The Diagnosis, Treatment, Surveillance and Control of Cystic Echinococcosis in the Province of Rio Negro: The “One-Health” Model

Guillermo Mujica,Claudia Grizmado,Marcos Seleiman,Gabriel Talmon,Mariano Sobrino,Carlos Hugo Mercapide,Patricia Blanco,Daniel Araya,Edmundo Larrieu,Oscar Panomarenko,Hebe Tissot,Leonardo Uchiumi,Jose Luis Labanchi,Eduardo Herrero,Juan Carlos Salvitti,Marcos Arezo

doi:10.3390/parasitologia1040019

Abstract

Cystic Echinococcosis (CE) is an endemo-epidemic disease in the Rio Negro Province, República Argentina. Due to the number of cases, the length of hospital stays after surgery and its associated mortality, it is a serious public health problem that generates high costs for the health system. Oriented towards its control, primary prevention activities have been carried out since 1980, based on the deworming of dogs and the vaccination of lambs; secondary prevention has consisted in the actively search for cases through serological or ultrasonographic screening; and tertiary prevention has been based on timely treatment, either by surgery or by medical treatment with albendazole. All these prevention activities have been carried out under the concept and strategies of the “One Health” model, through both inter-institutional and interdisciplinary work, as well as with the support, commitment and critical participation of the community. As a result, an important drop has been observed in the prevalence of CE in humans and in its lethality (0.5% in 1997–2020, no deaths in the last two years); moreover, an important decrease has been observed in costs to the health system, due to the reduction of hospitalizations and the number of surgeries.

Highlights

Primary prevention includes all the actions that are aimed at the prevention of the disease and all the activities that are oriented towards health education and the fostering of health habits; secondary prevention consists of early diagnosis in order to reduce impact of the disease, including the actions undertaken to detect it in the asymptomatic period
Beginning of copro enzyme-linked immunosorbent assays (ELISAs) tests on farms
The arecoline test was performed on 23,895 dogs in the period 1980–2003

Summary

Introduction

Cystic Echinococcosis (CE) is a zoonosis that has an impact on the health systems of endemic areas, due to the high number of medical consultations and the high costs generated by the treatment of patients (many of it surgical), together with the need to keep control programs that need to be sustained for many years to be truly effective. CE mostly affects rural populations, and for the study and treatment of their condition they must be sent to tertiary referral hospitals with surgical devices, hundreds of kilometers away, with consequent uprooting, loss of workdays and family breakdown. CE generates production losses linked to affected sheep and goats [1,2]. Beginning of copro ELISA tests on farms.

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Conclusion