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Background: Echinococcosis is a uncommon condition in pediatric patients, and encompasses alveolar and cystic forms, predominantly affecting the lungs and liver. Transmission occurs primarily through zoonotic means, such as the contamination of water and food by infected dog and other canid feces. Diagnosis can be challenging due to nonspecific symptoms that often mimic pneumonia. The case: A 6-year-old female patient from a rural area in Ecuador who initially presented with nonspecific symptoms indicative of pneumonia. However, further investigation into socio-environmental factors led to a diagnosis of pulmonary and hepatic hydatid disease. Conclusion: The timely and accurate diagnosis of this infectious disease enabled the patient to receive appropriate treatment and surgical intervention, leading to her complete recovery.
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Metformin, a safe biguanide derivative with antiproliferative properties, has shown antiparasitic efficacy against the Echinococcus larval stage. Hence, we assessed the efficacy of a dose of 250 mg kg-1 day-1 in experimental models of advanced CE, at 6 and 12 months post-infection with oral and intraperitoneal administration, respectively. At this high dose, metformin reached intracystic concentrations between 0.7 and 1.7 mM and triggered Eg-TOR inhibition through AMPK activation by AMP-independent and -dependent mechanisms, which are dependent on drug dose. Cystic metformin uptake was controlled by increased expression of organic cation transporters in the presence of the drug. In both experimental models, metformin reduced the weight of parasite cysts, altered the ultrastructural integrity of their germinal layers, and reduced the intracystic availability of glucose, limiting the cellular carbon and energy charge and the proliferative capacity of metacestodes. This glucose depletion in the parasite was associated with a slight increase in cystic uptake of 2-deoxiglucose and the transcriptional induction of GLUT genes in metacestodes. In this context, drastic glycogen consumption led to increased lactate production and altered intermediary metabolism in treated metacestodes. Specifically, the fraction of reducing soluble sugars decreased twofold, and the levels of non-reducing soluble sugars, such as sucrose and trehalose, were modified in both cystic fluid and germinal cells. Taken together, our findings highlight the relevance of metformin as a promising candidate for CE treatment and warrant further research to improve the therapeutic conditions of this chronic zoonosis in humans.
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Equinococose , Metformina , Metformina/farmacologia , Animais , Equinococose/tratamento farmacológico , Equinococose/parasitologia , Camundongos , Carbono , Glucose/metabolismo , Echinococcus granulosus/efeitos dos fármacos , Echinococcus granulosus/metabolismo , Feminino , Larva/efeitos dos fármacosRESUMO
Background: Cystic echinococcosis (CE) is a widespread neglected zoonotic disease caused by Echinococcus granulosus sensu lato (EG) with a global burden of control in the billions of dollars. E. granulosus' life cycle involves definitive, intermediate, and humans as dead-end hosts. Echinococcosis control programs use strategies that focus on any of these hosts. We aimed to provide a comprehensive and up-to-date overview of the EG control interventions worldwide. Methods: We conducted a scoping review by mapping all studies on interventions for EG control following the Arksey and O'Malley Framework. We screened identified articles, and charted and coded selected papers. We classified the data based on target host, type of study, and control mechanism. We described the efficacy or safety outcomes, and the associated barriers/facilitators for the intervention. Critical appraisal was conducted. Results: From 7,853 screened studies, we analyzed 45: seven centered on human interventions, 21 on animals, and 17 on both. Studies on humans focused on educational strategies and human CE monitoring. The studies on animals were field trials and most were based on Praziquantel (PZQ) for dogs. Studies focused on both animals and humans had, in general, more participants, lasted longer, and covered larger geographical areas. Overall, the quality of studies was moderate to low. Conclusions: Available evidence suggests that long-term interventions aimed at both animals and humans can achieve significant reduction in EG transmission, particularly when PZQ treatment for dogs is included. Higher quality evidence, standardization of methodologies, and better reporting on post-intervention outcomes are necessary for drawing stronger conclusions. Further evidence is needed to assess the sustainability and scalability of control measures. Nonetheless, an integrative One Health approach is essential for overcoming the multiple challenges associated with sustaining long-term control efforts for Echinococcosis.
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BACKGROUND: Cystic echinococcosis (CE) is a chronic disease considered a neglected one. Cystic echinococcosis is endemic in Uruguay and the region. Surgery, using various technical approaches, has the potential to safely remove the cyst(s) and lead to a complete cure in a high number of patients with simple forms of CE. However, surgery may be impractical in patients with multiple cysts in several organs, high surgical risk, or in patients with previous multiple surgeries. In these cases, the pharmacological treatment with the benzimidazolic drug Albendazole (ABZ) alone or combined with Praziquantel (PZQ), has been promising as the best choice to achieve improvement or cure. METHODS: In this study, we analyze the results obtained on the anti-parasitic treatment of 43 patients diagnosed with CE between the years 2003 and 2020. Patients were treated before and/or after surgery with ABZ or the combination ABZ/PZQ. The standardize protocol of the anti-parasitic drug treatment before surgery was 7 days, 15 days or 1 month depending on the urgency and availability of the surgical procedure. All cases that involved confirmed locations on lungs underwent immediate surgery with minimal pre-treatment when possible. After surgery, the standardize protocol of anti-parasitic drug treatment consisted of six cycles of 30 days each and resting intervals of 15 days in between. ABZ was used in all cases, administered orally, twice daily, at a total dosage of 15 mg/kg/day, with food high in fat content for improved absorption. The follow up was carried out according to WHO-IWGE guidelines for 5 years. RESULTS: Of the 43 patients fourteen were ≤ 15 years of age and had a differentiated pre-surgical treatment. From the ≥ 16 years of age, 36 completed the treatments and the 5 years follow up. Four patients changed geographical locations, without a forwarding contact, after the post-surgery treatment. No patient died during the study. Of the 36 patients that completed the study, 32 were treated only with ABZ; 93.75% achieved treatment success as determined by improvement or cure, and 6.25% treatment failure determined by no change or worsening. The last four patients received the ABZ/PZQ combination therapy and achieved 100% treatment success. CONCLUSION: The pharmacological treatment resulted in a good option not only as palliative but also as potentially curative. The main relevance of its use was in cases with previous multiple surgeries or surgeries with potential life-threatening complications due to the number and location of cysts and concurrent comorbidities. A follow-up of at least 5 years would be recommended to assure remission and control of the transmission. More randomized trials are needed to provide clear clinical evidence of different pharmacological treatments for CE.
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Albendazol , Anti-Helmínticos , Equinococose , Praziquantel , Humanos , Albendazol/uso terapêutico , Albendazol/administração & dosagem , Praziquantel/uso terapêutico , Praziquantel/administração & dosagem , Equinococose/tratamento farmacológico , Equinococose/cirurgia , Masculino , Feminino , Uruguai , Adulto , Pessoa de Meia-Idade , Seguimentos , Anti-Helmínticos/uso terapêutico , Anti-Helmínticos/administração & dosagem , Adulto Jovem , Resultado do Tratamento , Adolescente , Idoso , Quimioterapia CombinadaRESUMO
Cystic echinococcosis is caused by the tissue-dwelling larva (hydatid) of Echinococcus granulosus sensu lato. A salient feature is that this larva is protected by the acellular laminated layer (LL). As the parasite grows, the LL sheds abundant particles that can accumulate in the parasite's vicinity. The potential of LL particles to induce inflammation in vivo has not been specifically analysed. It is not known how each of its two major components, namely highly glycosylated mucins and calcium inositol hexakisphosphate (InsP6) deposits, impacts inflammation induced by the LL as a whole. In this work, we show that LL particles injected intraperitoneally cause infiltration of eosinophils, neutrophils and monocytes/macrophages as well as the disappearance of resident (large peritoneal) macrophages. Strikingly, the absence of calcium InsP6 enhanced the recruitment of all the inflammatory cell types analysed. In contrast, oxidation of the mucin carbohydrates caused decreased recruitment of neutrophils. The carbohydrate-oxidised particles caused cell influx nonetheless, which may be explained by possible receptor-independent effects of LL particles on innate immune cells, as suggested by previous works from our group. In summary, LL particles can induce acute inflammatory cell recruitment partly dependent on its mucin glycans, and this recruitment is attenuated by the calcium InsP6 component.
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Echinococcus granulosus , Ácido Fítico , Animais , Echinococcus granulosus/imunologia , Ácido Fítico/farmacologia , Ácido Fítico/metabolismo , Equinococose/imunologia , Equinococose/parasitologia , Inflamação , Neutrófilos/imunologia , Mucinas/metabolismo , Camundongos , Macrófagos/imunologia , Macrófagos/metabolismo , Eosinófilos/imunologia , Feminino , Larva/imunologiaRESUMO
Cystic echinococcosis control in South American countries requires a comprehensive integrative 'One Health' approach. While insular nations have seen successful in their elimination programmes, South American countries face persistent challenges in hostile environments, with Echinococcus granulosus s.l., posing a significant public health concern. Vaccination of intermediate hosts has demonstrated the efficacy of the EG95 vaccine in reducing transmission rates. For example, since 2009, Rio Negro Province in Argentina has added, with marked success, the EG95 vaccine to the control programme, supplementing dog deworming. The Aysen Region of Chile has also reported encouraging preliminary results in reducing cyst prevalence in vaccinated sheep after 3 years of vaccination. The challenges in aligning control strategies with socio-cultural factors, especially in indigenous communities, underlines the need for context-specific strategies. The Rio Negro programme demonstrated commendable compliance, underlining the importance of community engagement in achieving lasting success. The most promising strategies for effective echinococcosis control involved dog deworming and the routine vaccination of sheep and/or goats, underscoring the importance of sustained implementation until all grazing animals have been replaced. For lasting success, these interventions need to be combined with a robust surveillance system.
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Introducción. La hidatidosis biliar es la complicación más frecuente de la hidatidosis hepática. La colangiopancreatografía retrógrada endoscópica desempeña un papel clave en el tratamiento. Caso clínico. Femenina de 57 años acude por dolor abdominal, vómito, diarrea, leucocitosis, hiperbilirrubinemia, en colangioresonancia magnética presenta vía biliar dilatada, defecto de señal en tercio proximal y distal. La colangiopancreatografía retrógrada endoscópica evidencia presencia de cuerpo extraño de aspecto de membranas, vía biliar dilatada, se extrae quistes de aspecto parasitario. Conclusión. El tratamiento de elección es quirúrgico y farmacológico, la colangiopancreatografía retrógrada endoscópica antes de la cirugía, asegura la extracción del material hidatídico y trata la obstrucción biliar, identifica el trayecto fistuloso y facilita su cierre mediante colocación de prótesis y esfinterotomía, por lo que constituye un tratamiento no quirúrgico efectivo y con margen amplio de seguridad.
Introduction: Biliary hydatid disease is the most common complication of hepatic hydatid disease. Endoscopic retrograde cholangiopancreatography plays a key role in treatment. Clinical case: A 57-year-old female presented with abdominal pain, vomiting, diarrhea, leukocytosis, mixed hyperbilirubinemia, and magnetic resonance cholangiography showed a dilated bile duct and a signal defect in the proximal and distal third. Endoscopic retrograde cholangiopancreatography shows the presence of a foreign body with a membrane appearance, a dilated bile duct, and cysts with a parasitic appearance. Conclusion: The treatment of choice is surgical and pharmacological, endoscopic retrograde cholangiopancreatography before surgery ensures the extraction of hydatid material and treats biliary obstruction, identifies the fistulous tract and facilitates its closure by placing a prosthesis and sphincterotomy, which is why it constitutes a Effective non-surgical treatment with a wide margin of safety.
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Humanos , Feminino , Pessoa de Meia-Idade , Ductos Biliares/parasitologia , Colangite , Colangiopancreatografia Retrógrada Endoscópica , Trato Gastrointestinal/diagnóstico por imagem , Equinococose , Endoscopia , Cirurgia Geral , Ductos Biliares , Equinococose Hepática , Equador , Esfincterotomia , Hiperbilirrubinemia , LeucocitoseRESUMO
Scavenger receptors participate in a wide range of biological functions after binding to multiple non-self or altered self-ligands. Among them, CD5 and CD6 are lymphocyte scavenger receptors known to interact with different microbial-associated molecular patterns, and the administration of the recombinant soluble ectodomains of human CD5 (rshCD5) and/or CD6 (rshCD6) has shown therapeutic/prophylactic potential in experimental models of fungal, bacterial and echinococcal infections. The latter is a zoonosis caused by the larval stage of the cestode parasite Echinococcus granulosus sensu lato, which in humans can induce secondary cystic echinococcosis (CE) after the spillage of protoscoleces contained within fertile cysts, either spontaneously or during surgical removal of primary hydatid cysts. Herein, we have analysed the mechanisms behind the significant protection observed in the mouse model of secondary CE following prophylactic administration of rshCD5 or rshCD6. Our results show that both molecules exhibit intrinsic antiparasitic activities in vitro, as well as immunomodulatory functions during early secondary CE, mainly through Th1/Th17 cytokine bias and promotion of peritoneal polyreactive antibodies. These data support the relevance of the parasite components bound by rshCD5 and rshCD6, as well as the potential of their prophylactic administration as a useful strategy to reduce secondary CE in patients.
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Anti-Infecciosos , Equinococose , Animais , Camundongos , Humanos , Antiparasitários , Zoonoses , Receptores DepuradoresRESUMO
Cystic echinococcosis (CE) is a zoonotic disease caused by the tapeworm Echinococcus granulosus sensu lato (s.l). In the intermediate host, this disease is characterized by the growth of cysts in viscera such as liver and lungs, inside of which the parasite develops to the next infective stage known as protoscoleces. There are records that the infected viscera affect the development and morphology of E. granulosus s.l. protoscolex in hosts such as buffalo or humans. However, the molecular mechanisms that drive these differences remains unknown. Weighted gene co-expression network analysis (WGCNA) using a set of RNAseq data obtained from E. granulosus sensu stricto (s.s.) protoscoleces found in liver and lung cysts reveals 34 modules in protoscoleces of liver origin, of which 12 have differential co-expression from protoscoleces of lung origin. Three of these twelve modules contain hub genes related to immune evasion: tegument antigen, tegumental protein, ubiquitin hydrolase isozyme L3, COP9 signalosome complex subunit 3, tetraspanin CD9 antigen, and the methyl-CpG-binding protein Mbd2. Also, two of the twelve modules contain only hypothetical proteins with unknown orthology, which means that there are a group of unknown function proteins co-expressed inside the protoscolex of liver CE cyst origin. This is the first evidence of gene expression differences in protoscoleces from CE cysts found in different viscera, with co-expression networks that are exclusive to protoscoleces from liver CE cyst samples. This should be considered in the control strategies of CE, as intermediate hosts can harbor CE cysts in liver, lungs, or both organs simultaneously.
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Cistos , Equinococose , Echinococcus granulosus , Humanos , Animais , Echinococcus granulosus/genética , Evasão da Resposta Imune , Genótipo , Equinococose/genética , Equinococose/parasitologiaRESUMO
Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.
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Introducción. La hidatidosis o equinococosis es una zoonosis parasitaria que se adquiere al ingerir huevos de cestodos del género Echinococcus. El diagnóstico clínico raramente se hace en sitios no endémicos. La mayoría de los pacientes se encuentran asintomáticos y los hallazgos incidentales en los estudios de imágenes o en procedimientos quirúrgicos permiten la sospecha diagnóstica. Caso clínico. Paciente masculino de 70 años, residente en área rural del municipio de Puerto Libertador, departamento de Córdoba, Colombia, quien consultó por masa abdominal en epigastrio y mesogastrio, parcialmente móvil e indolora. Resultados. En cirugía se identificaron lesiones quísticas mesentérica y hepática. Después de la cirugía y mediante estudios de inmunohistoquímica, se confirmó el diagnóstico de quiste hidatídico. El paciente tuvo una evolución satisfactoria. Conclusión. La hidatidosis quística mesentérica y hepática sintomática es una enfermedad rara en sitios no endémicos, donde la cirugía constituye un pilar fundamental en el diagnóstico y tratamiento, sumado al manejo médico farmacológico.
Introduction. Hydatidosis or echinococcosis is a parasitic zoonosis that is acquired by ingesting eggs of cestodes of the genus Echinococcus. Clinical diagnosis is rarely made in non-endemic sites. Most patients are asymptomatic and incidental findings on imaging studies or surgical procedures allow for diagnostic suspicion. Clinical case. A 70-year-old male patient, resident in a rural area of the municipality of Puerto Libertador, department of Córdoba, Colombia, who consulted for an abdominal mass in the epigastrium and mesogastrium, partially mobile and painless. Results. In surgery, mesenteric and hepatic cystic lesions were identified. After surgery and through immunohistochemistry studies, the diagnosis of hydatid cyst was confirmed. The patient had a satisfactory evolution. Conclusion. Symptomatic mesenteric and hepatic cystic hydatidosis is a rare disease in non-endemic sites, where surgery constitutes a fundamental pillar in the diagnosis and treatment in addition to pharmacological medical management.
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Humanos , Zoonoses , Equinococose Hepática , Equinococose , Laparotomia , MesentérioRESUMO
ABSTRACT Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.
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BACKGROUND Echinococcosis and schistosomiasis, caused by parasitic worms, pose significant threats to millions of people in the world. Rapid and effective pathogen detection and epidemic control by public health authorities are urgently needed. OBJECTIVES In this study, we aimed to develop rapid on-site detection method to detect echinococcosis and schistosomiasis. METHODS Recombinase polymerase amplification (RPA) was utilised to examine its efficacy of detection of echinococcosis and schistosomiasis. FINDINGS The detection probes for RPA were created through comparing parasitic genomes from international genomic data and the sequences generated by our group. We established an optimised RPA on-site testing platform, which significantly reduces the detection time (less than 30 min) and simplifies the operation (free of expensive equipment) as compared to traditional polymerase chain reaction (PCR) method. MAIN CONCLUSIONS This RPA detection platform in our study for identifying echinococcosis or schistosomiasis pathogens would be greatly applicable for epidemic investigation, border screening, and early clinical diagnosis.
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Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.
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In an attempt to find new anti-echinococcal drugs, resveratrol (Rsv) effectiveness against the larval stages of Echinococcus granulosus and E. multilocularis was evaluated. The in vitro effect of Rsv on parasites was assessed via optical and electron microscopy, RT-qPCR and immunohistochemistry. In vivo efficacy was evaluated in murine models of cystic (CE) and alveolar echinococcosis (AE). The impact of infection and drug treatment on the mouse bone marrow hematopoietic stem cell (HSC) population and its differentiation into dendritic cells (BMDCs) was investigated via flow cytometry and RT-qPCR. In vitro treatment with Rsv reduced E. granulosus metacestode and protoscolex viability in a concentration-dependent manner, caused ultrastructural damage, increased autophagy gene transcription, and raised Eg-Atg8 expression while suppressing Eg-TOR. However, the intraperitoneal administration of Rsv was not only ineffective, but also promoted parasite development in mice with CE and AE. In the early infection model of AE treated with Rsv, an expansion of HSCs was observed followed by their differentiation towards BMCDs. The latter showed an anti-inflammatory phenotype and reduced LPS-stimulated activation compared to control BMDCs. We suggest that Rsv ineffectiveness could have been caused by the low intracystic concentration achieved in vivo and the drug's hormetic effect, with opposite anti-parasitic and immunomodulatory responses in different doses.
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ABSTRACT Cystic echinococcosis (CE) is a parasite-borne disease caused by the larval stage of Echinococcus granulosus belonging to family Taeniidae, is an endemic disease, distributed worldwide as a neglected parasite with socioeconomic repercussions. It causes severe alterations in liver of infected host, and it could be fatal if untreated. The main objective of the present study is to measure and evaluate the condition of hydatidosis in slaughtered sheep in Al Baha region, Saudi Arabia. A total of 601 slaughtered sheep in Al Baha abattoirs were examined for hydatidosis during the year 2020. Various organs were examined for the presence of parasite cysts, and the cyst contents were examined by light microscopy. Also, liver sections infected with cysts were examined for pathological alterations and host-parasite interactions. Forty-two animals were infected (6.09%) with the highest prevalence during summer. During gross examination, it was observed that the sheep liver is the most affected organ by the disease. The liver contained multiple cysts with varying sizes, filled with clear to slightly turbid fluid containing protoscoleces. Detailed sections of the infected liver revealed significant fibrosis around the central vein, portal vein congestion, infiltration of inflammatory cells, and necrosis. Sections through hydatid cysts showed the presence of three surrounding layers with a laminar membrane bordering the cyst lined by a germinal epithelium surrounding several brood capsules with many protoscolesces inside supported by a set of rostellar hooklets. Considerable efforts should be spent to control the transmission of parasitic cysts and inhibit the incorrect disposal of infected meat from slaughterhouses. Also, more focus should be done on epidemiological and control programs of these parasites.
RESUMO A equinococose cística (EC) é uma doença transmitida por parasitas causada pelo estágio larval do Echinococcus granulosus, pertencente à família Taeniidae, é uma doença endêmica, distribuída mundialmente como um parasita negligenciado com repercussões socioeconômicas. Ela causa alterações graves no fígado do hospedeiro infectado e pode ser fatal se não for tratada. O principal objetivo do presente estudo é medir e avaliar a condição da hidatidose em ovelhas abatidas na região de Al Baha, na Arábia Saudita. Um total de 601 ovelhas abatidas em matadouros de Al Baha foram examinadas quanto à hidatidose durante o ano de 2020. Vários órgãos foram examinados quanto à presença de cistos de parasitas, e o conteúdo dos cistos foi examinado por microscopia de luz. Além disso, seções de fígado infectadas com cistos foram examinadas quanto a alterações patológicas e interações hospedeiro-parasita. Quarenta e dois animais foram infectados (6,09%), com a maior prevalência durante o verão. Durante o exame macroscópico, observou-se que o fígado das ovelhas é o órgão mais afetado pela doença. O fígado continha vários cistos de tamanhos variados, preenchidos com fluido claro a levemente turvo contendo protocistos. Seções detalhadas do fígado infectado revelaram fibrose significativa ao redor da veia central, congestão da veia porta, infiltração de células inflamatórias e necrose. As seções através dos cistos hidáticos mostraram a presença de três camadas circundantes, com uma membrana laminar que margeia o cisto, revestida por um epitélio germinativo que envolve várias cápsulas de cria com muitos protoscolescentes em seu interior, sustentados por um conjunto de ganchos rostelares. Esforços consideráveis devem ser despendidos para controlar a transmissão de cistos parasitários e inibir o descarte incorreto de carne infectada em abatedouros. Além disso, deve-se dar mais atenção aos programas epidemiológicos e de controle desses parasitas.
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INTRODUCCIÓN: La hidatidosis es una zoonosis cuyo control más eficiente y eficaz es la promoción en salud, especialmente en la población infante-juvenil. OBJETIVO: Medir el impacto de un programa de intervención educativa sobre hidatidosis en escolares del norte de Chile. MÉTODO: Estudio intervencional educativo con fases pre y post test en 3.145 estudiantes de educación preescolar, primaria y secundaria de tres comunas. Se definieron dimensiones, unidades educativas y sistemas de evaluación incorporados en las bases curriculares. Se calculó el puntaje de logro de respuestas correctas utilizando la prueba t. Se estimó el tamaño del efecto mediante d de Cohen y análisis de varianza mixto. RESULTADOS: Se encontraron diferencias estadísticamente significativas en la muestra total y en las variables género, comuna, procedencia rural-urbana y nivel de educación. Los puntajes post intervención fueron mayores y con tamaños de efecto grandes a excepción de los primeros niveles de educación. Se hallaron puntajes mayores post test y efectos de interacción con diferencias significativas en rural-urbano y en comuna anteriormente intervenida. La dimensión mejor evaluada fue "medidas de autocuidado" y la más baja "tenencia responsable de perros". CONCLUSIONES: El programa educativo fue efectivo al ser dirigido a grupos etarios, mediante métodos pedagógicos en las bases curriculares de los establecimientos educacionales.
BACKGROUND: Hydatidosis is a zoonosis whose most efficient and effective control is health promotion, especially in children and youth. AIM: To measure the impact of an educational intervention program on hydatidosis in schoolchildren in northern Chile. METHOD: Educational interventional study was performed with pre-post test phases in 3,145 students of preschool, primary and secondary education from three districts. Dimensions, educational units and evaluation systems were defined and incorporated into the curricular bases. The correct answer achievement score was calculated using the T-test. Effect size was estimated using Cohen's d and mixed analysis of variance. RESULTS: Statistically significant differences were found in the total sample and in variables such as gender, district, rural-urban origin and level of education. Post-intervention scores were higher than pre-intervention and with large effect sizes, except for the first levels of education. Higher post-test scores and interaction effects were found with significant differences in rural-urban and in a previously intervened district. The best evaluated dimension was "self-care measures" and the lowest was "responsibly keeping dogs". CONCLUSIONS: The educational program was effective when directed to age groups, through pedagogical methods in the curricular bases of educational facilities.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Educação em Saúde , Equinococose/prevenção & controle , Chile , Estudos Prospectivos , Avaliação Educacional/métodos , Doenças Negligenciadas/prevenção & controleRESUMO
La equinococosis quística es una zoonosis de origen parasitario con distribución cosmopolita. En nuestro país continúa siendo una enfermedad endémica, afectando principalmente pequeños centros poblados y áreas rurales pobres relacionadas a la producción ovina. Los planes de control requieren de un abordaje holístico, con la participación de diferentes instituciones, profesionales y en especial de la comunidad. La cooperación regional busca monitorizar el avance de la enfermedad y centrar las medidas de acción sobre cuatro ejes, definidos según los puntos de intervención más comunes para la quiebra del ciclo de transmisión y la consecuente reducción en incidencia y prevalencia de la enfermedad. La presente revisión utilizó literatura obtenida en diferentes bases de datos, bibliotecas virtuales y sitios web regionales y locales con el objetivo describir las principales estrategias de control, vigilancia y prevención aplicadas actualmente en nuestro país.
Cystic echinococcosis is a zoonosis of parasitic origin with cosmopolitan distribution. In our country it continues to be an endemic disease, affecting mainly small population centers and poor rural areas related to sheep production. Control plans require a holistic approach, with the participation of different institutions, professionals and especially the community. Regional cooperation seeks to monitor the progress of the disease and focus action measures on four axes, defined according to the most common points of intervention to break the transmission cycle and consequently reduce the incidence and prevalence of the disease. This review used literature obtained from different databases, virtual libraries and regional and local websites with the aim of describing the main control, surveillance and prevention strategies currently applied in our country.
A equinococose cística é uma zoonose de origem parasitária com distribuição cosmopolita. Em nosso país, continua a ser uma doença endêmica, afetando principalmente pequenos centros populacionais e áreas rurais pobres relacionadas à produção de ovinos. Os planos de controle exigem uma abordagem holística, com a participação de diferentes instituições, profissionais e, principalmente, da comunidade. A cooperação regional busca monitorar o progresso da doença e concentrar as medidas de ação em quatro eixos, definidos de acordo com os pontos de intervenção mais comuns para interromper o ciclo de transmissão e, consequentemente, reduzir a incidência e a prevalência da doença. Esta revisão utilizou a literatura obtida em diferentes bases de dados, bibliotecas virtuais e sites regionais e locais com o objetivo de descrever as principais estratégias de controle, vigilância e prevenção aplicadas atualmente em nosso país.
Assuntos
Humanos , Animais , Vigilância Sanitária , Equinococose/prevenção & controle , Vigilância de Zoonoses , Uruguai/epidemiologia , Equinococose/diagnósticoRESUMO
RESUMEN Objetivo. Este estudio se realizó retrospectivamente para evaluar el estado de equinococosis quística de los animales de granja, analizando las muestras enviadas al Instituto de Control Veterinario de Samsun de la República de Türkiye, Ministerio de Agricultura y Silvicultura, entre el Enero de 2016 y el Diciembre de 2022. Materiales y Métodos. Un total de 818 ovejas, 160 cabras y 990 materiales de necropsia de ganado bovino se examinaron macroscópicamente e histopatológicamente de acuerdo con las directrices de la Organización Mundial de Sanidad Animal (WOAH). Los quistes se detectaron en 61 materiales de todos los materiales examinados. Resultados. Se encontró que la tasa de positividad de equinococosis quística total en animales de granja era del 3,1% en el norte de Türkiye. Se detectaron quistes en al menos uno de los hígados y pulmones. Se detectó en hígado en 24 casos (39.3%), pulmón en 23 casos (37.7%) y tanto pulmón como hígado en 11 casos (18%). Además, se encontraron quistes tanto en pulmón como en bazo (1 caso), riñón e hígado (1 caso) y corazón e hígado (1 caso). La tasa de positividad fue mayor en ovejas que en otros rumiantes, y la diferencia con otras especies de rumiantes fue estadísticamente significativa. (p<0.001). Se encontró que la diferencia entre las tasas de prevalencia por años era estadísticamente significativa (p=0.001). Conclusiones. Türkiye se define como una región altamente endémica para Echinococcus granulosus y Echinococcus multilocularis. La vigilancia debe realizarse regularmente para implementar programas de control. La información presentada en este estudio contribuirá a obtener una idea sobre el estado de la equinococosis quística en el ganado en el norte de Türkiye y al desarrollo de estrategias de prevención y control.
ABSTRACT Objective. This study was conducted retrospectively to assess the cystic echinococcosis status of farm animals from the samples sent to Samsun Veterinary Control Institute of the Republic of Türkiye, Ministry of Agriculture and Forestry, between January 2016 and December 2022. Materials and Methods. A total of 818 sheep, 160 goats, and 990 cattle necropsy materials were examined macroscopically and histopathologically according to World Organisation for Animal Health (WOAH) guidelines. Cysts were detected in 61 of examined materials. Results. The rate of total cystic echinococcosis positivity in farm animals was found to be 3.1% in northern Türkiye. Cysts were detected in at least one of the liver and lungs. It was detected in the liver in 24 cases (39.3%), the lung in 23 cases (37.7%), and both the lung and liver in 11 cases (18%). In addition, cysts were found in both of lung and spleen (1 case), kidney and liver (1 case), and heart and liver (1 case). The positivity rate was higher in sheep than in other ruminants, and the difference with other ruminant species was statistically significant. (p<0.001). The difference between prevalence rates by years was found to be statistically significant (p=0.001). Conclusion. Türkiye is defined as a highly endemic region for Echinococcus granulosus and Echinococcus multilocularis. Surveillance should be done regularly to implement control programs. The information presented in this study will contribute to gaining an idea about the status of cystic echinococcosis in livestock in northern Türkiye and to the development of prevention and control strategies.
RESUMO
Parasitic infections rarely involve the oral and maxillofacial regions and pose a diagnostic challenge when they do. Hydatid cysts are parasitic cysts caused by Echinococcus granulosus. Intraosseous involvement is observed in 3% of cases, of which only 2-6% are in the maxillofacial region. A scientific literature search revealed only seven cases involving the mandible. We report a rare case in a 16-year-old female patient who presented with facial asymmetry and well-defined radiolucency of the ramus. Our findings will help in understanding the diagnostic issues caused by non-specific presentation and difficulties in suspecting such a rare diagnosis as echinococcosis of the oral or maxillofacial region. A thorough systemic investigation is essential as 20-30% of these cases show multiorgan involvement.