Human cystic echinococcosis in southwest Iran: a 15-year retrospective epidemiological study of hospitalized cases

Reza Shahriarirad,Mohammad Rastegarian,Hajar Taghizadeh,Mehrdad Eskandarisani,Bahador Sarkari,Amirhossein Erfani

doi:10.1186/s41182-020-00238-3

Reza Shahriarirad, Mohammad Rastegarian + Show 4 more

Open Access

https://doi.org/10.1186/s41182-020-00238-3

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Abstract

BackgroundCystic echinococcosis (CE) is considered as a neglected disease with significant mortality and morbidity in most of the developing countries. The current study aimed to retrospectively assess the demographic and epidemiologic features of human CE surgical cases in a 15-year period in Fars province, southwestern Iran.MethodsA 15-year (2004–2018) retrospective study was conducted to find out the epidemiological and clinical picture of CE in patients who undergone surgeries for CE in two main hospitals in Fars Province, southwestern Iran. Hospital records were reviewed, and data were retrieved from each CE patient’s record.ResultsA total of 501 CE surgical cases were recorded during a 15-year period, corresponding to an average annual incidence of 33.4 and a surgical incidence rate of 0.74/100,000 population. Of these, 242 (48.6%) were male, and 256 (52.4%) were female. Patients’ age ranged from 2 to 96 years, with a mean age of 34.92 (± 19.87) years. A significantly higher rate of CE cases was noted in subject’s ≥ 50 years of age. The highest frequency of cases (62:12.5%) was recorded in the year 2017. The most commonly involved organs were liver (339 cases; 57.8%) and lung (279 cases; 47.6%). Concurrent involvement of two organs was seen in 58 (9.9%) cases of both lung and liver, 10 (1.6%) cases of lung and other locations (but not liver), and 23 (3.9%) cases of liver and other locations (but not lung). Reoperation was noted in 67 (13.4%) of the cases. The size of the lung hydatid cyst varied, ranging between 2 and 24 cm (mean = 7.33, SD = 3.737). The size of liver hydatid cysts ranged from 1 to 26 cm (mean 9.04, SD = 4.275).ConclusionThe findings of the current study demonstrated a nearly constant prevalence of CE during the last 15 years in southern Iran. Further studies are needed to find out the reasons behind the recurrence of the disease, which is substantial, in surgically-treated patients.

Highlights

Cystic echinococcosis (CE) is considered as a neglected disease with significant mortality and morbidity in most of the developing countries
Humans become infected via ingesting embryonated eggs through hands, water, or food contaminated with parasite eggs that passed through the feces of definitive hosts
Data collection In this retrospective study, hospital records of CE patients were reviewed, and data were retrieved for a 15year period, from 2004 to 2018 at the main university– affiliated and referral hospitals (Nemazi and Shahid Faghihi) in Shiraz, capital of Fars Province

Summary

Introduction

Cystic echinococcosis (CE) is considered as a neglected disease with significant mortality and morbidity in most of the developing countries. Cystic echinococcosis (CE), due to Echinococcus granulosus, is one of the most significant zoonotic diseases, throughout most parts of the world [1]. Herbivores such as sheep, goats, and swine are intermediate hosts of E. granulosus, which become infected by eating the worm eggs passed in the carnivores’ feces. Carnivores, as definitive hosts, ingest the cyst-containing organs of herbivores and harbor worms in their digestive system [2]. Humans become infected via ingesting embryonated eggs through hands, water, or food contaminated with parasite eggs that passed through the feces of definitive hosts. Clinical manifestations of CE vary based on the size, location, and condition of the cystic structure [3]

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