowledge Elicitation approach. Eating habits, lack of food-chain control, lack of awareness from relevant agencies, globalization, and water quality were identified as major drivers for FBP infection. Prioritized research needs to be largely focused on methodological gaps, but also on surveillance concerns, impact-assessment issues, and the role of microbiota. Despite the European focus, these responses should be relevant to those concerned with FBPs globally.
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Affiliation(s)
- Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 270, 8057 Zürich, Switzerland
| | - Lucy J Robertson
- Parasitology Laboratory, Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, 0102 Oslo, Norway.
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Loi F, Laddomada A, Coccollone A, Marrocu E, Piseddu T, Masala G, Bandino E, Cappai S, Rolesu S. Socio-economic factors as indicators for various animal diseases in Sardinia. PLoS One 2019; 14:e0217367. [PMID: 31158242 PMCID: PMC6546212 DOI: 10.1371/journal.pone.0217367] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/10/2019] [Indexed: 11/19/2022] Open
Abstract
The need to consider the role of social factors in the efficacy of farm management and, consequently, in the onset and persistence of diseases typical to animal farms is increasingly being realized increasingly worldwide. Many risk analysis studies have been conducted to assess the role of various factors in the development of animal diseases; however, very few have accounted for the role of social factors. The aim of this work was to bridge this gap, with the main hypothesis that different socio-economic factors could be valid indicators for the occurrence of different animal diseases. A socio-economic analysis was performed using demographic characteristics of the farmers and data from 44 social indicators released by the Italian Statistician National Institute of Statistics (ISTAT) database. African swine fever (ASF) in wild boars (WB) and domestic pigs and other endemic animal diseases and zoonoses in Sardinia were considered, such as cistic echinococcosis (CE), contagious agalactia (CA), trichinellosis, West Nile disease (WND), and bluetongue (BT). Seven different negative binomial regression models were fitted using the number of cases between 2011-2017. Three indicators-cultural demand, employment rate, and legality-showed a statistically significant association with risk for all the diseases considered, but with varying effects. Some indicators, such as the age and sex of the farmer, material deprivation index, number of farms and animals, micro-criminality index, and rate of reported thefts were common to ASF, CA, trichinellosis, and CE cases. Others such as the forest surface and the energy produced from renewable sources were common to BT, WND, and ASF in WB. Tourism in seasons other than summer was a valid predictor of ASF and trichinellosis, while out-of-region hospital use had a statistically significant role in CE risk identification. These results may help understand the social context in which these diseases may occur and thus guide the design and implementation of additional risk management measures that go beyond well-known veterinary measures.
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Affiliation(s)
- Federica Loi
- OEVR—Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Cagliari, Italy
- * E-mail:
| | - Alberto Laddomada
- Istituto Zooprofilattico Sperimentale della Sardegna “G. Pegreffi”, Sassari, Italy
| | - Annamaria Coccollone
- OEVR—Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Cagliari, Italy
| | - Elena Marrocu
- OEVR—Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Cagliari, Italy
| | - Toni Piseddu
- CeNRE—Centro Nazionale di Referenza per l’Echinococcosi/Idatidosi, Sassari, Italy
| | - Giovanna Masala
- CeNRE—Centro Nazionale di Referenza per l’Echinococcosi/Idatidosi, Sassari, Italy
| | - Ennio Bandino
- Istituto Zooprofilattico Sperimentale della Sardegna “G. Pegreffi”, Sassari, Italy
| | - Stefano Cappai
- OEVR—Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Cagliari, Italy
| | - Sandro Rolesu
- OEVR—Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Cagliari, Italy
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Schurer JM, Nishimwe A, Hakizimana D, Li H, Huang Y, Musabyimana JP, Tuyishime E, MacDonald LE. A One Health systematic review of diagnostic tools for Echinococcus multilocularis surveillance: Towards equity in global detection. Food Waterborne Parasitol 2019; 15:e00048. [PMID: 32095619 PMCID: PMC7034026 DOI: 10.1016/j.fawpar.2019.e00048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 12/16/2022] Open
Abstract
Echinococcus multilocularis is a zoonotic cestode of canid definitive hosts that is emerging as a parasite of medical and veterinary concern in regions of North America, Europe and Asia. Infection with the metacestode stage (alveolar echinococcosis - AE) is life-threatening, especially for patients who reside in low resource countries and lack access to modern diagnostic tests and treatments. The overall objectives of this One Health review were to systematically describe the diagnostic tests currently employed in endemic countries to detect E. multilocularis in people, canids and the environment, and to report the test characteristics of new diagnostic techniques for population surveillance. In this systematic review of English and Chinese language databases, we identified 92 primary records of E. multilocularis surveillance in canids (N = 75), humans (N = 20) and/or the environment (food, soil; N = 3) and 12 grey literature records that reported E. multilocularis surveillance or health systems protocols between 2008 and 2018. Surveillance for E. multilocularis was conducted using a broad range of combined morphological, molecular, immunological and imaging techniques. Nine studies reporting diagnostic evaluations for cestode or metacestode detection were identified, including studies on copro-antigen ELISA, copro-PCR, intestinal examination, Western Blot, magnetic capture RT-PCR and immunochromatography. Our dataset includes prevalence estimates for E. multilocularis in canids, people, or environment in 27 of the 43 endemic countries and reports data gaps in surveillance, laboratory methods, and diagnostic sensitivity. International consensus on gold standard diagnostic techniques and harmonization of human, canid and environmental surveillance data across political boundaries are needed to comprehensively assess the global burden and distribution of this parasite.
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Affiliation(s)
- Janna M. Schurer
- Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton 01536, USA
- University of Global Health Equity, KG 7 Ave, 5th Floor, PO Box 6955, Kigali, Rwanda
| | - Arlene Nishimwe
- University of Global Health Equity, KG 7 Ave, 5th Floor, PO Box 6955, Kigali, Rwanda
| | - Dieudonne Hakizimana
- University of Global Health Equity, KG 7 Ave, 5th Floor, PO Box 6955, Kigali, Rwanda
| | - Huan Li
- College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Yu Huang
- College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | | | - Eugene Tuyishime
- University of Global Health Equity, KG 7 Ave, 5th Floor, PO Box 6955, Kigali, Rwanda
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Laurimäe T, Kinkar L, Varcasia A, Dessì G, Sgroi G, D'Alessio N, Veneziano V, Saarma U. First detection of zoonotic tapeworm Echinococcus granulosus sensu lato genotype G7 in continental Italy. Parasitol Res 2019; 118:2193-2201. [PMID: 31134335 DOI: 10.1007/s00436-019-06346-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
The larval stage of the species complex Echinococcus granulosus sensu lato (s.l.) is the cause of a widespread zoonotic disease known as cystic echinococcosis (CE). The disease is highly prevalent in southern Italy and represents a serious public health issue. The main aim of this study was to characterize E. granulosus s.l. genotypes from wild boar on a continental area of Italy (Campania region), using recently developed mtDNA markers of nad2 and nad5 for reliable identification of different genotypes. Here, nad5 (680 bp) allowed for a clear identification of G1 and G3, whereas a combination of nad2 (714 bp) and nad5 (1394 bp in total) did the same for genotype G7 and its haplogroups G7a and G7b. The results of this study revealed for the first time the presence of genotype G7 in continental Italy. While haplogroup G7b was previously shown to be restricted to the islands of Corsica and Sardinia, here we demonstrate that haplogroup G7b is also present on the mainland of Italy. This work has implications in designing future strategies to reduce CE in Italy.
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Affiliation(s)
- Teivi Laurimäe
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Vanemuise 46, 51003, Tartu, Estonia
| | - Liina Kinkar
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Vanemuise 46, 51003, Tartu, Estonia
| | - Antonio Varcasia
- Laboratorio di Parassitologia e Malattie Parassitarie, Ospedale Didattico Veterinario Dipartimento di Medicina Veterinaria, Università degli Studi di Sassari, Via Vienna 2, 07100, Sassari, Italy
| | - Giorgia Dessì
- Laboratorio di Parassitologia e Malattie Parassitarie, Ospedale Didattico Veterinario Dipartimento di Medicina Veterinaria, Università degli Studi di Sassari, Via Vienna 2, 07100, Sassari, Italy
| | - Giovanni Sgroi
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Nicola D'Alessio
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
| | - Vincenzo Veneziano
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Vanemuise 46, 51003, Tartu, Estonia.
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Loi F, Berchialla P, Masu G, Masala G, Scaramozzino P, Carvelli A, Caligiuri V, Santi A, Bona MC, Maresca C, Zanoni MG, Capelli G, Iannetti S, Coccollone A, Cappai S, Rolesu S, Piseddu T. Prevalence estimation of Italian ovine cystic echinococcosis in slaughterhouses: A retrospective Bayesian data analysis, 2010-2015. PLoS One 2019; 14:e0214224. [PMID: 30934010 PMCID: PMC6443144 DOI: 10.1371/journal.pone.0214224] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/10/2019] [Indexed: 11/18/2022] Open
Abstract
Cystic echinococcosis (CE) is a complex zoonosis with domestic and sylvatic life-cycles, involving different intermediate and definitive host species. Many previous studies have highlighted the lack of a surveillance system for CE, its persistence in Italy, and endemicity in several Italian regions. Because of the absence of a uniform surveillance program for both humans and animals, disease occurrence is widely underestimated. This study aimed to estimate the prevalence of ovine CE in Italy. Survey data on the prevalence of Echinococcus granulosus complex infections in Italian sheep farms from 2010 to 2015 were obtained in collaboration with Regional Veterinary Epidemiology Observatories (OEVRs). Bayesian analysis was performed to estimate the true CE farm prevalence. The prior true CE prevalence was estimated using data from Sardinia. Second, Bayesian modelling of the observed prevalence in different regions and the true prevalence estimation from the first step were used to ultimately estimate the prevalence of ovine CE in Italy. We obtained survey data from 10 OEVRs, covering 14 Italian regions. We observed that the risk of CE infection decreased over the years, and it was strictly correlated with the density of susceptible species. Using Sardinia as prior distribution, where the disease farm prevalence was approximately 19% (95% CI, 18.82-20.02), we estimated that the highest endemic CE farm prevalence was in Basilicata with a value of 12% (95% BCI: 7.49-18.9%) and in Piemonte 7.64%(95% BCI: 4.12-13.04%). Our results provide spatially relevant data crucial for guiding CE control in Italy. Precise information on disease occurrence location would aid in the identification of priority areas for disease control implementation by the authorities. The current underestimation of CE occurrence should urge the Italian and European governments to become aware of the public health importance of CE and implement targeted interventions for high-risk areas.
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Affiliation(s)
- Federica Loi
- Osservatorio Epidemiologico Veterinario Regionale, Cagliari, Italy
| | - Paola Berchialla
- Dipartimento di Scienze Cliniche e Biologiche, Università degli studi di Torino, Torino, Italy
| | - Gabriella Masu
- Istituto Zooprofilattico Sperimentale della Sardegna “G. Pegreffi”, Sassari, Italy
| | - Giovanna Masala
- Istituto Zooprofilattico Sperimentale della Sardegna “G. Pegreffi”, Sassari, Italy
| | - Paola Scaramozzino
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Roma, Italy
| | - Andrea Carvelli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Roma, Italy
| | - Vincenzo Caligiuri
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici – Napoli, Italy
| | - Annalisa Santi
- Istituto Zooprofilattico Sperimentale della Lombardia Emilia Romagna "B. Ubertini", Brescia, Italy
| | - Maria Cristina Bona
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Torino, Italy
| | - Carmen Maresca
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche, Perugia, Italy
| | - Maria Grazia Zanoni
- Istituto Zooprofilattico Sperimentale della Lombardia Emilia Romagna "B. Ubertini", Brescia, Italy
| | - Gioia Capelli
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro - Padova, Italy
| | - Simona Iannetti
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | | | - Stefano Cappai
- Osservatorio Epidemiologico Veterinario Regionale, Cagliari, Italy
| | - Sandro Rolesu
- Osservatorio Epidemiologico Veterinario Regionale, Cagliari, Italy
| | - Toni Piseddu
- Istituto Zooprofilattico Sperimentale della Sardegna “G. Pegreffi”, Sassari, Italy
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Validation of a one-step PCR assay for the molecular identification of Echinococcus granulosus sensu stricto G1-G3 genotype. Mol Biol Rep 2019; 46:1747-1755. [PMID: 30734170 DOI: 10.1007/s11033-019-04625-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/18/2019] [Indexed: 12/22/2022]
Abstract
The Italian National Reference Center for Echinococcosis (CeNRE, Sassari, Italy) set up a diagnostic protocol of "one-step-PCR" useful for the detection of E. granulosus sensu stricto (E.g.s.s.) and the identification of its genotype (G1-G3). The purpose of this work was to perform the validation of the "PCR E.g.s.s." method. The procedures were performed employing the criteria of the World Organization for Animal Health as well as of the Italian Accreditation Body (ACCREDIA) based on the Regulation UNI CEI EN ISO/IEC 17025. Positive DNA samples belonging to E. granulosus, E. ortleppi, E. multilocularis, E. canadensis species were used for the experiments. Analytical specificity evidenced primer pairs Cal (Calreticulin l gene of 1001 bp) with an specificity higher respect to Ef1 (Elongation-Factor 1 Alpha gene of 706 bp) and NAD (Dehydrogenase-subunit 1 gene of 219 bp). The analytical sensitivity presented the capability to detect a very low amount of parasite DNA corresponding to a concentration of 12.5 pg/µl; accuracy and precision related to the operator performance, along with repeatability and reproducibility, evidenced high concordance among results and demonstrated an excellent κ values of Cohen. According to the good performance related to the evaluated parameters, the method "PCR E.g.s.s." was suitable for the validation procedure, and consequently, to be undergone to the accreditation process. In conclusion, the results demonstrated an elevated robustness and reliable features of the "PCR E.g.s.s." able to perform a rapid diagnosis of E. granulosus in only "one step", hence, it is likely to avoid the sequencing step.
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Abstract
Among parasitic hepatic cystic lesions, the most common disease is represented by cystic echinococcosis (CE), especially in high endemic countries. European epidemiology of CE in children is difficult to assess because of under-reporting but is increasing, because of high immigration flows from endemic countries and an increased awareness. Hydatidosis can be localized in every part of the body. The liver and lungs are the most common localizations in both children and adults. Multiorgan involvement is rarely reported in children. Different tests are available. Usually the sensitivity of serological screening tests is variable, ranging between 60% and 90%. The immunoblot assay is used as a confirmatory test because of its higher sensitivity and specificity. Radiological tests are the criterion standard for diagnosis of CE, with an ultrasound accuracy of approximately 90%. In case of inactive and uncomplicated cysts the watch-and-wait approach is recommended. Albendazole, currently used for 3 to 6 months consecutively represents the most commonly used drug in children even if there is limited experience in treating children younger than 6 years of age. Percutaneous treatment with the puncture, aspiration, injection, and reaspiration technique is a minimally invasive procedure. Surgery is indicated based on cyst characteristics in case of big cysts with multiple daughter cysts, single superficial cysts at risk of spontaneous or traumatic rupture, cysts related with the biliary tract in which the percutaneous treatment is contraindicated, and cysts compressing related structures.
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Lötsch F, Budke CM, Auer H, Kaczirek K, Waneck F, Lagler H, Ramharter M. Evaluation of direct costs associated with alveolar and cystic echinococcosis in Austria. PLoS Negl Trop Dis 2019; 13:e0007110. [PMID: 30703091 PMCID: PMC6354963 DOI: 10.1371/journal.pntd.0007110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 12/23/2018] [Indexed: 01/24/2023] Open
Abstract
Background Cystic echinococcosis (CE) is a globally occurring zoonosis, whereas alveolar echinococcosis (AE) is endemic only in certain parts of the Northern Hemisphere. The socioeconomic impact of human echinococcosis has been shown to be considerable in highly endemic regions. However, detailed data on direct healthcare-related costs associated with CE and AE are scarce for high income countries. The aim of this study was to evaluate direct costs of human disease caused by CE and AE in Austria. Methods Clinical data from a registry maintained at a national reference center for echinococcosis at the Medical University of Vienna were obtained for the years 2012–2014. These data were used in conjunction with epidemiological data from Austria’s national disease reporting system and diagnostic reference laboratory for echinococcosis to assess nationwide costs attributable to CE and AE. Results In Austria, total modelled direct costs were 486,598€ (95%CI 341,825€ – 631,372€) per year for CE, and 683,824€ (95%CI 469,161€ - 898,486€) for AE. Median costs per patient with AE from diagnosis until the end of a 10-year follow-up period were 30,832€ (25th– 75th percentile: 23,197€ - 31,220€) and 62,777€ (25th– 75th percentile: 60,806€ - 67,867€) for inoperable and operable patients, respectively. Median costs per patients with CE from diagnosis until end of follow-up after 10 years were 16,253€ (25th– 75th percentile: 8,555€ - 24,832€) and 1,786€ (25th– 75th percentile: 736€ - 2,146€) for patients with active and inactive cyst stages, respectively. The first year after inclusion was the most cost-intense year in the observed period, with hospitalizations and albendazole therapy the main contributors to direct costs. Conclusions This study provides detailed information on direct healthcare-related costs associated with CE and AE in Austria, which may reflect trends for other high-income countries. Surgery and albendazole therapy, due to surprisingly high drug prices, were identified as important cost-drivers. These data will be important for cost-effectiveness analyses of possible prevention programs. Cystic and alveolar echinococcosis, caused by E. granulosus and E. multilocularis, both occur in humans in Austria. Lesions may develop at any site, with the liver being most frequently affected. Morbidity–especially for alveolar echinococcosis–can be significant and treatment may include major surgery or long-term suppressive medical therapy. The present study was performed to investigate direct healthcare-related costs of cystic and alveolar echinococcosis in Austria based on the data from a clinical registry maintained at the reference center for echinococcosis, the reference laboratory for echinococcosis and data from the national disease reporting system. Annual incidences of AE and CE were estimated at λ = 12 and λ = 40 newly diagnosed cases per year, respectively. Estimated costs due to cystic echinococcosis were 486,598€ (95%CI 341,825€ – 631,372€) per year, and 683,824€ (95%CI 469,161€ - 898,486€) for AE. Major cost drivers were surgical interventions with hospitalizations and drug costs. These data will provide a basis for cost-effectiveness analyses of prevention programs, and highlight possible targets for cost reduction strategies.
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Affiliation(s)
- Felix Lötsch
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Herbert Auer
- Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Klaus Kaczirek
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Fredrik Waneck
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Heimo Lagler
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Coluzzi F, Meniconi RL, Caruso D, Rivosecchi F, Petrone L, Goletti D, Ettorre GM. Severe chest allodynia as an unusual first presentation of hydatid disease: a case report. BMC Infect Dis 2019; 19:37. [PMID: 30626351 PMCID: PMC6327474 DOI: 10.1186/s12879-019-3670-7] [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: 11/14/2017] [Accepted: 01/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cystic echinococcosis (CE) is a worldwide zoonosis and the liver is the most commonly affected organ. Clinical manifestations range from completely asymptomatic cysts to a potential lethal cyst rupture and anaphylaxis. Case presentation Severe chest allodynia was an unusual clinical presentation of hepatic cyst rupture in the retroperitoneal space, without any other specific symptoms. CE diagnosis was confirmed by computed tomography scan and magnetic resonance. The patient underwent hepatectomy with complete resolution of the neuropathic pain. Conclusions Retroperitoneal hydatid cyst rupture is a rare event and its clinical manifestation may mimic other chest neuropathies.
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Affiliation(s)
- Flaminia Coluzzi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Roberto Luca Meniconi
- Division of General Surgery and Liver Transplantation, POIT Department, San Camillo Hospital - "Lazzaro Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy.
| | - Damiano Caruso
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Flaminia Rivosecchi
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Linda Petrone
- Department of Epidemiology and Preclinical Research, Translational Research Unit, "Lazzaro Spallanzani" National Institute for Infectious Diseases (INMI)- IRCCS, Rome, Italy
| | - Delia Goletti
- Department of Epidemiology and Preclinical Research, Translational Research Unit, "Lazzaro Spallanzani" National Institute for Infectious Diseases (INMI)- IRCCS, Rome, Italy
| | - Giuseppe Maria Ettorre
- Division of General Surgery and Liver Transplantation, POIT Department, San Camillo Hospital - "Lazzaro Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy
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The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2017. EFSA J 2018; 16:e05500. [PMID: 32625785 PMCID: PMC7009540 DOI: 10.2903/j.efsa.2018.5500] [Citation(s) in RCA: 517] [Impact Index Per Article: 86.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2017 in 37 European countries (28 Member States (MS) and nine non-MS). Campylobacteriosis was the commonest reported zoonosis and its EU trend for confirmed human cases increasing since 2008 stabilised during 2013-2017. The decreasing EU trend for confirmed human salmonellosis cases since 2008 ended during 2013-2017, and the proportion of human Salmonella Enteritidis cases increased, mostly due to one MS starting to report serotype data. Sixteen MS met all Salmonella reduction targets for poultry, whereas 12 MS failed meeting at least one. The EU flock prevalence of target Salmonella serovars in breeding hens, laying hens, broilers and fattening turkeys decreased or remained stable compared to 2016, and slightly increased in breeding turkeys. Salmonella results on pig carcases and target Salmonella serovar results for poultry from competent authorities tended to be generally higher compared to those from food business operators. The notification rate of human listeriosis further increased in 2017, despite Listeria seldom exceeding the EU food safety limit in ready-to-eat food. The decreasing EU trend for confirmed yersiniosis cases since 2008 stabilised during 2013-2017. The number of confirmed shiga toxin-producing Escherichia coli (STEC) infections in humans was stable. A total of 5,079 food-borne (including waterborne) outbreaks were reported. Salmonella was the commonest detected agent with S. Enteritidis causing one out of seven outbreaks, followed by other bacteria, bacterial toxins and viruses. The agent was unknown in 37.6% of all outbreaks. Salmonella in eggs and Salmonella in meat and meat products were the highest risk agent/food pairs. The report further summarises trends and sources for bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever), West Nile virus and tularaemia.
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