Why more research needs to be done on echinococcosis in Pakistan

Background:Echinococcosis has a worldwide geographical distribution with endemic foci on every inhabited continent.Due to the frequent outbreaks in different parts of Pakistan in the recent past,echinococcosis is being described as a neglected tropical disease and is considered one of the most neglected parasitic diseases in the country.In endemic regions,predominantly settings with limited resources,there are high numbers of echinococcosis patients,as these communities do not have access to appropriate treatment.In Pakistan,there are limited reports on echinococcosis.The disease is prevalent in human and livestock,but this has not been sufficiently explored yet.Pakistan is an agricultural country and due to the disease’s zoonotic mode of transmission,there is a dire need of future research on it.The present paper is an effort to highlight the importance of echinococcosis in Pakistan.Discussion:There is a dire need for future research on echinococcosis in Pakistan as very few investigations had been carried out on this topic thus far.The prevalence of the disease in neighbouring countries highlights that Pakistan might be at severe risk of this zoonotic infection and further supports the need for more research.In Pakistan,the majority of the population lives in rural areas with limited acess to proper hygienic/sanitary facilities.These conditions favour the outbreak of diseases such as echinococcosis.The limited available data could result in higher outbreaks in the future,and thus cause the already weak healthcare system to overburden.The country has a meagre annual budget for health,which is being spent on known infections such as polio,dengue fever and hepatic viral infections.A proper surveillance system for echinococcosis is required across the country as treatment is usually expensive,complicated and may require extensive surgery and/or prolonged drug therapy.Development of new/novel drugs and other treatment modalities receives very little,if any,attention.Prognostic awareness programmes against this infection involve deworming of the infected animals,improved food inspection and slaughterhouse hygiene,and public education campaigns.Conclusion:Future research on echinococcosis is anticipated to demonstrate whether the epidemiology,diagnosis and recombinant vaccines/antibodies relating to echinococcosis can meet the quality standards(purity,potency,safety and efficacy)defined by the World Health Organization.Research work should be carried out on the epidemiology and serodiagnosis of echinocossis in the different areas of Pakistan,which will be useful for the proper eradication of echinococcosis in this region.The health department should implement awareness-raising campaigns for the general public in order to reduce the burden of disease.

Knowledge,attitudes and practices related to cystic echinococcosis endemicity in Pakistan

Background:Cystic echinococcosis(CE)is a human and animal health problem in many endemic areas worldwide.It is considered a neglected zoonotic disease caused by the larval form(hydatid cyst)of Echinococcus spp.tapeworm.There are limited studies on echinococcosis in Pakistan.Methods:A cross-sectional survey was conducted to find out recent knowledge,attitudes and practices on the occurrence of cystic echinococcosis in butchers and dog owners in both urban and rural areas of Rawalpindi/Islamabad regions,Pakistan.The quantitative data was collected in the form of questionnaires to investigate the knowledge and awareness of CE among community members and their routine practices that were behind the factors involved in hydatid cyst infection.The practices and infrastructure of abattoirs/butcher shops and their role in transmission of cystic echinococcosis were also evaluated in the present study.Results:The participants involved in the study were dog owners and people who kept animals.A total of 400 people were interviewed and 289 questionnaires were received.The results showed that only 4.1%of people have heard about the disease,and 58.1%were closely associated with dogs.Sixty-three percent of dogs in study area were consuming uncooked organs(e.g.liver,lung,etc.)of slaughtered animals,while 100%of dogs at butcher shops were consuming uncooked organs.Home slaughtering was common in 20.06%.Among butchers,32.3%had heard about zoonoses and 7.61%knew about CE.The statistical analysis showed that there was highly significant difference(P<0.05)among most of the practices that were associated with the prevalence of CE.Conclusions:It was concluded from the present study that,the knowledge and awareness of CE among people of Rawalpindi/Islamabad were low.Because of dogs and poor knowledge of CE among community members and butchers,the transmission of echinococcosis is facilitated.Therefore,there is urgent need to strengthen awareness and health education among people,as well as proper practices related to the CE not only in the study area,but also in other areas of Pakistan.