Current Opinion in Clinical Management of Human Cystic Echinococcosis in the Liver

Abstract

Cystic echinococcosis remains a serious and threatening disease in countries on all continents where it is endemic. It is a zoonosis that continues to be neglected, despite all the efforts of the teams working on it and the WHO. Therefore, it is never too much to remember the clinical management of this disease in humans. This is what we intend in this manuscript. The disease is caused by the larval stages of cestodes (tapeworms) of the genus Echinococcus found in the small intestine of carnivores, which infects humans due to accidental ingestion of eggs of these parasites. The most frequent and most widespread across all continents is cystic echinococcosis, caused by Echinococcus granulosus (sensu lato). The annual incidence of CE can range from less than 1 to 200 per 100,000 inhabitants in various endemic areas. In China and Central Asia, the population risk is more than 40 million people, with a mortality rate of about 2% - 4%. Objectives: One of the objectives of this manuscript is to recall the parasite cycle and the form of contamination, a very important public health aspect, and draw attention to this neglected zoonosis that affects millions of people, particularly in the countries of Central Asia, the Mediterranean basin and South America. Last but not least, we intend to draw attention to the correct nomenclature in relation to the terms that define the disease, the different stages, and the proper designations, particularly with regard to therapeutic modalities. Method: The manuscript also aims to describe the form of contamination of the disease, the diagnostic methods, in particular the use of ultrasound, and the therapeutic modalities, some of which, particularly the invasive ones, must be carried out in Centres dedicated to the study and treatment of this zoonosis. Conclusion: Despite these important data and the socioeconomic impact Echinococcosis remains a neglected disease. Given this situation, all forms of echinococcosis remain serious public health threats, particularly in South America, the Mediterranean basin, and Central Asia, which must deserve the attention of the states of these continents and the WHO.