Research Article: Surveillance of Human Echinococcosis in Castilla-Leon (Spain) between 2000-2012

Date Published: October 20, 2015

Publisher: Public Library of Science

Author(s): Amparo Lopez-Bernus, Moncef Belhassen-García, Montserrat Alonso-Sardón, Adela Carpio-Perez, Virginia Velasco-Tirado, Ángela Romero-Alegria, Antonio Muro, Miguel Cordero-Sánchez, Javier Pardo-Lledias, Paul Robert Torgerson.

Abstract: AbstractBackgroundCystic echinococcosis (CE) is an important health problem in many areas of the world including the Mediterranean region. However, the real CE epidemiological situation is not well established. In fact, it is possible that CE is a re-emerging disease due to the weakness of current control programs.MethodologyWe performed a retrospective observational study of inpatients diagnosed with CE from January 2000 to December 2012 in the Western Spain Public Health-Care System.Principal findingsDuring the study period, 5510 cases of CE were diagnosed and 3161 (57.4%) of the cases were males. The age mean and standard deviation were 67.8 ± 16.98 years old, respectively, and 634 patients (11.5%) were younger than 45 years old. A total of 1568 patients (28.5%) had CE as the primary diagnosis, and it was most frequently described in patients <45 years old. Futhermore, a secondary diagnosis of CE was usually found in patients >70 year old associated with other causes of comorbidity. The period incidence rate was 17 cases per 105 person-years and was significantly higher when compared to the incidence declared through the Notifiable Disease System (1.88 cases per 105 person-years; p<0.001).ConclusionsCE in western Spain is an underestimated parasitic disease. It has an active transmission, with an occurrence in pediatric cases, but has decreased in the recent years. The systematic search of Hospital Discharge Records of the National Health System Register (HDR) may be a more accurate method than other methods for the estimation of the incidence of CE in endemic areas.

Partial Text: Human echinococcosis is a zoonotic infection caused by cestodes of the genus Echinococcus sp. Four species infect humans: cystic echinococcosis (CE) is caused by Echinococcus granulosus, alveolar echinococcosis (AE) is caused by E. multilocularis, and polycystic forms are caused by either E. vogeli or E. oligarthrus; however, they are less frequently associated with human infection.

The design was a retrospective observational study of inpatients diagnosed with CE in the Western Spain Public Health-Care System from January 2000 to December 2012.

Between January 2000 and December 2012, 5510 patients with CE were registered with HDR in the 14 hospitals. The main demographic data of the participants are shown in Table 1.

CE is a worldwide zoonotic infection that affects human and animal health, and it is the cause of significant economic loss for the agricultural sectors and public health systems in the endemic area [8]. Recent studies have shown that CE is a re-emerging disease in several countries and regions, even in places where the prevalence was previously low[5,6,11].



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