Cystic echinococcosis in the Eastern Mediterranean region: Neglected and prevailing!

Abstract

Cystic echinococcosis (CE) is distributed worldwide, extending from China to the Middle East and from Mediterranean countries to the sub-Saharan Africa and South America. According to WHO, one million people around the world are suffering from CE with an estimated burden of 183,573 DALYs. The annual monetary burden of the disease due to treatment costs and CE-related livestock losses has been estimated at US$ 3 billion. CE is endemic in all countries within the WHO Eastern Mediterranean Regional Office (EMRO). The region, which includes most of the Middle East and North Africa, is one of the most ancient foci of the domestic cycle of CE and is recognized as one of the major hotspots of CE. There are 22 countries in the EMRO, where about 688 million people are living at risk of CE. In many EMRO countries, little is known about CE epidemiology and transmission. WHO included echinococcosis in a list of 17 neglected tropical diseases (NTDs) and 12 neglected zoonotic diseases (NZDs). Accordingly, different regional offices of WHO organized several initiatives for CE control and prevention. WHO's Western Pacific regional office considered echinococcosis as one of the region's major health topics, and several preventive measures have been implemented in the American region with the support of Pan American Health Organization (PAHO) in Argentina, Peru, Uruguay, and Chile. Although CE is endemic in all 22 EMRO countries, surprisingly, CE is absent from the health topics list of diseases and conditions in this region. Therefore, CE clearly requires further attention in the WHO EMRO agenda, and the need for elaboration of specific measures for CE control is becoming apparent in EMRO countries, where substantial collaborations among the member states and WHO EMRO is of paramount importance. Major topics of collaborative activities include training programs and health communication on different aspects of CE control, analysis of CE burden, national and international surveillance and disease registry systems, technical support to promote epidemiological studies for collecting baseline data, cost-benefit analysis of control PLOS NEGLECTED TROPICAL DISEASES

Epidemiological, Morphometric, and Molecular Investigation of Cystic Echinococcosis in Camel and Cattle From Upper Egypt: Current Status and Zoonotic Implications

“…In accordance with its distribution, several previous studies revealed the endemicity of the disease in Egypt and neighboring countries of the Mediterranean basin and Middle East ( 19 – 30 ). The prevalence rates varied greatly among intermediate hosts of various species because of the influence of a variety of environmental factors and hygienic conditions ( 25 ), which is potentiated by the presence of infected stray dogs that are mostly used for guarding purposes or by the ease access of these dogs to slaughter houses ( 25 , 29 ).…”

“…The discrepancy in the occurrence of CE in camels and cattle in the present study vs. those reported in several previous studies may be attributed to several factors, such as hygienic practices during slaughter, sex and age of the slaughtered animals, the method of detection, the geographic location, and various climatic conditions ( 25 , 45 , 73 , 74 ). The unhygienic disposal of condemned carcasses and infected organs, the ease of access stray dogs to slaughter houses, and the unauthorized slaughter are also relevant factors in the transmission of CE ( 29 , 30 , 74 , 75 ).…”

Cystic echinococcosis in sheep and goats of Lebanon

“…Cystic echinococcosis (CE) is ranked second in the list of food-borne parasites worldwide, listed among the most severe parasitic diseases in humans (World Health Organization and Food and Agriculture Organization of the United Nations, 2014) and prioritized by the World Health Organization as one of the 17 neglected tropical diseases (WHO, 2015). It is also known to be the most important parasitic zoonosis in the Mediterranean region (Dakkak, 2010;Ismail et al, 2018;Borhani et al, 2020), with stable endemicity in the Middle East due to the high diversity of intermediate hosts, mainly sheep and goats, followed by camels and cattle (Al Kitani et al, 2015). CE is creating a serious public health problem and is a burden to national economy for most countries in this region (Grosso et al, 2012;Thys et al, 2019).…”

An Adrift and Homeless Cyst within the Peritoneal Cavity

“…CE is considered to be endemic in all eastern Mediterranean region, and this region is one the major hotspots of CE. Despite this fact, CE is not among the health topic list of diseases in this region which requires more attention [ 4 ]. In Pakistan as one of these countries, CE is also endemic but their data is still limited [ 5 ].…”