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Luga P, Gjata A, Akshija I, Mino L, Gjoni V, Pilaca A, Zobi M, Martinez GE, Richter J. What do we know about the epidemiology and the management of human echinococcosis in Albania? Parasitol Res 2023:10.1007/s00436-023-07878-4. [PMID: 37272973 DOI: 10.1007/s00436-023-07878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/06/2023]
Abstract
Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due to Echinococcus (E.) granulosus usually involves livestock and dogs; alveolar echinococcosis (AE) due to E. multilocularis involves rodents and canines such as foxes and dogs. Human hosts are infected accidentally via hand to mouth and/or foodborne/waterborne pathways. Albania is deemed to be endemic for cystic echinococcosis (CE), but there is a scarcity of data to confirm this. A systematic literature search was performed in PubMed, Google Scholar, and in other medical sources. Because of the scarcity of existing information, data confirming CE cases were reviewed from the medical hospital records of Albania's largest Hospital, the Mother Teresa University Hospital (UHCMT) Tirana, and from a large private laboratory in Tirana (Pegasus laboratory). A total of eight eligible publications on 540 CE patients were found. Three hundred forty seven additional cases hospitalized in UHCMT from 2011 to 2020 were confirmed, as well as 36 laboratory cases and 10 Albanian cases notified in Germany. Taking all cases into account and considering 162 overlapping cases, 771 cases were documented from 2011 to 2020. The only case reported as AE was most likely a multi-organic CE. Surgery was the most frequent therapy approach used (84.7%). Autochthonous human CE seems to be widespread, and transmission is ongoing in Albania. CE patients in Albania undergo surgery more frequently compared with CE cases in other European countries. In order to establish a realistic estimate of prevalence and incidence of CE in Albania, mandatory notification should be reinforced. Stage-specific therapy can be used in CE to reduce therapy cost and diminish mortality by avoiding surgical overtreatment.
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Affiliation(s)
- Poleta Luga
- Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Freie and Humboldt University Berlin and Berlin Institute of Health, 13353, Berlin, Germany
| | - Arben Gjata
- Tirana/General & Digestive Surgery Department, University of Medicine, No. 3. Dibrës Str. 370, Tirana, Albania
| | - Ilir Akshija
- Statistics Department, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Ledina Mino
- Pegasus Med Laboratory, Bulevardi "Zhan D'Ark", Tirana, Albania
| | - Valbona Gjoni
- Department of National Reference Laboratories, Institute of Public Health, Aleksander Moisiu Str. 80, Tirana, Albania
| | - Arben Pilaca
- International Hospital Tirana, Dritan Hoxha Str, Tirana, Albania
| | - Michael Zobi
- Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Freie and Humboldt University Berlin and Berlin Institute of Health, 13353, Berlin, Germany
| | - Gabriela Equihua Martinez
- Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Freie and Humboldt University Berlin and Berlin Institute of Health, 13353, Berlin, Germany
| | - Joachim Richter
- Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Freie and Humboldt University Berlin and Berlin Institute of Health, 13353, Berlin, Germany.
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Ramosaço E, Kolovani E, Ranxha E, Vyshka G. Primary multiple cerebral hydatid cysts in an immunocompetent, low-risk patient. IDCases 2020; 21:e00882. [PMID: 32642431 PMCID: PMC7334456 DOI: 10.1016/j.idcr.2020.e00882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 02/05/2023] Open
Abstract
Cystic echinococcosis is a zoonotic infection that occurs worldwide. Humans are infected through ingestion of parasite eggs in contaminated food, water or through direct contact with infected dogs, which are the definite host. Humans serve accidentally as intermediate host, and occurrences are common in children and young adults. Cystic echinococcosis is endemic in Mediterranean, South American, Middle Eastern, Central Asia, East Africa countries and Australia. The liver is the most frequently involved organ, followed by lungs. Hydatid cysts have been reported only in 2% of cases in the brain. Primary cerebral hydatid disease is a rare entity, but should be considered in the differential diagnosis of cerebral lesions.
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Affiliation(s)
- Ergys Ramosaço
- Infectious Diseases Clinic, University Hospital Centre “Mother Teresa” Tirana, Albania
| | - Entela Kolovani
- Infectious Diseases Clinic, University Hospital Centre “Mother Teresa” Tirana, Albania
| | - Eris Ranxha
- Stroke Unit, University Hospital Centre “Mother Teresa” Tirana, Albania
| | - Gentian Vyshka
- Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Address: Rr. Dibres 371, Tirana Albania
- Corresponding author.
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The impact of socio-cultural factors on transmission of Taenia spp. and Echinococcus granulosus in Kosovo. Parasitology 2017; 144:1736-1742. [DOI: 10.1017/s0031182017000750] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SUMMARYEchinococcus granulosus sensu latu (s.l.) and Taenia hydatigena are common parasites of ruminant intermediate hosts in the Balkans. Transmission is linked mainly to home slaughtering and the feeding of infected organs to dogs. In Kosovo, many old sheep are slaughtered particularly during Eid al-Adha (Feast of Sacrifice). To determine whether this tradition could affect parasite transmission, we compared the probability of 504 dogs to contract taenid infections after deworming during one period before Eid al-Adha and a similar period beginning with this event. Initially, taeniid eggs were detected in 6·2% (CI 4·2–8·6) of the dogs. The prevalence before Eid al-Adha was significantly lower (1·2%, CI 0·4–2·6) as compared with the prevalence after the event (4·3%, CI 2·6–6·3). A comparable trend was apparent at species level for T. hydatigena and E. granulosus. These results indicate that the pronounced increase of taeniid infections, including E. granulosus s.l., after Eid al-Adha is linked to traditional home slaughtering that occurs during this celebration. This particular epidemiological situation provides an opportunity for implementing focussed control activities.
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Deplazes P, Rinaldi L, Alvarez Rojas CA, Torgerson PR, Harandi MF, Romig T, Antolova D, Schurer JM, Lahmar S, Cringoli G, Magambo J, Thompson RCA, Jenkins EJ. Global Distribution of Alveolar and Cystic Echinococcosis. ADVANCES IN PARASITOLOGY 2017; 95:315-493. [PMID: 28131365 DOI: 10.1016/bs.apar.2016.11.001] [Citation(s) in RCA: 548] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses. Echinococcus multilocularis (causative agent of AE) is widely distributed in the northern hemisphere where it is typically maintained in a wild animal cycle including canids as definitive hosts and rodents as intermediate hosts. The species Echinococcus granulosus, Echinococcus ortleppi, Echinococcus canadensis and Echinococcus intermedius are the causative agents of CE with a worldwide distribution and a highly variable human disease burden in the different endemic areas depending upon human behavioural risk factors, the diversity and ecology of animal host assemblages and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. Both AE and CE are regarded as neglected zoonoses, with a higher overall burden of disease for CE due to its global distribution and high regional prevalence, but a higher pathogenicity and case fatality rate for AE, especially in Asia. Over the past two decades, numerous studies have addressed the epidemiology and distribution of these Echinococcus species worldwide, resulting in better-defined boundaries of the endemic areas. This chapter presents the global distribution of Echinococcus species and human AE and CE in maps and summarizes the global data on host assemblages, transmission, prevalence in animal definitive hosts, incidence in people and molecular epidemiology.
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Affiliation(s)
- P Deplazes
- University of Zürich, Zurich, Switzerland
| | - L Rinaldi
- University of Naples Federico II, Napoli, Italy
| | | | | | - M F Harandi
- Research centre of Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - T Romig
- University of Hohenheim, Stuttgart, Germany
| | - D Antolova
- Institute of Parasitology SAS, Kosice, Slovak Republic
| | - J M Schurer
- University of Saskatchewan, Saskatoon, SK, Canada; University of Washington, Seattle, WA, United States
| | - S Lahmar
- National School of Veterinary Medicine, Sidi Thabet, Tunisia
| | - G Cringoli
- University of Naples Federico II, Napoli, Italy
| | - J Magambo
- Meru University of Science and Technology, Meru, Kenya
| | | | - E J Jenkins
- University of Saskatchewan, Saskatoon, SK, Canada
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