Abstract
Cystic echinococcosis (CE) is recognized as a neglected disease of public health significance throughout the world, particularly in low and middle-income countries. The objectives of this study were to describe the characteristics, attitudes, knowledge, and practices of some Basrah province residents diagnosed with CE. Using a questionnaire survey, we interviewed 50 surgically operated cases of CE from Basrah, south Iraq. The cases comprised of 31 females and 19 males, of which 74% originated from rural areas. The questionnaire contained 30 questions and focused on gathering the demographic characteristics of the patients and capturing their overall knowledge, attitudes, and practices toward CE. Approximately half of the participants reported slaughtering livestock at home for their families’ consumption, 78% indicated the presence of a large number of stray dogs roaming freely about their village, 86% reported that they never boiled water before drinking it, and 26% reported not washing vegetables before eating them. Although a large proportion of the participants (72%) had heard of hydatid disease before becoming sick, over half (57%) were not aware of how the disease can be transmitted from animals to humans. This study highlights a gap in One Health education efforts regarding CE in southern Iraq, with a lack of counselling of patients on how to prevent reinfection. An intensive One Health education program should be implemented in Basrah to reduce CE at the human–animal interface. Lack of awareness on zoonoses among medical professionals, who are supposed to disseminate advice on preventative measures to their patients, is a challenge to the public health system.
Highlights
Cystic echinococcosis (CE) is a neglected disease of public health significance in many low and middle-income countries [1]
The obvious representativeness of female interviewees is in line with a previous finding from a retrospective study in Iraq where we reported that CE affected more females (61.2%) than males (38.8%) [15]
Many of the interviewed cases in this study owned dogs and reported that large numbers of free-roaming dogs were in the vicinity of where the cases lived
Summary
Cystic echinococcosis (CE) is a neglected disease of public health significance in many low and middle-income countries [1]. The disease is caused by a tapeworm belonging to the genus Echinococcus which is transmitted between carnivores (dogs and wolves: The definitive hosts) and primarily livestock (the intermediate hosts), with humans accidentally acquiring the infection, usually through consuming food or water contaminated with eggs shed by the definitive host [2]. Once ingested by an intermediate host the eggs hatch in the small intestine releasing oncospheres, which penetrate the Diseases 2019, 7, 4; doi:10.3390/diseases7010004 www.mdpi.com/journal/diseases. The highest prevalence of CE in humans is typically found in sheep-raising rural communities, as sheep are considered the most important intermediate host. The emergence of human echinococcosis may be attributed to a change in the local ecology and increasing urbanization resulting in greater exposure of people to infected dogs [6,7]. Several studies have highlighted the role of socio-demographic characteristics; including age, gender, occupation, and level of education as essential factors in the transmission of echinococcosis to humans [8,9,10]
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