Cystic echinococcosis in adult hospitalized patients: A 10-year retrospective study in Western Romania

Abstract

Background: Human cystic echinococcosis (CE) is a parasitic zoonotic disease caused by tapeworms of the genus Echinococcus.Due to high rates of echinococcosis in humans and animals, Romania is listed among the first contries worldwilde, being recognized as a highly endemic area.The aim of the present study was to evaluate the epidemiological aspects of this disease in patients hospitalized in surgical clinics in Timisoara, Western Romania. Methods & Materials: This retrospective study included 228 adult patients admitted in 6 surgical clinics in Timisoara, between January 1st2007 and September 30th2017.Clinical, laboratory and epidemiological data were collected from the clinical records of these patients. Results: The 228 patients aged 19 to 82 years (mean = 46.2), 124(54.4%)were females, 136 (59.6%) from rural area.High prevalence of CE was observed in patients aged 50-59 years (21.7%) and 30-39 years (20.7%). Hospitalization period ranged between 3 and 46 days (mean 13.4 days).The meanlength of hospital stay was significantly higher in patients aged 60-69 years(16 days) compared to those aged 30-39 years (11 days), 40-49 years (7.5 days) and 50-59 years (11 days)(p < 0.05).Seventy-two patients (31.6%) had two or more hospitalizations.The most frequent localizations of the cysts were: liver (75.9%) and lung (10.5%). Multiple cysts have been reported in 53 (23.2%) patients.Fifty-one patients (22.4%) presented complications: anaphylactic shock, cardio-respiratory arrest, bacterial superinfection, cystic rupture, biliary fistula.The mean lengh of hospital stay was significantly higher in patients with complications (15.7 days) compared to those without complications (12.7 days)(p = 0.017). A significantly higher mean length of hospitalization was recorded in patients who underwent cystectomy (15.4 days) compared to those in whom percutaneous procedure (9 days) was performed(p < 0.001). Conclusion: Our findings indicate a higher prevalence of CE in females and rural area. Liver and lungs were the most affected organs.The length of hospital stay may be reduced in patients undergoing percutaneous procedure and in those without complications. Public Health Autorities should improve monitoring CE in order to evaluate and design of targeted prevention and control actions.