Cystic echinococcosis amongst small ruminants and humans in central Ethiopia

Occurrence and Economic Impact of Cystic Echinococcosis in Cattle Slaughtered in the Matabeleland Region, Zimbabwe

BACKGROUND

Cystic echinococcosis is a neglected disease responsible for millions of infections in both animals and humans. The toll on the global economy is estimated to be in the billions of United States dollars. Although much effort has been made by public health authorities to curb the rise in new infections, the occurrence of cystic echinococcosis is still being noted, especially in low-income countries. This study was conducted in the Matabeleland region of Zimbabwe to determine the incidence of cystic echinococcosis in bovines.

METHODS

Meat inspection records from 2011 through 2021 kept at licensed abattoirs in the Matabeleland region were used to generate annual total figures of bovines slaughtered in the region, together with the corresponding number of organs condemned due to cystic echinococcosis. Descriptive statistics showing the overall incidence in each year, incidence per district, and cysts in infected organs were expressed as a percentage of the total number of cattle slaughtered per category.

RESULTS

Bulawayo had the highest occurrence of cystic echinococcosis (1.359%, 95% CI, 1.254-1.412), followed by Matabeleland South (0.914%, 95% CI, 0.886-0.929) and then Matabeleland North (0.848%, 95% CI 0.818-0.863) provinces. The Bulilima, Bulawayo, and Bubi districts had the highest occurrences of cystic echinococcosis at 1.749%, 1.358%, and 1.286%, respectively. The lung was the most frequently affected organ (n=7155; at 0.854 %; and 95% CI, 0.8334-0.874%, followed by the liver (0.053%; 95% CI, 0.048-0.058%). The total direct economic loss due to organ condemnation during the study period was US$ 24,812.43.

An Epidemiological Survey to Investigate the Prevalence of Cystic Echinococcosis in Slaughtered Bovine Hosts in Punjab, Pakistan

Cystic echinococcosis (CE) is a neglected zoonotic disease of worldwide geographical distribution. CE is most common in underdeveloped and herding communities where people survive on animal husbandry and agricultural activities. The prevalence of CE in livestock and its risk factors are widely underreported, because of inefficient surveillance systems. The aim of this study was to evaluate the epidemiological characteristics and prevalence of CE in cattle in Punjab, Pakistan. Data were collected from slaughterhouses from September 2021 to February 2022. Ante- and postmortem examination and cyst characterization were performed. Epidemiological, demographic, and one health data were collected. A total of 8877 animals (8096 buffalo, 781 cattle) were examined, and the prevalence of CE was 6.22% (n = 552) in all animals, with a higher prevalence in cattle (15.20% vs. buffalo 5.83%). Prevalence was not significantly different in males and females. Of the 23 districts studied, the highest prevalence was in the Haripur district of KP (20.85%). The majority of animals studied were older than 3 years. Most cysts were found in animals older than 5 years. Lungs and liver were the predominant sites for the presence of cysts (65.58% and 31.34%, respectively. Of the collected cysts, 29.71% were fertile. The findings may be useful in estimating the eco-epidemiology of CE and improving surveillance and prevention programs in Pakistan.

Africa-wide meta-analysis on the prevalence and distribution of human cystic echinococcosis and canine Echinococcus granulosus infections

BACKGROUND

Echinococcosis is a neglected zoonosis of increasing public health concern worldwide. According to the World Health Organization, 19,300 lives and 871,000 disability-adjusted life-years are lost globally each year because of cystic echinococcosis. Annual costs associated with cystic echinococcosis were estimated at US$ 3 billion because of treatment of cases and losses in the livestock industry.

METHODS

We performed the random-effects model of meta-analysis using 51-year (1970-2021) data available from AJOL, Google Scholar, PubMed, Science Direct, Scopus and Web of Science. We also applied the Joanna Briggs Institute critical appraisal instrument for studies reporting prevalence data, the Cochran's Q-test, Egger's regression test and the single study deletion technique to respectively examine within-study bias, heterogeneity, across-study bias and sensitivity.

RESULTS

Thirty-nine eligible studies on human cystic echinococcosis (HCE) from 13 countries across the five African sub-regions showed an overall prevalence of 1.7% (95% CI 1.1, 2.6) with a statistically significant (P < 0.001) sub-group range of 0.0% (95% CI 0.0, 14.1) to 11.0% (95% CI 7.6, 15.7). Highest prevalences were observed in Eastern Africa (2.7%; 95% CI 1.4, 5.4) by sub-region and Sudan (49.6%; 95% 41.2, 58.1) by country. Another set of 42 studies on Echinococcus granulosus infections (EGI) in dogs from 14 countries across the five African sub-regions revealed an overall prevalence of 16.9% (95% CI 12.7, 22.3) with a significant (P < 0.001) variation of 0.4 (95% CI 0.0, 5.9) to 35.8% (95% CI 25.4, 47.8) across sub-groups. Highest prevalences of E. granulosus were observed in North Africa (25.6%; 95% CI 20.4, 31.6) by sub-region and Libya (9.2%; 95% CI 5.7, 13.9) by country.

CONCLUSION

Human cystic echinococcosis and EGI are respectively prevalent among Africans and African dogs. We recommend a holistic control approach that targets humans, livestock, dogs and the environment, which all play roles in disease transmission. This approach should involve strategic use of anthelminthics in animals, standardized veterinary meat inspection in abattoirs, control of stray dogs to reduce environmental contamination and proper environmental sanitation. Mass screening of humans in hyper-endemic regions will also encourage early detection and treatment.

A Comparative Evaluation of Four Different Immunoassays in the Diagnosis of Cystic Echinococcosis Using a Crude and Purified Hydatid Cyst Fluid Antigen

PURPOSE

Cystic echinococcosis (CE) is one of the most neglected tropical diseases as per WHO which has an immense public health significance. Diagnosis of CE is difficult as specific clinical signs are manifested only after the hydatid cyst attains a considerable size. Immunodiagnosis is a reliable method of diagnosing CE.

METHODS

SDS-PAGE was performed for the hydatid cyst fluid antigens. The antigen purity was tested by Western blotting and four different immunoassays were evaluated using these two antigens in sheep and buffalo in diagnosis of CE.

RESULTS

SDS-PAGE revealed four bands of 72, 64, 48 and 24 kDa for crude antigen and a single 72 kDa band for purified antigen. Among sheep sera, ELISA was most sensitive (70%) using crude antigen and also while using the purified antigen (80%). In case of buffaloes, ELISA, DID and CIEP were more sensitive (83.3%) using crude antigen, whereas DID and CIEP were more sensitive (83.3%) using purified antigen.

CONCLUSION

In sheep, while using the crude antigen ELISA was the most sensitive assay and IHA was the least sensitive assay. While using the purified antigen also, ELISA was the most sensitive and others were absolutely specific except for IHA being less sensitive. In buffaloes, using crude antigen, all the immunoassays CIEP, DID and ELISA were highly sensitive in diagnosing CE infection except IHA, whereas using the purified antigen, both CIEP and DID were more sensitive than ELISA and IHA which were comparatively less sensitive in detecting CE in buffalo sera.

A systematic review and meta-analysis on prevalence and distribution of Taenia and Echinococcus infections in Ethiopia

Background

Tapeworm infections are among the tropical neglected parasitic diseases endemically occurring in Ethiopia. This systematic review and meta-analysis aims at estimating the pooled prevalence and distribution of Taenia and Echinococcus infections in humans and animals from reports from Ethiopia.

Methods

The systematic search was conducted in four bibliographic databases (PubMed, Google Scholar, Africa Journal Online and Science Direct). Additional data were retrieved from grey literature. Studies that met the inclusion criteria were considered for the systematic review and meta-analysis. The meta-analysis was conducted using MetaXL add-in for Microsoft Excel. Heterogeneity and inconsistency were evaluated using Cochran’s Q and I² statistics, respectively.

Results

The study provides a country-based database of Taenia and Echinococcus infections consisting of 311 datasets from 201 publications which were mostly abattoir surveys; of these, 251 datasets were subjected to meta-analysis. Most of the studies were from Oromia (32.8%) followed by Amhara (22.9%) regional states. The pooled prevalence of cystic echinococcosis in intermediate and accidental hosts was calculated as 22% (95% CI 18–26%) and high study variability (Q = 24,420.65, I² = 100%, P = 0.000). Moreover, a pooled prevalence of Echinococcus infections in final hosts was calculated as 33% (95% CI 20–48%) and low study variability (Q = 17.24, I² = 65%, P = 0.001). Similarly, study subjects (human, cattle, sheep, goat and wolf) were infected by Taenia spp. with pooled prevalence of 3% (95% CI 2–4%) and moderate study variability (Q = 279.07, I² = 89, P = 0.000). Meanwhile, the pooled prevalence of Taenia hydatigena, T. ovis and T. multiceps infections in intermediate hosts were calculated as 38%, 14% and 5%, respectively. The random effect meta-analysis of bovine cysticercosis showed a pooled prevalence of 7% (95% CI 5–9%) and high study variability was of (Q = 4458.76; I² = 99%, P = 0.000). Significant differences in prevalence of Taenia and Echinococcus infections between study sites or different livestock origins have been reported.

Conclusion

The study evidenced a comprehensive dataset on the prevalence and distribution of Taenia and Echinococcus infections at different interfaces by regions and hosts and hence can aid in the design of more effective control strategies.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-04925-w.

Epidemiology and spatial distribution of Echinococcus granulosus in sheep and goats slaughtered in a hyperendemic European Mediterranean area

Background

Cystic echinococcosis (CE) is a worldwide parasitic zoonosis caused by the larval stage of Echinococcus granulosus sensu lato affecting livestock, particularly sheep and goats. However, often this parasitosis is underestimated. For this reason, this study aimed to evaluate the epidemiological features and spatial distribution of CE in sheep and goats slaughtered in a hyperendemic Mediterranean area.

Methods

A survey was conducted in the Basilicata region (southern Italy) from 2014 to 2019. A total of 1454 animals (1265 sheep and 189 goats) from 824 farms were examined for hydatid cyst detection by visual inspection, palpation and incision of target organs. All the CE cysts were counted and classified into five morphostructural types (unilocular, multiseptate, calcified, caseous and hyperlaminated). Molecular analysis was performed on 353 cysts. For spatial analysis, a kriging interpolation method was used to create risk maps, while clustering was assessed by Moran’s I test.

Results

CE prevalence of 72.2% (595/824) and 58.4% (849/1454) was observed at the farm and animal levels, respectively, with higher values in sheep (62.9%) than goats (28.0%). The liver and lungs were the most frequently infected organs in both sheep and goats. Most of recovered cysts were of the calcified and multiseptate morphotypes. All the isolates were identified as E. granulosus sensu stricto (genotypes G1–G3). Spatial distribution showed a moderate clustering of positive animals.

Conclusion

The findings of this study can be used to better understand the eco-epidemiology of echinococcosis and to improve CE surveillance and prevention programs in regions highly endemic for CE.

Graphical abstract

Meta-Analysis of the Prevalence of Echinococcus in Sheep in China From 1983 to 2020

Echinococcosis is a zoonosis caused by the larval stage of cestode species that belong to the genus Echinococcus. The infection of hydatid in sheep is very common in China, especially in the northwestern China. Here, we conducted the first systematic review and meta-analysis of echinococcosis in sheep in China. Six databases (PubMed, ScienceDirect, Baidu Library, CNKI, Wanfang, and VIP Chinese Journal Database) were used to retrieve the literatures on echinococcosis in sheep in China from 1983 to 2020, and 74 studies. The random effects model was used in the “meta” package of the R software and the PFT was chosen for rate conversion. The research data were analyzed through subgroup analysis and univariate meta-regression analysis to reveal the factors that lead to research heterogeneity. The combined prevalence of Echinococcus in the selected period was estimated to be 30.9% (192,094/826,406). In the analysis of sampling year, the lowest positive rate was 13.9% (10,296/177,318) after 2011. The highest prevalence of Echinococcus was 51.1% (278/531) in the southwestern China. The highest infection rate in sheep was 20.1% (58,344/597,815) in the liver. The analysis based on age showed that the infection rate of elderly sheep was significantly higher than that in younger animals (P < 0.05). We also evaluated the effects of different geographic and climatic factors on the prevalence of Echinococcus in sheep. The results showed that the prevalence of Echinococcus was higher in high altitude, cold, humid, and high rainfall areas. It is necessary to carry out long-term monitoring and control of echinococcosis, cut off the infection route, and reduce the risk of infection in the high risk areas.

Prioritizing smallholder animal health needs in East Africa, West Africa, and South Asia using three approaches: Literature review, expert workshops, and practitioner surveys

Managing the health needs of livestock contributes to reducing poverty and improving the livelihoods of smallholder and pastoralist livestock keepers globally. Animal health practitioners, producers, policymakers, and researchers all must prioritize how to mobilize limited resources. This study employed three approaches to prioritize animal health needs in East and West Africa and South Asia to identify diseases and syndromes that impact livestock keepers. The approaches were a) systematic literature review, b) a series of expert workshops, and c) a practitioner survey of veterinarians and para-veterinary professionals. The top constraints that emerged from all three approaches include endo/ ectoparasites, foot and mouth disease, brucellosis, peste des petits ruminants, Newcastle disease, and avian influenza. Expert workshops additionally identified contagious caprine pleuropneumonia, contagious bovine pleuropneumonia, mastitis, and reproductive disorders as constraints not emphasized in the literature review. Practitioner survey results additionally identified nutrition as a constraint for smallholder dairy and pastoralist small ruminant production. Experts attending the workshops agreed most constraints can be managed using existing veterinary technologies and best husbandry practices, which supports a shift away from focusing on individual diseases and new technologies towards addressing systemic challenges that limit access to veterinary services and inputs. Few research studies focused on incidence/ prevalence of disease and impact, suggesting better incorporation of socio-economic impact measures in future research would better represent the interests of livestock keepers.

Prevalence and distribution of Echinococcus spp. in wild and domestic animals across Africa: A systematic review and meta-analysis

Cystic echinococcosis (CE), a worldwide zoonosis, is highly prevalent in Africa particularly in northern and eastern Africa where data are more abundant than other regions. However, harmonization of available data through systematic review and meta-analysis may foster improved transboundary cooperation for the control of CE in Africa. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, research articles (from 2000 to 2019) were retrieved from ScienceDirect, PubMed, African Journals OnLine and Google Scholar databases. A total of 98 studies of 806,624 animals from 13 countries comprising 264,016 goats, 247,326 sheep, 251,106 cattle, 28,314 camels, 4,764 buffaloes, 2,920 equids, 1,966 pigs, 408 wild boars and 50 Norway rats were available for systematic review and meta-analysis of pooled prevalence including 5,048 dogs, 345 lions, 220 hyenas, 94 wolves and 47 jackals/foxes analysed for Echinococcus infection. In total, 46,869 animals were infected and pooled prevalence of CE in intermediate hosts was highest in camels (17.1%; 95% CI: 12.1-22.8) and lowest in pigs (0.3%; 95% CI: 0.1-0.6). Results also showed uneven species/genotype distribution across the continent such that Echinococcus granulosus sensu stricto (G1, G3) constituted 74.45% of the total isolates from East Africa, E. canadensis (G6/7) accounted for 60.3% and 97.4% in North and West Africa, respectively, while 81.3% of E. ortleppi (G5) were recorded for southern Africa. The comparatively higher prevalence estimates for eastern and northern Africa than other regions indicate where efforts on CE management should now be given greater attention in Africa. Additionally, this study also advocates for better cooperation between countries within the same sub-region and the establishment of joint CE control programmes.

Review of Cystic Echinococcosis in Nigeria: A Story of Neglect

Purpose

Cystic echinococcosis (CE) caused by Echinococcus granulosus sensu lato is a widespread zoonotic disease of global concern. In Nigeria, the exact picture/status of CE is unclear, as most of the states are largely uninvestigated. Yet, as with every parasitic zoonosis, the first step towards planning a comprehensive management and control programme involves assessment of available national/regional prevalence data, host range, and risk factors at play in the transmission dynamics.

Methods

Published articles on echinococcosis were searched on PubMed and Africa Journal Online (AJOL) databases. Inclusion criteria were based on studies reporting prevalence of echinococcosis in animals and humans (including case reports) from 1970 to 2018.

Results

In this study, we evaluated and summarized cystic echinococcosis reports in Nigeria and found that post 1970–80s, studies on cystic echinococcosis have remained sparse regardless of the high prevalence recorded in the early years of CE investigation. In addition, information on the genetic population structure and the role of wildlife in CE transmission is still lacking.

Conclusions

This study appraises the prevalence and distribution of CE in Nigeria and identified areas where surveillance and control efforts should be focused and intensified.

Genetic characterization of Echinococcus species in eastern Ethiopia

Cystic echinococcosis (CE) is a neglected zoonotic disease with considerable economic and public health burden worldwide, particularly affecting developing countries like Ethiopia. To initiate effective prevention and control of CE, comprehensive data on the local lifecycles of the various species/genotypes of Echinococcus are needed. In the present study, conducted in eastern Ethiopia, a total of 1106 livestock animals were examined at three slaughterhouses, which resulted in combined prevalence of morphologically and molecularly confirmed CE of 8.4% (75/891) in cattle, 1.1% (1/95) in sheep, 0.0% (0/95) in goats and 12.0% (3/25) in camels. All cystic lesions recovered during post mortem examination were assessed for cyst condition and underwent molecular characterization by PCR and sequencing of a 1081 bp fragment of the mitochondrial cox1 gene. A total of 175 cysts belonged to E. granulosus s.s. (n = 165), E. ortleppi (n = 6) and E. canadensis G6/7 (n = 4). Of all examined cysts, only 14 were fertile and contained protoscoleces, all from the lungs of cattle: 5 were E. granulosus s.s., 6 E. ortleppi and 3 E. canadensis G6/7. In sheep, only one sterile liver cyst of E. granulosus s.s. was found, while in camels seven sterile or caseated/calcified cysts of E. granulosus s.s. and E. canadensis G6/7 were found in liver and lungs. In conclusion, the prevalence of CE was rather low compared to other regions of Ethiopia, and, based on the number of fertile cysts, three Echinococcus spp. contributed almost equally to transmission. Cattle seem to be, epidemiologically, the most important livestock species. Our data provide a substantial basis for more detailed investigations of the transmission dynamics of CE in the study area.

Knowledge, attitudes and practices towards cystic echinococcosis in livestock among selected pastoral and agro-pastoral communities in Uganda

A cross-sectional study was done from March 2013 to May 2014 to assess knowledge, attitudes, and practices towards cystic echinococcosis (CE) or hydatidosis among selected pastoral and agro-pastoral communities in Uganda. A structured questionnaire was administered to 381 respondents. Multivariate logistic regression analysis was done to find the relationship between knowledge about CE and factors such as age, sex, and level of education across all regions. The odds ratio and confidence interval were used to determine the difference in responses across regions. It was shown that age above 36 years was significantly (p < 0.001) associated with awareness about CE in livestock. Likewise, uneducated (p < 0.0001) and agro-pastoralists (p = 0.01) were significantly less knowledgeable than the educated and pastoralists across all regions. The overall knowledge towards CE in livestock was low 17.8% (95% CI = 14.0-21.6). Dog ownership was high and they never dewormed their freely roaming dogs. Dogs shared water with livestock. In conclusion, knowledge about CE in livestock was low across all regions. Therefore, public health education and formulation of policies towards its control by the relevant stakeholders should be done. Also, the true prevalence of CE in livestock needs to be done so that the magnitude and its public health significance are elucidated.

Global Distribution of Alveolar and Cystic Echinococcosis

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.