Epidemiology and clinical features of human cystic echinococcosis in adults from an endemic area (Morocco)

Abstract

Background: Cystic echinococcosis is a parasitic disease of major public health concern in many countries. Infection is generally acquired during childhood and symptoms may appear later in adulthood. The study aimed to determine the pattern and characteristics of cystic echinococcosis in adults from an endemic area (Morocco), where a control and prevention program has been implemented. Methods: Adult patients diagnosed and operated for echinococcosis between 2010 and 2016 were investigated. Reports containing details regarding each patient were established and completed. Results: Over the study period, 260 patients were investigated with a decreasing trend in patients' numbers. Adults from rural areas were significantly predominant (74.2%) (p < 0.01). Females were more infected (55.8%) than males (44.2%). Adults aged 18-43 years were the most affected (52.3%) (p < 0.01). All of the patients had single organ involvement. Liver location was preponderant (63.8%) and patients with uncommon locations were rare (6.9%). Cysts' distribution varied by gender, age group and origin. Mean length of hospital stay was 5.5 days, with relatively higher periods in patients aged 57-82 years and in patients with unusual locations of cysts. Conclusion: Active transmission of cystic echinococcosis can still occur in areas where surveillance programs have been implemented. Many factors affect features of the disease and should be considered in prevention and control programs in endemic areas.

Epidemiological profile of Echinococcosis in Morocco from 2014 to 2018: case of Tangier-Tetouan-Al Hoceima Region

“…The female were more affected then males in our results in agreement with other studies from Morocco and many other countries [8,14,20,[24][25][26][27]. This could be associated with the work performed by women as cooking activities (attitudes of tasting raw vegetables) [8]; cleaning milking (ruminant animals) and feeding dogs and cattle [14].…”

“…In our study, most cases affected were adults. This was reported in many other studies in Morocco as well as countries from Mediterranean region, Middle East and Asia [8,14,19,20,21,22]. Infantile age has also been observed in our results knowing that 10% to 20% of CE cases ≤16 years can be detected in childhood because of the rapid development of infection at an early age in some cases [23].…”

“…The number of cases per year reported was 18 [13][14][15][16][17][18][19][20][21][22] cases. This number still be inferior to the number of cases reported (average of 37.1 cases/year) in other study carried out in a the south region of morocco between 2010 and 2016 [8]. However, this frequency of CE cases may not reflect the real occurrence of the disease in our region.…”

“…The incidence observed in our study present a decrease tendency between 2015 and 2018 (0.8 to 0.5 cases/100,000 inhabitant) in opposite of the increase of this incidence reported in Morocco in 1980 to 2008 (3.6 to 5.2 cases / 100,000 inhabitant) [12]. The rural areas was the environment the most affected in our region as well as in other region of Morocco [8] and other countries in Europe, Middle East and Asia [4,13,15].…”

“…Other study reported a mean number of 37.1 of CE cases per year in some Moroccan endemic area [7] . On the other hand, It was reported that this zoonotic diseases affected the female sex , adult age, especially in rural and slums cities where the stray dog were present [8]. The abundance of dog; the decreasing of knowledge level about infection; the inadequate and lack of hygiene in abattoir are some risk factors responsible for maintaining the human and animal transmission of Echinococcus worldwide [9,10].…”