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PubMed2002

Rapid dot-ELISA for the detection of specific antigens in the cyst fluid from human cases of cystic echinococcosis.

A rapid dot-ELISA was developed for the detection of specific antigens in samples of cyst fluid from human cases of Echinococcus granulosus infection, permitting the confirmation of cystic echinococcosis (CE). Peroxidase-conjugated antibodies against antigen B (derived from the fluid in the cysts of sheep infected with E. granulosus) were used to test cyst-fluid samples from 22, surgically confirmed cases of human CE and 21 domestic animals (horses, sheep, buffalo, a cow and a camel) with CE. All of these samples were found to be strongly positive in the dot-ELISA, by direct reading with the naked eye. In contrast, fluid samples from seven, non-parasitic liver cysts of human origin were all negative, and a sample taken from the residual cavity left in a patient after previous CE surgery showed a weakly positive reaction. The antigen-detection assay, which can be completed within 10 min, may be a useful 'bedside' test for the differential diagnosis of cysts during surgery or percutaneous treatment for suspected CE.

Animals↗
PubMed2003

The seroprevalences of cystic echinococcosis, and the associated risk factors, in rural-agricultural, bedouin and semi-bedouin communities in Jordan.

An ELISA was used to determine the seroprevalence of cystic echinococcosis (CE), caused by Echinococcus granulosus, in representatives of the rural-agricultural, semi-bedouin and bedouin communities of Jordan. The knowledge, attitudes and practices (KAP) pertaining to the transmission of CE in such communities were also investigated. In the ELISA, serum samples from 2388 subjects were tested for IgG antibodies reacting with antigens in crude sheep hydatid fluid (CSHF). The rural-agricultural subjects were significantly more likely to be seropositive (11.4%) than the semi-bedouin (5.0%) or bedouin (3.7%), but male and female subjects were equally likely to be seropositive. Among the rural-agricultural and semi-bedouin subjects, those aged 11-20 years were most likely to be seropositive. Among the bedouin subjects, however, seroprevalence was highest for those aged 31-40 years. When the distribution of 59 seropositive subjects detected within 36 rural-agricultural households was investigated, 12 (33.3%) of the households were each found to have at least two seropositive members. Immunoblotting indicated that 27.1% of the seropositive rural-agricultural subjects showed immunoreactivity to at least one of the CSHF antigen-B components (of 8-12, 16 and 24 kDa). The living conditions, practices and lifestyles of the rural-agricultural, semi-bedouin and bedouin communities favour the spread of CE in Jordan and warrant an effective programme for the control of the disease.

Adolescent↗
PubMed2004

Efficacy of chloroquine in the treatment of Plasmodium vivax malaria in Turkey.

In most regions of the world, chloroquine (CQ) has been the standard treatment for Plasmodium vivax malaria for more than 40 years. Recently, however, CQ-resistant P. vivax has been reported from Oceania, several parts of Asia, and South America. The therapeutic efficacy of CQ in the treatment of acute, P. vivax malaria has now been assessed in two areas of the Turkish province of Sanliurfa: the towns of Karacadag and Sekerli. On admission and on days 2, 3, 7, 14, 21, and 28, all 112 patients investigated were examined clinically and blood samples were collected and smeared. Treatment consisted of 10 mg CQ/kg on day 0, the same dose on day 1, and 5 mg CQ/mg on day 2, each dose being supervised. Worryingly, 14.7% of the patients from Karacadag and 10.3% of those from Sekerli showed apparent treatment failure between days 3 and 28. In Sanliurfa province, in south-eastern Turkey, there therefore seems to be a high risk of therapeutic failure in patients given CQ to cure P. vivax malaria, probably because of CQ resistance.

Acute Disease↗
PubMed2006

Canine echinococcosis in Turkana (north-western Kenya): a coproantigen survey in the previous hydatid-control area and an analysis of risk factors.

A study of Echinococcus granulosus infection in dogs, with risk-factor analysis, was carried out in the endemic area of northern Turkana district, Kenya, using necropsy on 42 strays and a coproantigen-ELISA survey of 161 owned animals. During the post-mortem examinations, 14 (33%) of the necropsied dogs were found infected with E. granulosus, with a mean burden of 540 worms (range=two to 4080 worms). The 26 necropsied dogs that came from the north-western Lokichoggio division--an area where, from 1983 to 1997, there had been a continuous programme of hydatid control--showed a similar prevalence of infection to the other dogs (34.6%) but a significantly lower mean burden, of 53 worms (range=two to 300). Forty-two (26%) of the animals tested for Echinococcus coproantigen were found positive. Although the dogs from the Lokichoggio division were more likely to be coproantigen-positive (29%) than those from the central Kakuma division (20%) or the north-eastern division (18%), the differences were not statistically significant. In questionnaire-based interviews, the owners of the dogs tested for coproantigens were asked about possible risk factors for canine infection with E. granulosus. Women were found to have twice the level of contact with dogs as men. The results of a univariate analysis of the dog-owners' responses revealed six factors that appeared to be significantly associated with a coproantigen-positive dog: non-restraint of the dog (P<0.001); dog fed on raw offal (P<0.001); the improper disposal of slaughter offal (P<0.001); the dog-owner's lack of knowledge about the transmission of echinococcosis (P=0.001); the dog not receiving anthelmintic treatment (P=0.003); and dog age < or =5 years (P=0.01). The results of a multivariate analysis confirmed that lack of dog restraint, access to raw offal, and young age of the dog (< or =5 years) each significantly increased the risk of coproantigen positivity (P, 0.005). Dogs that scavenged from cooking pots, were used to clean babies, had access to the inside of houses, and/or slept indoors appeared, however, to be at no increased risk of coproantigen positivity. The present results are discussed in relation both to older information on the epidemiology and role of human behaviour in the transmission of E. granulosus in Turkana, and the effects of the hydatid-control programme that ran continuously in the north-western division of Turkana between 1983 and 1997.

Animal Husbandry↗
PubMed2006

Magnetic resonance imaging of alveolar echinococcosis experimentally induced in the rat lung.

Pulmonary alveolar echinococcosis (AE) caused by the metacestode of Echinococcus multilocularis is a lethal zoonosis and is a lesion secondarily induced by hematogenous dissemination from hepatic AE lesions. In the present study, a hematogenous pulmonary AE model was experimentally induced in rats by the injection of echinococcal larval tissue homogenate to the tail vein, and then the pathological and diagnostic aspects of pulmonary AE were examined by magnetic resonance imaging (MRI). Histological primary, mature and degenerated AE lesions were observed 5, 18 and 50 weeks after injection, respectively. These lesions were discriminated as signal-void, hypointense and hyperintense regions in T1-weighted MRI (T1WI), respectively. The change in signal intensity in T1WI might reflect the content of proteinaceous fluid as a result of AE cyst degeneration. Western blot analysis of sera with antibodies of two epitopes (Em18 and Em16) of E. multilocularis provided evidence for AE infection in the early stage. T1WI in combination with Western blot analysis could possibility become definitive and early signs of hematogenous pulmonary AE infection.

Animals↗
PubMed2004

Hepatic alveolar echinococcosis in cynomolgus monkeys (Macaca fascicularis).

Alveolar echinococcosis was diagnosed in 12 cynomolgus monkeys (Macaca fascicularis) at postmortem examination within a period of 6 years. Besides consistent involvement of the liver, parasitic lesions were also present in mesenteric lymph nodes, pancreas, lung, and kidney. In the liver, various patterns of host's responses to parasitic tissue could be distinguished. Infiltration of macrophages, often multinucleated, around usually intact metacestodes was the main feature of one pattern. A second pattern was characterized by the presence of abundant, normally degenerate granulocytes in addition to macrophages surrounding collapsed laminated structures. Finally and as a third pattern, some cysts were surrounded by marked collagen deposition, which was usually not a significant feature of the other foci. Parasitic cysts with protoscolices were observed in foci with the first and third pattern but not in the second one. The simultaneous occurrence of all three patterns was observed in most animals. Type AA amyloid was identified either in the space of Dissé, macrophages or blood vessel walls in nine animals using immunohistochemistry. Identity of parasitic structures such as metacestodes of Echinococcus multilocularis was confirmed immunohistochemically. All animals that could be tested serologically (7/12) had detectable antibodies against the E. multilocularis-specific Em2 antigen. Liver lesions of six animals were additionally analyzed by polymerase chain reaction, yielding the amplification of a specific E. multilocularis DNA fragment in each case.

Animals↗
PubMed1994

Chest wall echinococcosis.

The chest wall is an uncommon localization for hydatid cyst. In this article, six patients were operated on because of chest wall hydatid cysts between the years 1989 to 1991 have been reported. Four of them had previously undergone surgery for pulmonary or hepatic hydatidosis; the chest wall was the primary site in two patients. Operative procedures for chest wall echinococcosis were cystectomy (four patients), cystotomy and evacuation (one patient), and chest wall resection (one patient). There was no mortality. Mean follow-up was 26 months (range, 14 to 36 months). No recurrence has occurred yet.

Adult↗
PubMed1980

Surgical treatment of coronary insufficiency produced by cardiac echinococcosis.

We report two cases in which the pertinent angiographic studies disclosed the presence of hydatid cysts of the left ventricle, producing complete obstruction of the left anterior descending coronary artery in one patient and of the left anterior descending coronary artery and the circumflex coronary artery in the other patient. Both patients were successfully treated by excision of the cyst and myocardial revascularization with saphenous venous bypass grafts. From the analysis of symptoms in cardiac echinococcosis, we concluded that precordial pain is the most common complaint, that it can be due to coronary insufficiency, and that at the present, coronary angiographic studies have to be performed systematically in these patients, since coronary involvement by the cyst can explain some of the clinical manifestations and complications of the disease and can also influence its surgical management.

Angiography↗
PubMed1981

Cardiac echinococcosis. Late sudden death after surgical treatment.

Surgical treatment of cardiac echinococcosis does not always cure the disease. Late sudden death is not exceptional and is generally caused by the rupture of hidden secondary pericardial cysts. If the primary cyst is ruptured, the surgeon must explore the pericardium and remove it completely, since it is the possible location of other hidden secondary cysts and of microscopic fertile elements.

Adult↗
PubMed1999

[Experimental investigation of canine echinococcosis from swine hydatic cyst in Mexico].

OBJECTIVE: To evaluate the infection and obtain the adult state of the cestode, echinococcosis was reproduced in dogs using the hydatic cyst of swine. METHODS: Two groups were formed, one of five and the other of three dogs, each animal in the experimental group was given two grams of germinative membrane of fertile hydatic cyst by oral route. The second was the control group. Both groups were evaluated clinically, serologically and parasitologically. One animal was killed on the 35th day after infection and each five successive days until the 55th day. In the second group all the animals were killed on the 55th day. Eggs of the cestode were observed in feces from the 51st post-infection day. The morphological evaluation was made through microscopic observation of the mucous intestine scraping. RESULTS: Fifty cestodes were analyzed, ten from each of the infected dogs, 49 (98%) presented three proglottids and 1 (2%) had four; 18 (36%) of the cestodes presented a gravid proglottid. The length of the strobila varied from 1.6 to 2.6 mm. The average of the long and short hooks was 31 and 34, respectively. The length of the long hooks varied from 0.081 to 0.09 mm, the short hooks from 0.034 to 0. 041 mm. The quantity of plasmatic proteins and the number of leukocytes were significantly greater in the control group (P < 0. 05); the quantity of alpha-globulins was larger in the infected group (P < 0.05). CONCLUSIONS: The results confirmed the dog-pig cycle, a subclinical infection in the definitive hosts, that makes the diagnosis and control in species closely related to the human being difficult.

Animals↗
PubMed2004

Echinococcosis in southern Brazil: efforts toward implementation of a control program in Santana do Livramento, Rio Grande do Sul.

This investigation aimed to design a strategy for echinococcosis control in Santana do Livramento county, an endemic area in state of Rio Grande do Sul (Brazil). Fecal samples from 65 dogs were obtained from urban, suburban and rural areas. Purging with Arecoline Bromhidrate (AB) was done to visualize Echinococcus granulosus, and Enzyme Linked Immunosorbent Assay (ELISA) was performed to detect parasite coproantigen. Samples were obtained at the beginning and at the end of treatment with Praziquantel. A third fecal sampling was also done in rural areas four months after the end of treatment. Each dog was treated immediately after the first purging and every 30 days for eight months. In urban and suburban areas no infected dogs were found. In rural areas, first evaluation showed 11.36% and 27.69% of infected dogs by AB and ELISA, respectively. No infected dogs were diagnosed in the second evaluation and in the third evaluation 36.84% and 47.37% infected dogs were identified by AB and ELISA, respectively. Medication program to combat dog infection resulted in successful interruption of parasite transmission, but the project failed to create awareness of the need for dog prophylaxis among rural populations as well as to establish a permanent control program in this municipality.

Animals↗
PubMed2006

Notes on human cases of cystic echinococcosis in Peru.

Cystic echinococcosis (CE) is a high prevalent zoonosis in the central and southern Peruvian Andes. Serum samples (n50)from patients presenting presumptive clinical and radiological diagnosis of CE (group 1), were tested for antibodies against Echinococcus granulosus metacestode using Arc-5 double diffusion assay (DD5), immunoelectrophoresis (IEF), and immunoelectrotransfer blot (EITB) techniques. Serum samples (n18) from patients presenting other parasite infections (paragonomiasis, cysticercosis, and fascioliasis) or healthy blood donors (n15), were designated as control groups. The overall sensitivity of the tests was of 94% (DD5 and IEF tests) or 96% (EITB test). Only patients from group 1 were seropositive for CE. Polypeptides of 21, 31, and 48 kDa were considered positive for CE. Based on these results, this study demonstrates that CE also occurs in other coastal departments (Piura, Ancash, Ica, Arequipa, and Tacna) besides Lima.

Adolescent↗
PubMed2000

Failure to identify alveolar echinococcosis in trappers from South Dakota in spite of high prevalence of Echinococcus multilocularis in wild canids.

Echinococcus multilocularis causes a rare but potentially lethal zoonotic disease in humans. This tapeworm has been known to be endemic in foxes (Vulpes vulpes) and coyotes (Canis latrans) within the northern United States since the 1960s. One purpose of this study was to provide recent data on the prevalence of E. multilocularis in foxes and coyotes from eastern South Dakota. In a survey conducted from 1987 to 1991 and involving 137 foxes and 9 coyotes from this area, 74.5% of the foxes and 4 of the coyotes were infected. To assess the possible prevalence of alveolar echinococcosis in a group at presumptive high risk, we also conducted a serological survey of members of the South Dakota Trappers Association in 1990 and 1991. Serum samples from 115 trappers were evaluated for the presence of E. multilocularis antibodies using enzyme-linked immunosorbent assay tests involving a purified antigen called Em2, a crude E. multilocularis antigen, and a recombinant E. multilocularis antigen called II/3-10. None of the trappers showed antibody evidence for the presence of E. multilocularis. Roughly half of the surveyed individuals had trapped more than 50 foxes during their life, and almost one-fourth had trapped more than 1,000 foxes.

Adolescent↗
PubMed2005

Echinococcosis of the heart: clinical and echocardiographic features in 12 patients.

UNLABELLED: We describe the clinical and echocardiographic features in 12 patients with hydatid cyst of the heart who were screened between 1985 and 2001. Presenting symptoms have a wide variability but the main symptom was precordial pain. The electrocardiogram was always abnormal and showed T wave inversion in 8 cases, ST depression in 5 cases, incomplete right bundle-branch block in one case and atrial fibrillation in one case. Transthoracic echocardiography and transoesophageal echocardiography constitute the imaging procedure of choice for the diagnosis of cardiac hydatid cyst with a high sensibility, specificity. Computed tomography (CT) was performed in all patients and confirmed the echocardiographic data. MRI was performed in one patient with right atrium hydatid cyst location and confirmed the echocardiographic data. CONCLUSION: In the presence of atypical symptomatology in a patient coming from an endemic area of hydatid cyst, the diagnosis of cardiac echinococcosis is possible.TTE and TEE are the imaging procedure of choice and sufficient for the diagnosis of cardiac hydatid cyst. CT and/or MRI provide more information about the extension of echinococcus disease in other intra- or extrathoracic locations.

Cohort Studies↗
PubMed1997

Treatment of complicated pulmonary echinococcosis with albendazole in childhood.

The case of an 11-year-old boy suffering from pulmonary hydatid disease with rupture and bacterial superinfection is presented. After 3 courses of chemotherapy with albendazole the boy recovered fully, uneventfully and without relapse. Conservative management should always be considered before surgical intervention in children with echinococcosis, even when complications have occurred.

Albendazole↗
PubMed1995

Primary cardiac echinococcosis in childhood. Case report.

Cardiac echinococcosis is rare and usually occurs in adults. In a 12-year-old boy a left ventricular hydatid cyst was diagnosed by two-dimensional echocardiography and computed tomography and the cyst was surgically removed.

Cardiomyopathies↗
PubMed2006

Global socioeconomic impact of cystic echinococcosis.

Cystic echinococcosis (CE) is an emerging zoonotic parasitic disease throughout the world. Human incidence and livestock prevalence data of CE were gathered from published literature and the Office International des Epizooties databases. Disability-adjusted life years (DALYs) and monetary losses, resulting from human and livestock CE, were calculated from recorded human and livestock cases. Alternative values, assuming substantial underreporting, are also reported. When no underreporting is assumed, the estimated human burden of disease is 285,407 (95% confidence interval [CI], 218,515-366,133) DALYs or an annual loss of US $193,529,740 (95% CI, $171,567,331-$217,773,513). When underreporting is accounted for, this amount rises to 1,009,662 (95% CI, 862,119-1,175,654) DALYs or US $763,980,979 (95% CI, $676,048,731-$857,982,275). An annual livestock production loss of at least US $141,605,195 (95% CI, $101,011,553-$183,422,465) and possibly up to US $2,190,132,464 (95% CI, $1,572,373,055-$2,951,409,989) is also estimated. This initial valuation demonstrates the necessity for increased monitoring and global control of CE.

Animals↗
PubMed2004

Serum sIL-2R, TNF-alpha and IFN-gamma in alveolar echinococcosis.

AIM: to approach the relationship between alveolar echinococcosis (AE) pathology and level of sIL-2R,TNF-alpha and IFN-gamma in sera and the significance of cytokines in development of AE. METHODS: After 23 patients with AE were confirmed by ELISA and ultrasound, their sera were collected and the concentrations of sIL-2R,TNF-alpha and IFN-gamma were detected by double antibody sandwich. Twelve healthy adults served as controls. According to the status of livers of AE patients by ultrasound scanning, they were divided into 4 groups: P(2), P(3), P(4) groups and C group (control). Average of concentrations of sIL-2R,TNF-alpha and IFN-gamma in homologous group was statistically analyzed by both ANOV and Newman-Keuls, respectively. RESULTS: The mean of sIL-2R in P(2) group was 97+/-29, P(3): 226+/-80, P(4): 194+/-23 and control group (111+/-30)X10(3) u/L (P<0.01). The mean of TNF-alpha in P(2) group was 1.12+/-0.20, P(3): 3.67+/-1.96, P(4): 1.30+/-0.25 and control group 0.40+/-0.19 mug/L (P<0.01). The mean of IFN-gamma in P(2) group was 360+/-20, P(3): 486+/-15, P(4): 259+/-19 and control group: 16+/-2 ng/L (P<0.01). Judged by ANOV and Newman-Keuls, the mean concentrations of sIL-2R, TNF-alpha and IFN-gamma had a significant difference among groups. Except for P(2) group, the mean sIL-2R between other groups of AE patients had a significant difference (P<0.05). The mean of TNF-alpha concentration in P(3) group was the highest (P<0.01). The mean of IFN-gamma concentration in all patients was higher than that in control group (P<0.01), but there was no difference between AE groups (P>0.05). CONCLUSION: Low sIL-2R level indicates an early stage of AE or stable status, per contra, a progression stage. Higher level of TNF-alpha might be related to the lesion of liver. The role of single IFN-gamma is limited in immunological defense against AE and it can not fully block pathological progression.

Adult↗