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Doszhanova G, Colpani A, Duisenova A, De Vito A, Zholdybay Z, Juszkiewicz K, Brunetti E, Katarbayev A, Kaniyev S, Zhakenova Z, Manciulli T, Mustapayeva A. The high burden of pediatric cystic echinococcosis in Kazakhstan: epidemiological and clinical consequences. Trans R Soc Trop Med Hyg 2023; 117:875-877. [PMID: 37721185 DOI: 10.1093/trstmh/trad065] [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: 02/15/2023] [Revised: 05/10/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is attributable to Echinococcus granulosus metacestodes. Ultrasound examinations enable a stage-specific approach to CE management. However, this approach is not often applied in endemic areas, which include Kazakhstan. METHODS We collected clinical and ultrasound data on CE pediatric patients seen at a national referral surgical center in Almaty, Kazakhstan, during 2015-2020. RESULTS We included 49 patients, and 79 cysts that were all surgically treated. All but one patient carried active cysts (CE1-CE3 stages). Twenty-six (53.2%) did not receive albendazole postsurgery. Children with CE1 and CE3a cysts underwent surgery, while the use of albendazole and percutaneous drainage were advised upon by experts. CONCLUSIONS A stage-specific approach to CE management in Kazakhstan is urgent, especially in the pediatric population. The rate of active cysts suggests continuing transmission of CE.
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Affiliation(s)
- Gaukhar Doszhanova
- Department of Infectious and Tropical Diseases, Asfendyiarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari 07100, Italy
| | - Amangul Duisenova
- Department of Infectious and Tropical Diseases, Asfendyiarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari 07100, Italy
| | - Zhamilya Zholdybay
- Department of Visual Diagnostics, Asfendiyarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Konrad Juszkiewicz
- Department of Infectious and Tropical Diseases, Asfendyiarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Enrico Brunetti
- WHO-Collaborating Center for the Clinical Management of Cystic Echinoccocosis, San Matteo Hospital Foundation, Pavia 27100, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Adyl Katarbayev
- Department of Children Infectious Diseases, Asfendiyarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Shokan Kaniyev
- Syzganov National Institute of Surgery, 62 Zheltoksan Street, Almaty 050004, Kazakhstan
| | - Zhanar Zhakenova
- Department of Visual Diagnostics, Asfendiyarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
| | - Tommaso Manciulli
- WHO-Collaborating Center for the Clinical Management of Cystic Echinoccocosis, San Matteo Hospital Foundation, Pavia 27100, Italy
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50121, Italy
| | - Aigerim Mustapayeva
- Department of Visual Diagnostics, Asfendiyarov Kazakh National Medical University, 94 Tole Bi Street, Almaty 050012, Kazakhstan
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Paduraru AA, Lupu MA, Sima L, Cozma GV, Olariu SD, Chiriac SD, Totolici BD, Pirvu CA, Lazar F, Nesiu A, Mihu AG, Cumpanas AA, Cretu OM, Olariu TR. Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007-2022. Microorganisms 2023; 11:2388. [PMID: 37894047 PMCID: PMC10609572 DOI: 10.3390/microorganisms11102388] [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: 08/23/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Cystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18-90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50-59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases.
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Affiliation(s)
- Ana Alexandra Paduraru
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Maria Alina Lupu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania
| | - Laurentiu Sima
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- General Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Gabriel Veniamin Cozma
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- Thoracic Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Sorin Dan Olariu
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgery I, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Sorin Dan Chiriac
- Discipline of Surgery III, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Bogdan Dan Totolici
- Department of General Surgery, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania
| | - Catalin Alexandru Pirvu
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgical Emergencies, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Fulger Lazar
- General Surgery Clinic, County Clinical Emergency Hospital, 300254 Timisoara, Romania; (S.D.O.)
- Discipline of Surgery II, Department of Surgery II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandru Nesiu
- Department of Biology and Life Sciences, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania;
- Department of Urology, Arad County Emergency Clinical Hospital, 310037 Arad, Romania
| | - Alin Gabriel Mihu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Biology and Life Sciences, Vasile Goldis Western University of Medicine and Pharmacy, 310025 Arad, Romania;
| | - Alin Adrian Cumpanas
- Discipline of Urology, Department XV, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Octavian Marius Cretu
- Discipline of Surgical Semiology I and Thoracic Surgery, Department of Surgery I, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (G.V.C.)
- General Surgery Clinic, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
| | - Tudor Rares Olariu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania (M.A.L.); (A.G.M.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania
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Yang Y, Cairang Y, Jiang T, Zhou J, Zhang L, Qi B, Ma S, Tang L, Xu D, Bu L, Bu R, Jing X, Wang H, Zhou Z, Zhao C, Luo B, Liu L, Guo J, Nima Y, Hua G, Wa Z, Zhang Y, Zhou G, Jiang W, Wang C, De Y, Yu X, Cheng Z, Han Z, Liu F, Dou J, Feng H, Wu C, Wang R, Hu J, Yang Q, Luo Y, Wu J, Fan H, Liang P, Yu J. Ultrasound identification of hepatic echinococcosis using a deep convolutional neural network model in China: a retrospective, large-scale, multicentre, diagnostic accuracy study. Lancet Digit Health 2023; 5:e503-e514. [PMID: 37507196 DOI: 10.1016/s2589-7500(23)00091-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/08/2023] [Accepted: 04/29/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Ultrasonography is the most widely used technique to diagnose echinococcosis; however, challenges in using this technique and the demand on medical resources, especially in low-income or remote areas, can delay diagnosis. We aimed to develop a deep convolutional neural network (DCNN) model based on ultrasonography to identify echinococcosis and its types, especially alveolar echinococcosis. METHODS This retrospective, large-scale, multicentre study used ultrasound images from patients assessed at 84 hospitals in China, obtained between Jan 1, 2002, and Dec 31, 2021. Patients with a diagnosis of cystic echinococcosis, alveolar echinococcosis, or seven other types of focal liver lesions were included. We tested ResNet-50, ResNext-50, and VGG-16 as the backbone network architecture for a classification DCNN model and input the perinodular information from the ultrasound images. We trained and validated the DCNN model to diagnose and classify echinococcosis using still greyscale ultrasound images of focal liver lesions in four stages: differentiating between echinococcosis and other focal liver lesions (stage one); differentiating cystic echinococcosis, alveolar echinococcosis, and other focal liver lesions (stage two); differentiating cystic echinococcosis, alveolar echinococcosis, benign other focal liver lesions, and malignant focal liver lesions (stage three); and differentiating between active and transitional cystic echinococcosis and inactive cystic echinococcosis (stage four). We then tested the algorithm on internal, external, and prospective test datasets. The performance of DCNN was also compared with that of 12 radiologists recruited between Jan 15, 2022, and Jan 28, 2022, from Qinghai, Xinjiang, Anhui, Henan, Xizang, and Beijing, China, with different levels of diagnostic experience for echinococcosis and other focal liver lesions in a subset of ultrasound data that were randomly chosen from the prospective test dataset. The study is registered at ClinicalTrials.gov (NCT03871140). FINDINGS The study took place between Jan 1, 2002, and Dec 31, 2021. In total, to train and test the DCNN model, we used 9631 liver ultrasound images from 6784 patients (2819 [41·7%] female patients and 3943 [58·3%] male patients) from 87 Chinese hospitals. The DCNN model was trained with 6328 images, internally validated with 984 images, and tested with 2319 images. The ResNet-50 network architecture outperformed VGG-16 and ResNext-50 and was generalisable, with areas under the receiver operating characteristic curve (AUCs) of 0·982 (95% CI 0·960-0·994), 0·984 (0·972-0·992), and 0·913 (0·886-0·935) in distinguishing echinococcosis from other focal liver lesions; 0·986 (0·966-0·996), 0·962 (0·946-0·975), and 0·900 (0·872-0·924) in distinguishing alveolar echinococcosis from cystic echinococcosis and other focal liver lesions; and 0·974 (0·818-1·000), 0·956 (0·875-0·991), and 0·944 (0·844-0·988) in distinguishing active and transitional cystic echinococcosis from inactive echinococcosis in the three test datasets. Specifically, in patients with the hepatitis B or hepatitis C virus, the model could distinguish alveolar echinococcosis from hepatocellular carcinoma with an AUC of 0·892 (0·812-0·946). In identifying echinococcosis, the model showed significantly better performance compared with senior radiologists from a high-endemicity area (AUC 0·942 [0·904-0·967] vs 0·844 [0·820-0·866]; p=0·027) and improved the diagnostic ability of junior, attending, and senior radiologists before and after assistance with AI with comparison of AUCs of 0·743 (0·714-0·770) versus 0·850 (0·826-0·871); p<0·0001, 0·808 (0·782-0·832) versus 0·886 (0·864-0·905); p<0·0001, and 0·844 (0·820-0·866) versus 0·870 (0·847-0·890); p=0·092, respectively. INTERPRETATION The DCNN model was shown to be accurate and robust, and could improve the ultrasound diagnostic ability of radiologists for echinococcosis and its types for highly endemic and remote regions. FUNDING National Natural Science Foundation of China and National Key Research & Development Program of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yongfeng Yang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China; Graduate School of Chinese People's Liberation Army, General Hospital, Beijing, China
| | - Yangdan Cairang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Tian'an Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianhua Zhou
- Department of Ultrasound, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Li Zhang
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Baowen Qi
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Shumei Ma
- Department of Ultrasound Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Lina Tang
- Department of Diagnostic Ultrasound, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Dong Xu
- Colorectal Surgery and Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Hangzhou, China
| | - Lingdai Bu
- Department of Ultrasound, People's Hospital of Bortala Mongol Autonomous Prefecture, Bortala Mongol Autonomous Prefecture, China
| | - Rui Bu
- Department of Ultrasound, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiang Jing
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zubang Zhou
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liwen Liu
- Department of Ultrasound, The Xijing Hospital of Air Force Medical University, Xi'an, China
| | - Jianqin Guo
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical College, Hainan, China
| | - Yuzhen Nima
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Guoyong Hua
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Zengcheng Wa
- Department of Ultrasound, Qinghai Red Cross Hospital, Xining, China
| | - Yuying Zhang
- Department of Ultrasound, Qinghai Provincial People's Hospital, Xining, China
| | - Guoyi Zhou
- Innovation Research Center, SonoScape, Shenzhen, China
| | - Wen Jiang
- Innovation Research Center, SonoScape, Shenzhen, China
| | | | - Yang De
- Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hui Feng
- Department of Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Chong Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ruifang Wang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jie Hu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qi Yang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yanchun Luo
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiapeng Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Haining Fan
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Jie Yu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
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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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5
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Uakhit R, Smagulova A, Syzdykova A, Abdrakhmanov S, Kiyan V. Genetic diversity of Echinococcus spp. in wild carnivorous animals in Kazakhstan. Vet World 2022; 15:1489-1496. [PMID: 35993082 PMCID: PMC9375211 DOI: 10.14202/vetworld.2022.1489-1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Aim: The study of Echinococcus infection among farm animals in Kazakhstan was carried out to monitor the invasion among livestock and map the data obtained. Unfortunately, there are only partial data on the study of echinococcosis among wild carnivores in Kazakhstan, which makes it difficult to conduct a comparative analysis of the epidemiological situation among wild animals. The present study aimed to estimate the genetic diversity of Echinococcus spp. (Leuckart, 1863) in Kazakhstan based on sequence analysis of cytochrome c oxidase subunit 1 (cox1) and dehydrogenase subunit 1 (nad1) of worms isolated from wild carnivorous animals wolf (Canis lupus), red fox (Vulpes vulpes) and corsac (Vulpes corsac). Materials and Methods: DNA from parasite tissue was used as a template for the amplification of the two mitochondrial genes cox1 and nad1. Sequencing was performed according to the manual for the Seq Studio Genetic Analyzer. The multiple alignments of obtained sequences were performed using the ClustalW algorithm in Mega (v.11) software. Alignments were exported as a Nexus extension and used as input for TCS v1.21 for the identification of haplotypes. The phylogenetic analysis was constructed according to the neighbor-joining method using Mega (v.11) software. Results: Analysis of the extensiveness of echinococcosis invasion showed that 6.3% were wolves, 18.2% were corsacs, and 85% were foxes. In total, 159 adults of Echinococcus spp. from the three species of animals in different parts of Kazakhstan were analyzed, and 17 individual biological samples were successfully sequenced. Sequence analysis of cox1 and nad1 genes revealed two types of echinococcosis – Echinococcus granulosus in red foxes and wolves, and Echinococcus multilocularis in corsacs. Sequencing of a portion of the mitochondrial genome made it possible to determine seven haplotypes of the pathogen in the studied samples of E. granulosus. Molecular analysis of cox1 and nad1 genes of E. multilocularis revealed three new haplotypes, which have significant variability compared with other studied Asian haplotypes. Conclusion: This study made it possible to fill the gaps in understanding the localization of the foci of the spread of the echinococcosis pathogen among the main wild carnivores and to determine the species reservoir of the pathogen in the greater territory of Kazakhstan.
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Affiliation(s)
- Rabiga Uakhit
- Saken Seifullin Kazakh Agrotechnical University, 62 Zhenis Avenue, Nur-Sultan 010011, Kazakhstan
| | - Ainura Smagulova
- Saken Seifullin Kazakh Agrotechnical University, 62 Zhenis Avenue, Nur-Sultan 010011, Kazakhstan
| | - Alfiya Syzdykova
- Saken Seifullin Kazakh Agrotechnical University, 62 Zhenis Avenue, Nur-Sultan 010011, Kazakhstan
| | - Sarsenbay Abdrakhmanov
- Saken Seifullin Kazakh Agrotechnical University, 62 Zhenis Avenue, Nur-Sultan 010011, Kazakhstan
| | - Vladimir Kiyan
- Saken Seifullin Kazakh Agrotechnical University, 62 Zhenis Avenue, Nur-Sultan 010011, Kazakhstan; National Center of Biotechnology, 13/5 Qorghalzhyn Hwy, Nur-Sultan 010011, Kazakhstan
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6
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Colpani A, Achilova O, D’Alessandro GL, Budke CM, Mariconti M, Muratov T, Vola A, Mamedov A, Giordani MT, Urukov X, De Silvestri A, Suvonkulov U, Brunetti E, Manciulli T. Trends in the Surgical Incidence of Cystic Echinococcosis in Uzbekistan from 2011 to 2018. Am J Trop Med Hyg 2022; 106:724-728. [PMID: 34902836 PMCID: PMC8832901 DOI: 10.4269/ajtmh.21-0261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/25/2021] [Indexed: 02/03/2023] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis with a cosmopolitan distribution caused by Echinococcus granulosus sensu lato tapeworms. Although Uzbekistan and other countries in Central Asia are considered endemic, estimates of disease burden are lacking. We present data regarding surgically managed cases of CE obtained from Uzbekistan's national disease surveillance registry. These data are from medical centers in Uzbekistan authorized to treat the disease and reported to the Uzbek Center for Sanitation and Epidemiology from the period 2011 to 2018. Information included patient age class (children 14 years or younger versus adults 15 years and older), but no data regarding cyst location. Incidence rates were calculated using data from the national population registry, and the Cuzick nonparametric test for trends was used to test for differences in the incidence over time at the country and regional levels. A total of 7,309 CE cases were reported. Of these, 857 (11.73%) involved pediatric patients. The mean incidence rates were 4.4 per 100,000 population in 2011 and 2.3 per 100,000 population in 2018 (P = 0.016). One region (Republic of Karalpakistan) showed a nonstatistically significant increase (P = 0.824). All other regions except three showed a statistically significant decrease. We present data showing a decrease in the overall incidence of surgically treated CE in Uzbekistan from 2011 to 2018. However, the presence of cases involving children suggests ongoing parasite transmission. The absence of clinical information (starting with cyst stage and localization) needs to be addressed to improve the national surveillance system. Field studies are also needed to further explore the epidemiology of CE in the country.
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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 and Immunology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Timur Muratov
- Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan
| | - Ambra Vola
- Unit of Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Arzu Mamedov
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maria Teresa Giordani
- Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Xusan Urukov
- Department of Infectious Diseases, San Bortolo Hospital, Vicenza, Italy
| | - Annalisa De Silvestri
- Center of Sanitation and Epidemiology, Well-Being Sanitary of Population, Payarik District Branch, Samarkand, Uzbekistan
| | | | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;,Unit of Infectious Diseases and Immunology, 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 and Immunology, IRCCS San Matteo Hospital Foundation, Pavia, Italy;,Address correspondence to Dr. Tommaso Manciulli, University of Pavia, Viale Brambilla 53, 27100 Pavia. E-mail: tommaso.manciulli01@ ateneopv.it
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7
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Saydam FN, Erdem H, Ankarali H, El-Arab Ramadan ME, El-Sayed NM, Civljak R, Pshenichnaya N, Moroti RV, Mahmuodabad FM, Maduka AV, Mahboob A, Prakash Kumari PH, Stebel R, Cernat R, Fasanekova L, Uysal S, Tasbakan M, Arapović J, Magdalena DI, Angamuthu K, Ghanem-Zoubi N, Meric-Koc M, Ruch Y, Marino A, Sadykova A, Batirel A, Khan EA, Kulzhanova S, Al-Moghazi S, Yegemberdiyeva R, Nicastri E, Pandak N, Akhtar N, Ozer-Balin S, Cascio A, Dimzova M, Evren H, Puca E, Tokayeva A, Vecchi M, Bozkurt I, Dogan M, Dirani N, Duisenova A, Khan MA, Kotsev S, Obradovic Z, Del Vecchio RF, Almajid F, Barac A, Dragovac G, Pishmisheva-Peleva M, Rahman MT, Rahman T, Le Marechal M, Cag Y, Ikram A, Rodriguez-Morales AJ. Vector-borne and zoonotic infections and their relationships with regional and socioeconomic statuses: An ID-IRI survey in 24 countries of Europe, Africa and Asia. Travel Med Infect Dis 2021; 44:102174. [PMID: 34699956 DOI: 10.1016/j.tmaid.2021.102174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. METHOD VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. RESULTS 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. CONCLUSIONS Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.
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Affiliation(s)
- Fatma Nurhayat Saydam
- Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas University, Faculty of Medicine, Batikent Medical Park Hospital, Ankara, Turkey
| | - Hakan Erdem
- ID-IRI Lead Coordinator, Ankara, Turkey; Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, 24343, Bahrain.
| | - Handan Ankarali
- Istanbul Medeniyet University, School of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | | | | | - Rok Civljak
- "Dr. Fran Mihaljevic" University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ruxandra Valentina Moroti
- National Institute for Infectious Diseases 'Matei Bals', and 'Carol Davila' University of Medicine and Pharmacy', Bucharest, Romania
| | | | | | - Amjad Mahboob
- Gajju Khan Medical College/Bacha Khan Medical Complex, Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Roman Stebel
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Roxana Cernat
- Clinical Infectious Disease Hospital Constanta, Ovidius University of Constanta, Romania
| | - Lenka Fasanekova
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Firat University Faculty of Medicine, Elazig, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, Izmir, Turkey
| | - Jurica Arapović
- Department of Infectious Diseases, Mostar University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | | | | | | | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Hospital of Medical Faculty, Istanbul, Turkey
| | - Yvon Ruch
- Strasbourg University Hospital (Nouvel Hôpital Civil - Centre Hospitalo-Universitaire de Strasbourg), Strasbourg, France
| | - Andrea Marino
- Department of Infectious Diseases, Garibaldi Nesima Hospital, Italy
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa Tameer-E-Millat University, Shifa International Hospital, Islamabad, Pakistan
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Samir Al-Moghazi
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | - Ravilya Yegemberdiyeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Emanuele Nicastri
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, G-8/3, Islamabad, Pakistan
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Firat University, Faculty of Medicine, Elazıg, Turkey
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Italy
| | - Marija Dimzova
- Clinic for Infectious Diseases and Febrile Conditions, Medical University, Skopje, Macedonia
| | - Hakan Evren
- Department of Infectious Diseases and Clinical Microbiology, University of Kyrenia, Kyrenia, Cyprus
| | | | - Alma Tokayeva
- Department of Infectious Diseases, Semey Medical University, Semey, Kazakhstan
| | | | - Ilkay Bozkurt
- Department of Infectious Diseases, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
| | - Mustafa Dogan
- Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
| | - Natalia Dirani
- Department of Infectious Diseases, Dar Al Amal University Hospital, Douris, Baalbak, Lebanon
| | - Amangul Duisenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Stanislav Kotsev
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Zarema Obradovic
- Faculty for Health Studies University of Sarajevo, Bosnia and Herzegovina
| | | | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Gorana Dragovac
- Centre of Disease Prevention and Control, Institute of Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Maria Pishmisheva-Peleva
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | | | - Marion Le Marechal
- Grenoble Alpes University, CHUGA, Infectious Diseases Department, 38043, Grenoble, France
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Perú
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8
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Mustapayeva A, Luca D'Alessandro G, Doszhanova G, Colpani A, Sadybekov N, Baimakhanov Z, Assanov E, Salybekov S, Kaniyev S, Serikuly E, Tagabayeva L, Budke CM, Vola A, Mariconti M, De Silvestri A, Yalisheva S, Sadykova A, Zholdybay Z, Katarbayev A, Zhakenova Z, Brunetti E, Juszkiewicz K, Duisenova A, Manciulli T. Ultrasound-based evaluation of the prevalence of abdominal cystic echinococcosis in the Turkestan region of Kazakhstan. Trans R Soc Trop Med Hyg 2021; 116:222-226. [PMID: 34499709 DOI: 10.1093/trstmh/trab105] [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: 04/07/2021] [Revised: 05/31/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human cystic echinococcosis (CE) is a zoonotic disease caused by Echinococcus granulosus sensu lato. CE is known to be endemic in some parts of Central Asia. We present findings from an ultrasound-based survey to estimate the prevalence of CE in the Turkestan oblast of Kazakhstan. METHODS In October 2019, six villages were chosen based on records from a national surveillance dataset. Inhabitants aged 5-90 y were invited to undergo a free abdominal ultrasound to screen for CE cysts. All identified cysts were staged according to the WHO-endorsed classification for CE cysts. RESULTS A total of 2252 individuals underwent ultrasound screening. Twenty-two (0.98%) individuals had CE, with a combined total of 33 cysts: 25 (75.7%) inactive (14 CE4, 11 CE5) and 8 (24.3%) active/transitional (2 CE1, 1 CE2, 3 CE3a, 2 CE3b). One patient had a postsurgical cavity. Sixty-eight patients (3.0%) reported CE prior to surgical treatment. In 25 (36.8%) previously diagnosed patients, albendazole prophylaxis was not used. CONCLUSIONS CE is endemic in the study region, with ongoing transmission. The number of surgically treated CE patients suggests an underestimation of the disease burden by the current surveillance system. Further studies on local CE epidemiology and the implementation of expert treatment recommendations are needed.
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Affiliation(s)
- Aigerim Mustapayeva
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Gian Luca D'Alessandro
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
| | - Gaukhar Doszhanova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Agnese Colpani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
| | - Nurbol Sadybekov
- Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | - Zhasulan Baimakhanov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Ernar Assanov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Samat Salybekov
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Shokan Kaniyev
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Erbol Serikuly
- Syzganov National Institute of Surgery, 62 Zheltoksan str., 050004 Almaty, Kazakhstan
| | - Lyazzat Tagabayeva
- Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | | | - Ambra Vola
- Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Mara Mariconti
- Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Unit of Biostatistics, IRCCS San Matteo Hospital Foundation, Piazzale Gogli 2, 27100 Pavia, Italy
| | - Sofyia Yalisheva
- Department of Genetics and Molecular Biology, Al Farabi Kazakh National University, 71 al-Farabi Ave., 050040 Almaty, Kazakhstan
| | - Ainur Sadykova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Zhamilya Zholdybay
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan.,Kazakh Institute of Oncology and Radiolology, 91 Abai ave., 050022 Almaty. Kazakhstan
| | - Adil Katarbayev
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Zhanar Zhakenova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy.,Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Piazzale Gogli 2, 27100 Pavia, Italy
| | - Konrad Juszkiewicz
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan.,KIT Royal Tropical Institute, Amsterdam, Netherlands
| | - Amangul Duisenova
- Asfendyiarov National Kazakh Medical University, 94 Tole Bi Street, 050012 Almaty, Kazakhstan
| | - Tommaso Manciulli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 54, 27100 Pavia, Italy
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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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10
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Abstract
OBJECTIVE We aimed to determine the effective factors in the selection of treatment methods for patients with hepatic hydatid cyst undergoing surgery and the variables effective when performing postoperative endoscopic retrograde cholangiopancreatography (ERCP). In addition, we aimed to reveal the factors affecting the recurrence, postoperative complications, and length of stay of these patients. MATERIALS AND METHODS A total of 107 patients diagnosed with hepatic hydatid cysts were treated surgically. Data were obtained from the records of these patients. Chi-square test was used for the analysis. The variables that were found to be significant in the chi-square analysis were included in the logistic regression (Backward: LR) analysis. RESULTS Of all patients, 6.5% underwent the puncture, aspiration, injection, and reaspiration (PAIR) technique, 67.3% underwent conservative surgery, and 26.2% underwent radical surgical treatment. In paired comparisons, a significant difference was found among the ultrasonographic size of the cyst (p = 0.033), the radiological classification of the cyst (0.006), and history of previous surgery and treatment methods for the cyst. The risk of performing ERCP was 25.710 [95% confidence interval (CI): 1.721-284.013] folds higher for cysts located in the left lobe, whereas it was 19.992 (95% CI: 2.004-199.488) folds higher for cysts located in both right and left lobes. When the radical surgical treatment method was taken as a reference, the status of ERCP implementation was 29.785 (95% CI: 1.844-480.996) folds higher for PAIR and 3.628 (95% CI: 0.355-37.103) folds higher for conservative surgery. CONCLUSION In conclusion, radical surgery is a significant treatment for hepatic hydatid cyst as its ultrasonographic cyst size increases with time. The location and treatment method of the cyst increases the complication of biliary fistula and requires ERCP.
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Affiliation(s)
- Hasan Cantay
- Department of General Surgery, Kafkas University School of Medicine, Kars, Turkey
| | - Turgut Anuk
- Department of General Surgery, Kafkas University School of Medicine, Kars, Turkey
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11
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Khan A, Ahmed H, Khan H, Saleem S, Simsek S, Brunetti E, Afzal MS, Manciulli T, Budke CM. Cystic Echinococcosis in Pakistan: A Review of Reported Cases, Diagnosis, and Management. Acta Trop 2020; 212:105709. [PMID: 32956637 DOI: 10.1016/j.actatropica.2020.105709] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 02/07/2023]
Abstract
Cystic echinococcosis (CE) is a zoonotic disease that occurs in humans and ungulates due to infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato. It has been estimated that approximately one million people are infected annually, resulting in US$3 billion in human and livestock-associated direct and indirect losses per year. CE is a serious public health concern in many parts of the world, including Pakistan. This review discusses the causative agent as well as the epidemiology, diagnosis, and treatment of CE in Pakistan.
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