Human and animal cystic echinococcosis in Tataouine governorate: hypoendemic area in a hyperendemic country, myth or reality?

Abstract Background Cystic echinococcosis (CE) has a worldwide distribution and is especially prevalent in North African countries. With a mean annual surgical incidence (ASI) of CE of 12.7 per 100,000 inhabitants, Tunisia is one of the most CE endemic countries in the Mediterranean area. Tataouine governorate is considered to be the most CE hypoendemic region in Tunisia (ASI = 0.92) despite favourable socioeconomic conditions that enable maintenance of the Echinococcus granulosussensu lato (s.l.) life-cycle and a significant environmental contamination with E. granulosuss.l. eggs. The aim of this study was to assess human CE seroprevalence, prevalence of CE in food animals and environmental contamination by E. granulosus s.l. eggs in different districts of Tataouine governorate. Methods This study was conducted from January to December 2018. A total of 374 human sera samples were tested for the presence of immunoglobulin G antibodies against E. granulosus using a commercial ELISA kit. Specimens were also collected from animals slaughtered at the Tataouine abattoir (n = 8609) and examined for the presence of hydatid cysts; 111 hydatid cysts were genotyped. Eggs of E. granulosuss.l. were identified by PCR and DNA sequencing from dog faecal samples (n = 288). Results Serological tests showed that 8.5% of the sera samples tested were positive for E. granulosus-specific antibodies. The average prevalence of hydatidosis in livestock was 1.6%, and CE infection was more prevalent in cattle than in sheep, goats and dromedaries. The contamination rate of dog faeces by E. granulosus sensu stricto eggs varied significantly from 0 to 23.5% depending on the collection area. Molecular analyses only revealed the presence of the G1 genotype for cysts and eggs. Conclusions Based on our findings, CE is likely to be more endemic in the Tataouine governorate than previously described. Thus, to implement an effective control programme against CE, a national survey should be carried out to determine human CE prevalence in the different Tunisian governorates. Graphic Abstract

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Cystic echinococcosis in slaughtered domestic ruminants from Tunisia

Journal of Helminthology ◽

10.1017/s0022149x12000430 ◽

2012 ◽

Vol 87 (3) ◽

pp. 318-325 ◽

Cited By ~ 28

Author(s):

S. Lahmar ◽

M. Trifi ◽

S. Ben Naceur ◽

T. Bouchhima ◽

N. Lahouar ◽

...

Keyword(s):

Cystic Echinococcosis ◽

Control Programme ◽

Asymptotic Model ◽

Hydatid Cysts ◽

Mean Intensity ◽

Ruminant Species ◽

Domestic Ruminants ◽

Infection Pressure ◽

Pulmonary Cysts ◽

The Mean

AbstractA total of 10,818 domestic ruminants (3913 cattle, 2722 sheep, 3779 goats, 404 dromedaries) slaughtered in various abattoirs in Tunisia between 2003 and 2010 were examined for the presence of Echinococcus granulosus hydatid cysts. The prevalence of cystic echinococcosis (CE) was 16.42% in sheep, 8.56% in cattle, 5.94% in dromedaries and 2.88% in goats. CE prevalence increased with age according to an asymptotic model and there was evidence of variation in infection pressure depending on the region of Tunisia where the animals were slaughtered. Cattle appeared to have the highest infection pressure of the species examined. The mean intensity of hepatic cysts was higher than that of pulmonary cysts in all species. The highest mean intensity of infection with E. granulosus larvae was observed in cattle (18.14) followed by sheep (9.58), goats (2.31) and dromedaries (2.12). The abundance of infection increased in a linear fashion with age in all animal species. Cyst abundance varied with species of animal and district of Tunisia. Cysts from dromedaries were more fertile (44.44%) than those from sheep (30.25%), goats (30.32%) and cattle (0.95%). The viability of the protoscoleces from fertile cysts from cattle (78.45%) was higher than those from sheep (70.71%) and camels (69.57%). The lowest protoscolex viability was recorded for hydatid cysts from goats (20.21%). This epidemiological study confirms the importance of CE in all domestic ruminant species, particularly in sheep, throughout Tunisia and emphasizes the need to interrupt parasite transmission by preventive integrated approaches in a CE control programme.

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Validity of a Serological Diagnostic Kit for SARS-CoV-2 Available in Iran

Archives of Iranian Medicine ◽

10.34172/aim.2020.75 ◽

2020 ◽

Vol 23 (9) ◽

pp. 629-632

Author(s):

Hamid Reza Shamsollahi ◽

Mostafa Amini ◽

Shaban Alizadeh ◽

Saharnaz Nedjat ◽

Ali Akbari-Sari ◽

...

Keyword(s):

Diagnostic Techniques ◽

Effective Control ◽

Molecular Technique ◽

Size Estimation ◽

Medical Sciences ◽

Serological Tests ◽

Standard Case ◽

Epidemic Size ◽

Low Sensitivity ◽

Negative Controls

Background: The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic broke out in December 2019 and is now characterized as a pandemic. Effective control of this infectious disease requires access to diagnostic techniques, for both case finding and epidemic size estimation. The molecular technique is routinely used worldwide. Although it is the "standard" case detection and management method, it has its own shortcomings. Thus, some easy-to-use rapid serological tests have been developed. Methods: One hundred and fourteen positive RT-PCR-diagnosed patients were tested by VivaDiag Kit, a brand of rapid serological kits available in hospitals affiliated to Tehran University of Medical Sciences (TUMS), Tehran, Iran. Frozen serum specimens taken from healthy people in summer and fall 2019 were also tested as negative controls. Results: Test sensitivity was 47.9% (95% confidence interval [CI]: 38.8-56.9) for IgM and 47.0% (95% CI: 38.0–56.0) for IgG. There was no difference between IgG and IgM seropositivity except in one case. Specificity was calculated as 99.0% (95% CI: 96.4–99.9) for IgM and of 100.0% (95% CI: 0.98.2–100.0) for IgG. Sensitivity was higher in men and older participants. Conclusion: This test can be used for epidemiological investigations, especially for the estimation of the level of infection in the community, after it is properly corrected for sensitivity and specificity. The low sensitivity could be attributed to the technical limitations of the kit or low levels of antibodies after infection. The different sensitivity in age and sex groups supports the hypothesis that different people show different immune responses to this virus.

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Serological tests in relation to the viability, fertility and localization of hydatid cysts in cattle, sheep, goats and swine

Veterinary Parasitology ◽

10.1016/0304-4017(80)90007-2 ◽

1980 ◽

Vol 7 (1) ◽

pp. 33-38 ◽

Cited By ~ 15

Author(s):

F. Martinez Gómez ◽

S. Hernández Rodriguez ◽

I. Navarrete López-Cózar ◽

R. Calero Carretero

Keyword(s):

Hydatid Cysts ◽

Serological Tests

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Risk factors for veterinary hospital environmental contamination with Salmonella enterica

Epidemiology and Infection ◽

10.1017/s0950268818001164 ◽

2018 ◽

Vol 146 (10) ◽

pp. 1282-1292

Author(s):

B. A. Burgess ◽

P. S. Morley

Keyword(s):

Environmental Contamination ◽

Salmonella Enterica ◽

Control Programme ◽

Specific Factor ◽

Large Animal ◽

Complex Data ◽

Analytic Methods ◽

Model Complex ◽

Healthcare Associated ◽

Veterinary Hospital

AbstractHealthcare-associated infections in veterinary hospitals are commonly attributed to Salmonella enterica, particularly in large animal facilities, and are characteristically associated with widespread environmental contamination. The objective of this study was to investigate factors influencing the likelihood of identifying environmental contamination of a veterinary hospital with S. enterica, while exploring different analytic methods to model complex factors that may influence this ecology. Environmental surveillance samples were collected in a large veterinary hospital as part of a long-term infection control programme. Data were collected retrospectively from the electronic medical records database. Many easily measured variables were complex in nature (i.e., they represented variance that is unmeasured or unidentified as a specific factor) necessitating the use of alternative analytic methods (variable cluster and principal components analyses) to provide perspective regarding the complex data structure and latent factors that may be contributing to this ecology. Subsequently, multivariable logistic regression was performed using generalised estimating equations. Results suggest the probability of detecting Salmonella in the environment increased as demand on personnel increased (e.g., in a busy hospital). Veterinary personnel need to remain vigilant in implementing practices that we believe empirically will mitigate risk for widespread environmental contamination and sustained transmission among patients (i.e., rigorous hygiene for personnel and the environment).

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Cystic echinococcosis: a 10-year experience from a middle-income country

Tropical Doctor ◽

10.1177/0049475519891338 ◽

2019 ◽

Vol 50 (2) ◽

pp. 117-121 ◽

Cited By ~ 1

Author(s):

Ayesha Butt ◽

Javaid Ahmed Khan

Keyword(s):

Abdominal Pain ◽

Medical Therapy ◽

Cystic Echinococcosis ◽

Middle Income Country ◽

Neglected Tropical Disease ◽

Hydatid Cysts ◽

Timely Manner ◽

Middle Income ◽

Hepatic Cysts ◽

High Index Of Suspicion

Cystic echinococcosis (CE), or hydatid disease, is a neglected tropical disease (NTD) afflicting one million people globally. This study aims to elucidate the presentation, treatment and outcomes of the disease in Pakistan. A review of charts of 225 patients (median age = 42.3 years) with CE admitted at Aga Khan Hospital, Karachi during 2007–2017, was carried out. Abdominal pain was present in 34.7% followed by fever in 26.2%. There were 142 (63.1%) cases of hepatic cysts and 55 (24.4%) of pulmonary hydatid cysts. Combined surgical and medical therapy was given to 130 (57.8%) patients. Surgery only was performed in 23 (10.2%) patients, medical therapy only was given to 35 (15.6%) patients, and puncture, aspiration, injection and reaspiration (PAIR) with medical therapy was given to 15 (6.7%) patients. Recurrence occurred in 14 (6.2%) patients and mortality in 7 (3.1%) patients. Owing to its non-specific presentation, a high index of suspicion is required to diagnose and treat CE in a timely manner.

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Multiple Hepatic and Renal Hydatid Cysts Managed with Laparoscopic Surgery

Case Reports in Surgery ◽

10.1155/2019/6969232 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Lamia Kouba ◽

Bayan Alsaid ◽

Taisser Almeree ◽

Mazen Allouche ◽

Abdulghani Alshalabi

Keyword(s):

Cystic Echinococcosis ◽

Treatment Options ◽

Hydatid Cysts ◽

Ct Guided ◽

Laparoscopic Excision ◽

History Of ◽

Percutaneous Removal ◽

Diagnostic Modalities ◽

One Year ◽

Laparoscopic Techniques

Cystic echinococcosis is a parasitic disease caused by Echinococcus granulosus. The liver and lungs are the most commonly infected organs. We present the first-of-a-kind case of laparoscopic excision of 8 hydatid cysts, of which seven were in the liver and one was in the kidney of a 40-year-old patient. The patient presented with fatigue and fever and a one-year history of vague abdominal pain. Albendazole was administered before surgical intervention. The postoperative follow-up period was notable for a renal fistula. The patient subsequently underwent CT-guided percutaneous removal of a central hepatic hydatid cyst that was inaccessible using laparoscopic techniques. Cystic echinococcosis is endemic in the Mediterranean region. The growing number of immigrants and refugees from endemic areas could increase the prevalence of the disease in nonendemic countries. Therefore, it is important for physicians worldwide to be familiar with the diagnostic modalities and possible treatment options for hydatid disease.

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Lymphocyte Populations in the Adventitial Layer of Hydatid Cysts in Cattle: Relationship With Cyst Fertility Status and Fasciola Hepatica Co-Infection

Veterinary Pathology ◽

10.1177/0300985819875721 ◽

2019 ◽

Vol 57 (1) ◽

pp. 108-114 ◽

Cited By ~ 1

Author(s):

Mauricio Jiménez ◽

Caroll Stoore ◽

Christian Hidalgo ◽

Felipe Corrêa ◽

Marcela Hernández ◽

...

Keyword(s):

Immune Response ◽

B Cells ◽

Hydatid Cyst ◽

Cystic Echinococcosis ◽

B Lymphocyte ◽

Fasciola Hepatica ◽

Hydatid Cysts ◽

T And B Cells ◽

Intermediate Hosts ◽

Adventitial Layer

Cystic echinococcosis is a worldwide zoonosis caused by the cestode Echinococcus granulosus. Two types of hydatid cysts occur in intermediate hosts: fertile cysts that generate protoscoleces from the germinal layer of the cyst, and infertile cysts that do not produce protoscoleces and are unable to continue the life cycle of the parasite. The adventitial layer, a host-derived fibrous capsule surrounding the hydatid cyst, is suggested to play an important role in local immune regulation during infection and in fertility of the cysts. Fasciola hepatica, another important parasite of cattle, induces a characteristic Th2-like immune response that could modulate the immune response against E. granulosus. Natural co-infection of both parasites is common in cattle, but no reports describe the local immune response against E. granulosus with F. hepatica infection in the same host. This study analyzed the number and distribution of T and B cells in the adventitial layer of liver and lung cysts and the relationship with cyst fertility and F. hepatica co-infection. T lymphocytes were the predominant cell type in the adventitial layer of infertile hydatid cysts and were more numerous in infertile hydatid cysts. B lymphocyte numbers were not associated with hydatid cyst fertility. Mast cells were infrequent in the adventitial layer. The number of T and B cells was not associated with F. hepatica co-infection. The present study contributes to the understanding of local immune responses in bovine cystic echinococcosis.

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Solidification of hydatid cyst fluid with an injectable chitosan/carboxymethylcellulose/β-glycerophosphate hydrogel for effective control of spillage during aspiration of hydatid cysts

Progress in Biomaterials ◽

10.1007/s40204-018-0082-5 ◽

2018 ◽

Vol 7 (1) ◽

pp. 35-54 ◽

Cited By ~ 3

Author(s):

Mostafa D. A. Azadi ◽

Shadi Hassanjili ◽

Khalil Zarrabi ◽

Bahador Sarkari

Keyword(s):

Hydatid Cyst ◽

Cyst Fluid ◽

Effective Control ◽

Hydatid Cysts ◽

Hydatid Cyst Fluid

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Incidence, Risk Factors, and Epidemiology of Cystic Echinococcosis: A Complex Socioecological Emerging Infectious Disease in Khyber Pakhtunkhwa, Province of Pakistan

BioMed Research International ◽

10.1155/2018/5042430 ◽

2018 ◽

Vol 2018 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Sumbal Haleem ◽

Sadaf Niaz ◽

Naveeda Akhtar Qureshi ◽

Riaz Ullah ◽

Mansour S. Alsaid ◽

...

Keyword(s):

Risk Factors ◽

Cystic Echinococcosis ◽

Organ Specificity ◽

Hydatid Cysts ◽

Age And Gender ◽

Khyber Pakhtunkhwa ◽

Close Relationship ◽

Incidence Risk ◽

Khyber Pakhtunkhwa Province ◽

And Gender

Cystic echinococcosis is a serious zoonotic disease caused by Echinococcus granulosus species complex. The current study is the first attempt to determine the level of infection in domestic livestock and to explore the CE-related knowledge and awareness among livestock farmers in different districts of Khyber Pakhtunkhwa, province of Pakistan. A total of 1297 animals were examined for hydatid cysts including 538 cows, 428 buffaloes, 208 sheep, and 123 goats, at different slaughter houses in different districts of Khyber Pakhtunkhwa in 2 years from September 2015 to September 2017. For epidemiological investigations, prevalence in association with various factors (climate, age, and gender), organ specificity, types of cysts (fertile, sterile, or calcified), and viability of cysts parameters was recorded. Basing on the results obtained, areas with high prevalence were selected for further follow-ups and administration of questionnaires to the farmers and dog owners, to provide baseline data about this parasitic disease and to identify potential areas of emergence with correspondence animal and of public health significance. The finding of this study revealed the presence of CE in livestock of KP, Pakistan. The prevalence of hydatid cysts was the highest in buffaloes (15.88%) followed by cows (15.79%), sheep (15.38%), and goats (3.25%). Our investigation revealed close relationship between prevalence and animal age and gender in different months of the year. These findings also showed the highest prevalence of hydatid cysts in liver (63.49%), followed by lungs (23.80%) and mesentery (2.64%). Fertile and viable cysts were observed in all animal species except goats. The highest percentage of fertile and viable cysts was reported from the liver and lungs of sheep. For evaluation of risk factors, a total of 384 respondents were investigated. The results of current study revealed that 97.9% of farmers are not familiar with CE and transmission of this infection from dogs to human and livestock. The present study shows that CE will continue to be of medical and veterinary importance in Pakistan.

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