Co‑infection of fasciolosis and hydatidosis and their financial loss in cattle slaughtered at Wolaita Sodo municipal abattoir,southern Ethiopia

Fasciolosis and hydatidosis are the world’s most common zoonotic major parasitic ailments of domesticated animals with financial and public health implications.A cross-sectional study was conducted on 384 randomly selected cattle slaughtered at Wolaita Sodo municipal abattoir to estimate the prevalence and associated risk factors for co-infection of hydatidosis and fasciolosis using the ante-and postmortem examination techniques.Of the 384 examined cattle,4.17%were found to harbor co-infections of hydatidosis and fasciolosis.Similarly,the prevalence of concurrent fasciolosis and hydatidosis infections was 76.56%and 23.44%in local and crossbred animals,respectively.The current study took into account risk factors such as age,breed,origin,and body condition score;however,there is a statistically insignificant association between the risk factors and the prevalence of concurrent fasciolosis and hydatidosis infection.In this study,overall fasciolosis was recorded at a rate of 9.38%,with the highest prevalence of F.hepatica at 8.59%,followed by unidentified flukes at 4.17%and F.gigantica at 0.78%.Likewise,the single prevalence of hydatidosis was recorded at 10.94%.Of the 142 examined cysts,the liver alone harbors 54 cysts,and the lung alone harbors 88 cysts,with a total of 43 calcified,21 sterile,56 viable,9 nonviable,and 13 mixed cysts.The predicted yearly financial loss from organ condemnation was 15,436,142.00 ETB Birr.This study demonstrated that hydatidosis and fasciolosis are two relatively widespread parasite diseases of cattle in Ethiopia,causing significant economic loss attributable to organ rejection and indirect weight loss.Thus,awareness of the impact of the disease on the community could disrupt the parasite’s life cycle,and its economic significance was forwarded to other points.

Treatment of Complicated Hepatic Cystic Hydatidosis with Intrabiliary Rupture by Pericystectomy in Combination with Roux-en-Y Hepaticojejunostomy

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ul-trosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments Ⅴ, Ⅵ in 6 cases, and segment Ⅳ in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2–4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

Prevalence and characterization of hydatidosis in animals slaughtered at Al Taif abattoir, Kingdom of Saudi Arabia

Hydatidosis is a zoonotic disease caused by the larval stage of Echinococcus granulosus, hydatidosis an important helminthzoonosis affecting sheep in the world. Hydatidosis is a wellknown disease in third world countries, especially in rural communities where humans live in close contact with domestic animals and dogs. Dogs act as intermediate hosts. The Al Taif city is about 90 kilometers away from mecca the holy city. In each year, millions of sheep and goats are slaughtered during the pilgrimage season. It is very important to assess the prevalence of hydatidosis since it can be transmitted through dogs which act as definitive hosts for the parasite. This study aims to determine the prevalence of hydatidosis and the fertility/sterility rates of hydatid cysts in sheep and goats slaughtered in Taif Abattoir, Kingdom of Saudi Arabia. In this study, 1098 sheep and 296 goats were examined;162 (13.5%) sheep and 18 (6.1%) goats were found harboring hydatid cysts. In goats 6% were harboring hydaated cyst, and 76% of the goat were of local origin. Differences in prevalence rates were highly significant

Serodiagnosis of human hydatidosis with an ELISA developed based on antigens derived from sheep hydatid cysts and comparison with a commercial human ELISA kit

Objective:To explore the serodiagnosis of hydatid cyst in human using different antigens of sheep(hydatid fluid,somatic and Lxcretory/secretory antigens of protoscolexi by ELISA and compares this result with commercial human ELISA kit.Methods:one hundred blood samples from patients with history of severe abdominal pain and cosinophilia were obtained.Ten serum samples were obtained from surgically and pathologically confirmed cystic echinococcosis patients from Mashhad university hospital as positive control and 5 serum samples from infant under one year old as negative control.Blood samples were centrifuged at 3000xg at 20℃for 15 min and sera were stored at-20℃.First,these samples were tested for the presence of antibody by commercial human ELISA.Then.ELISA was developed on microplates coated with hydatid fluid,Somatic and Excretory/secretory antigens of protoscolex of sheep.Results:The results of this study as analyzed by Kappa test showed that,hydatid fluid antigen could be used as a precise source of detection in indirect ELISA test.Conclusions:Hydatid fluid in comparison with Excretory-secretory and somatic antigens showed more compatibility agreement in kappa test which can be used for further studies in development of any ELISA test for diagnosis of human hydatidosis.

Treatment of liver hydatidosis:How to treat an asymptomatic carrier?

Liver hydatidosis is the most common clinical presentation of cystic echinococcosis(CE).Ultrasonographic mass surveys have demonstrated the true prevalence,including the asymptomatic characteristic of the majority of cases,providing new insight into the natural history of the disease.This raises the question of whether to treat or not to treat these patients,due to the high and unsuspected prevalence of CE.The high rate of liver/lung frequencies of cyst localization,the autopsy findings,and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion.The decision to treat an asymptomatic patient by surgery,albendazole,or puncture aspiration injection and reaspiration or to wait and watch,is based on conflicting reports in the literature,the lack of complications in untreated patients over time,and the spontaneous disappearance and involution of cysts.All these points contribute to difficulties of individual clinical decisions.The patients should be informed of the reasons and the risks of watchful/waiting without treatment,the possibility of complications,and the risks of the other options.As more information on the natural history of liver hydatidosis is acquired,selection of the best treatment will be come easier.Without this knowledge it would be very difficult to establish definitive rules of treatment.At present,it is possible to manage these patients over time and to wait for the best moment for treatment.Followup studies must be conducted to achieve this objective.

Prevalence of bovine hydatidosis in Kombolcha ELFORA abattoir, North Eastern Ethiopia

A study to determine the prevalence of bovine hydatidosis was conducted in Kombolcha ELFORA abattoir. A total of 400 cattle randomly sampled and examined after slaughter for the presence of hydatid cysts in the organs and viscera of the animals using the standard meat inspection procedures. Positive or suspected samples were taken to the parasitology laboratory at the Kombolcha regional laboratory and cyst identification, fertility and viability tests were performed. The statistical analysis showed that there was no difference (P > 0.05) between the prevalence of bovine hydatidosis and sex of animals, P > 0.05. The prevalence of hydatidosis was also found to be significant with the age and origin of the study animals (P < 0.05). Of 191 cysts examined, 154(80.63%) calcified, 1(0.51%) sterile, and 36(18.85%) fertile cysts. From the total fertile cysts, 24(72.22%) were found to be viable. Of 108 cysts recorded in the lung, 74(68.52%) calcified, 1(0.93%) sterile, 21(19.44%) viable and 12(11.11%) were non viable. Furthermore, of 70 cysts recorded in the liver, 67 (95.71%) were found to be calcified and 3(4.29%) viable. A total of 16,068 cattle were slaughtered from 2003 to August 2007 and the overall 1955 (12.17%) prevalence of hydatidosis was recorded. The results of this study showed that hydatidosis pose significant economic problems by causing condemnation of considerable numbers organs, rendering them unfit for market. Therefore, initiation and implementation of control measures is necessary in order to alleviate its economic impact as well as zoonotic risks to the human.

Hydatidosis and the duodenum: A systematic review of the literature

BACKGROUND Injury to the duodenum(fistula formation,compression,or other complications)by a hydatid cyst(HC)is an exceptional complication.AIM To perform a systematic review of the literature on the fistulization of HC in the duodenum.METHODS Following PRISMA guidelines,a search for HC with duodenal involvement was carried out in the databases of PubMed,SCielo and EMBASE without time limits.RESULTS Fourteen patients were identified,seven men and seven women,with a mean age of 53.14 years(SD=17.65,range:28-78).Three out of the 14(21%)had HC relapse.The most frequent clinical manifestations were abdominal pain and nausea and/or vomiting.Various imaging studies were performed in almost all cases,the most commonly used being abdominal computed tomography(10/14,71%).A range of surgical techniques were reported,most frequently HC drainage(41%)and enucleations(16%).Ten of the 14 patients had no complications and one patient died.The follow-up period and recurrences could not be determined.CONCLUSION The most frequent symptoms were abdominal pain,nausea and vomiting.Computed tomography was the most used diagnostic imaging technique,and HC drainage and fistula closure via laparotomy was the most frequent treatment.However,all diagnostic and therapeutic options for HC fistulizing the duodenum had a low level of evidence.

Human Hydatidosis: A Negliged Zoonosis and Underdeclared at the University Hospital Center of Tlemcen, Algeria: 16 Years of Registration from 2003 to 2018

Hydatid disease is considered as an important emerging neglected disease worldwide.Cystic echinococcosis is a neglected disease of public health significance in many low and middle-income countries.The objective of our study was to determine the epidemiological profile of human hydatidosis in Tlemcen.A prospective study was conducted at University Hospital Center(UHC)of Tlemcen,from 2003 to 2018 from the declaration of notifiable diseases.Data entry and analysis was done using Epi-info software 6.One hundred and fifty-eight(158)patients were declared during 16 years of registartion at the UHC of Tlemcen.Ninety three point zero three percent(93.03%)of the reports of cases were received from the surgical services and 6 cases from the pneumology department.A slight female predominance was noted with sex-ratio(Females/Males):1.15.More than half of the patients were subjects over 40 years old.Three cases were noted in children.The average age was 42.38±17.14 years.The liver was the most frequent organ involved in our study followed by pulmonary localization.Fifty one point eight seven(51.87%)of cases were from rural areas and 46.2%from urban areas.Human hydatidosis remains an under-reported and neglected disease in Tlemcen whose fight is essentially based on preventive measures and requires multisectoral collaboration.

Major Hepatic Resection in Hepatic Hydatidosis

Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical procedure remains unsettled. Objective: Safety and efficacy of major hepatic resection in multiple and giant hepatic hydatidosis. Patients & Methods: 63 patients had hepatic hydatidosis associated with spleen, lung, and suprarenal hydatidosis were managed by major hepatic resection between April 2005 to April 2011. 43 (68%) males and 20 (32%) females, age range 8 - 56 years. Cysts were found in the liver only in 51 (81%) patients, liver with spleen in 5 (8%), liver, spleen with lung in 2 (3.1%), liver and lung in 4 (6.3%), liver and suprarenal in one patient (1.6%). Results: Multiple cysts were found in 38 (60%) and solitary cyst in 25 (40%) with Cysts diameter ≤5 cmin 22 (35%), 5 - 10 cm in 16 (25%), and 10 - 38 in 25 (40%). Right hepatectomy in 24 (38%), right trisectionectomy in 2 (3.2%), right hepatectomy with Segment III in 4 (6.3%), right hepatectomy with Segment I in 2 (3.2%), left hepatectomy in 12 (19%), left lateral sectionectomy in 6 (9.5%), left hepatectomy with Segment VI in 3 (4.8%), left lateral sectionectomy with right posterior sectionectomy in 2 (3.2%), right hepatectomy with splenectomy in 7 (11%) and right hepatectomy with right suprarenal in one (1.6%) patient were performed. Hospital stay was 4.2 (3 - 13 days) There was one mortality and 12 (19%) morbidities. No recurrence on follow up period (8 - 60 months) was observed. Conclusion: Radical procedure is safe and effective option for hepatic hydatidosis and should be performed when the entire lobe is diffusely involved by huge or multiple hydatidosis with little healthy liver tissue.

Surgical treatment for thoracic hydatidosis: review of 1230 cases

Hydatid disease, a serious health problem, is endemic in many sheep and cattle raising areas. Though many kinds of medicines were used experimentally, operation is the only effective treatment for thoracic hydatidosis. The surgical treatments of 1230 patients with the disease in our division between June 1957 and December 2002 are discussed below.

Experience in the Surgical Treatment of Hepatic Hydatidosis

Of the 1290 cases of hydatidosis hospitalized,907(70.3%)cases of hepatic hydatid cyst(HHC) were treated surgicall in 1954-1990.There were 484(53.3%) males and 423(46.7%)females.

Cystic echinococcosis of the liver: A primer for hepatologists

Cystic echinococcosis(CE) is a complex, chronic and neglected disease with a worldwide distribution. The liver is the most frequent location of parasitic cysts. In humans, its clinical spectrum ranges from asymptom-atic infection to severe, potentially fatal disease. Four approaches exist in the clinical management of CE: surgery, percutaneous techniques and drug treatment for active cysts, and the "watch and wait" approach for inactive cysts. Allocation of patients to these treat-ments should be based on cyst stage, size and location, available clinical expertise, and comorbidities. However, clinical decision algorithms, efficacy, relapse rates, and costs have never been properly evaluated. This paper reviews recent advances in classification and diagnosisand the currently available evidence for clinical deci-sion-making in cystic echinococcosis of the liver.

In-vitro scolicidal activity of Mallotus philippinensis (Lam.) Muell Arg. fruit glandular hair extract against hydatid cyst Echinococcus granulosus

Objective: To investigate new scolicidal agent from natural resources to cope with the side effects associated with synthetic drugs in Echinococcosis. Methods: The scolicidal potential of methanolic fruit powder extract (10 and 20 mg/mL) of Mallotus philippinensis ( M. philippinensis ) was investigated. Viability of protoscoleces was confirmed by trypan blue exclusion method, where mortality was observed at concentration of 10 and 20 mg/mL in 60 min treatment against Echinococcus granulosus ( E. granulosus ), under in-vitro conditions with reference to the known standard drug Praziquantel . Results: At concentration 10 and 20 mg/mL, the mortality rate was observed 97% and 99% respectively for 60 min treatment; while up to 93% mortality was observed with 20 mg/mL for only 10 min treatment. The concentration above 20 mg/mL for above 2 h showed 100% mortality, irrespective of further incubation. Conclusions: As compared with the standard anti-parasitic drug Praziquantel our extract has significant scolicidal activity with almost no associated side effects.

Evaluation of rabbit antibody response against 8 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus

Objective:To immunize rabbits with 12 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus(E.granulosus) and measuring polyclonal antibody and humoral immune response using ELISA and gel diffusion.Methods:Two mentioned antigens were cloned and expressed in expression vector and purified by affinity chromatography.Four young rabbits were selected and challenged intradermallt with yielded recombinant antigens.Rabbits’ sera were collected post infection and were tested using ELISA and gel diffusion for polyclonal antibody detection 10 days after last injection.Results:The specific antibody against the recombinant peptides was efficiently produced within 4 weeks post infection.Conclusions: Produced recombinants proteins could induce the immune response of the rabbits successfully. This process might improve the clarification of diagnosis and vaccination as regards hydatidosis.

Percutaneous drainage as a first therapeutic step prior to surgery in liver hydatid cyst abscess:Is it worth it?

AIM To delay surgery until the patient is in a better condition, and thus to decrease postoperative morbidity. METHODS Using this algorithm we treated three patients aged 55, 75 and 80 years. In all three patients the clinical presentation was fever without a clear source of infection; all had nonspecific symptoms such as general malaise, dyspnea, and abdominal discomfort in the previous 15 d. They came to the emergency room at our hospital due to deterioration of their general condition. Analytical tests showed leukocytosis, neutrophilia and increased polymerase chain reaction. In all cases an abdominal computed tomography(CT) was performed and liver hydatid abscess(LHA) was detected. The mean size of the LHA was 12 cm.RESULTS All patients underwent CT-guided percutaneous drainage. The purulent material obtained was cultured, and Klebsiella pneumoniae, Streptococcus viridans and Streptococcus salivarius were identified. Antibiotic treatment was given adapted to antibiotic sensitivity testing. Surgery was performed two weeks after admission, once the patient's condition had improved. All three patients underwent an almost total cystectomy, cholecystectomy and omentoplasty in the residual cavity. Complications were: Clavien Ⅰ(atelectasis and pleural effusion) and Clavien Ⅱ(transfusion). The average length of stay(pre and postoperative) was 23 d. At the follow-up, no relapses were recorded.CONCLUSION LHA management is not standardized. Emergency surgery offers suboptimal results. Percutaneous drainage plus antibiotics allows improving patient's general condition. This enables treating patients in greater safety and also reduces complications.

Hydatid cyst of the colon:A systematic review of the literature

BACKGROUND Primary hydatid disease in the colon is an extremely rare finding. We performed a systematic review of cases of hydatidosis of the colon published to date. AIM To systematic review the published papers about hydatidosis of the colon. METHODS Following PRISMA guidelines, we performed an unlimited search for articles on CH in the MEDLINE (PubMed), EMBASE, Cochrane, Latindex and Scielo databases, published in English, Spanish, French, German or Italian between January 1, 1960 and December 15, 2018. The search items were:(Colon) AND [(hydatidosis) OR (hydatid disease) OR (echinococcosis)]. RESULTS Nine case reports were found [five men, four women, median age 64.55 years (range: 21-81)]. The most frequent clinical manifestation was abdominal pain (8/9)(88.9%). In almost all cases several image studies were carried out, but abdominal computed tomography was the most used (66.7%). Five resections of the colon (62.5%) and three sutures of the fistula between cyst and colon (37.5%) were performed. Four patients did not present post-operative complications, but one died. Postoperative period was recorded for a mean period of 35 months. No recurrences were recorded. CONCLUSION The most frequent symptom was abdominal pain (evidence level 4). Computed tomography was the most frequently used diagnostic imaging technique (evidence level 4). Colectomy was the most appropriate treatment (evidence level 5). All the diagnostic and therapeutic options for hydatid cysts located in colon have a low level of evidence.

Hydatid cyst of the gallbaldder: A systematic review of the literature

AIM To evaluate all the references about primary gallbladder hidatidosis looking for best treatment evidence.METHODS Search:1966-2015 in MEDLINE,Cochrane Library,SciELO,and Tripdatabase.Key words: "gallabladder hydatid disease" and "gallbladder hydatid cyst".We found 124 papers in our searches but only 14 papers including 16 cases were about hydatid cyst of the gallbladder(GBHC).RESULTS Eight cases of GBHC were women and seven men.One not mentioned.Median age was 48.3 years.The most frequent clinical symptom was abdominal pain(94%) usually in the right upper quadrant.Ultrasound was performed in ten patients(62.5%) but in most cases a combination of several techniques was performed.The location of the cysts was intravesicular in five patients.Five patients presented GBHC and liver hydatid cysts.Two patients presented cholelithiasis and one choledocholithiasis.The most frequent surgical technique was cholecystectomy by laparotomy(81.25%).Simultaneous surgery of liver cysts was carried out in five cases.Eleven patients did not present postoperative complications,but one died.The mean hospital stay was seven days.No recurrence of GBHC was recorded.CONCLUSION In GBHC,the most frequent symptom is right hypocondrium pain(evidence level V).Best diagnostic methods are ultrasound and computed tomography(level V,grade D).Suggested treatment is open cholecystectomy and postoperative albendazole(level V,grade D) obtaining good clinical results and none relapses.

Incurable and refractory spinal cystic echinococcosis: A case report

BACKGROUND Although the incidence and cure rate of spinal hydatidosis are low,the recurrence rate of spinal hydatidosis is high,and the prognosis of spinal hydatidosis is poor.Therefore,we report a typical case of refractory spinal hydatidosis to increase spine surgeons’awareness of the disease and reduce misdiagnosis and recurrence.CASE SUMMARY A 48-year-old man presented with back pain,significant weight loss,and paralysis of both lower limbs.The patient was misdiagnosed with spinal tuberculosis in an outside hospital.However,spinal magnetic resonance imaging(MRI)showed hyperintense cystic components on T2-weighted images and hypointensity on T1-weighted images.A lobulated,multiocular,honeycombappearance,septated cystic mass protruding intraspinally and compressing the spinal cord at segments T8–T9 was present.Paravertebral polycystic lobular lesions presented as a“bunch of grapes”.The ELISA test result for Echinococcus granulosus was positive.Then,a diagnosis of spinal hydatidosis and lung hydatid disease was made,and the patient underwent left transthoracic approach lobectomy,paravertebral lesion debridement,and subtotal vertebrectomy with vertebral body replacement of segments T8 and T9 by a mesh cage.The patient also underwent albendazole chemotherapy before and after surgery.One year after stopping the drug therapy,the patient developed recurrent T5 vertebral lesions and underwent a second subtotal vertebrectomy surgery.The patient is currently in good condition and is receiving long-term medication and follow-up.CONCLUSION The MRI feature of a“bunch of grapes”is a typical imaging indication of spinal hydatidosis.Subtotal vertebrectomy is a risk factor for postoperative recurrence.Total spondylectomy makes it possible to cure spinal hydatidosis,but antiparasitic drug therapy is also an important supplementary therapy to multimodal therapy.It is preferable for patients with spinal hydatidosis to receive life-long antiparasitic medication therapy and follow-up.

Infrathyroidian hydatid cyst: Diagnostic difficulties and therapeutic management, a case report

Hydatidosis is a cosmopolitan anthropozoonose common to humans and many mammals. The cervical localization is rare even in endemic countries. We report a case of cervical hydatidosis located in the infra-thyroidian region. The diagnosis was suspected on clinical and radiological examinations(Ultrasonography, computed tomography-scan). The surgical removal of the cyst was difficult because of the inflammatory tissue around the mass. The confirmation of the diagnosis was obtained by the histopathological examination. During the followup, a local recurrence of the disease was diagnosed after 9 mo treated successfully by surgery.

Misdiagnosed behavior change revealing fatal primitive intra-cerebral echinococcosis

Central nervous system involvement in hydatidosis is rare compared to other somatic localizations: 1-5%. It is schematically divided into two major types: cerebral involvement and spinal involvement. The brain is a rare localization of hydatid cyst accounting for only 2% of all hydatid disease. The psychiatric manifestations revealing cerebral hydatidosis remain exceptional and often unrecognized and neglected by practitioners despite their potential severity. We report two original observations of fatal cerebral hydatidosis revealed by behavior change (psychomotor agitation, aggressiveness, persecutory delusion, and auditory and visual hallucinations) insufficiently explored in two women aged 45 and 17. The possibility of cerebral hydatidosis must always be evoked in front of any psychiatric symptomatology that remains unexplained in endemic areas for echinococcosis.