1.Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study
Khan, A. ; Ahmed, H. ; Simsek, S. ; Gondal, M.A. ; Afzal, M.S. ; Irum, S. ; Muhammad, I. ; Mansur, H. ; Fatima, A. ; Ali, M.S. ; Riaz, N. ; Akbar, A. ; Weiping, W. ; Yayi, G.
Tropical Biomedicine 2019;36(2):324-334
Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases
in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral
risk factors, the diversity and ecology of animal host interactions and the genetic diversity
within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is
a neglected, economic and socio-cultural problem in Pakistan. The available data about the
incidence of CE is very limited and no extensive study has been reported in Pakistan. The
current study was aimed to analyze the hospital reported cases of CE and the associated risk
factors related to the incidence of CE. The hospital-based data of CE for the time period of
January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The
data covered demographic characteristics including age, gender, and cyst localization of
infected individuals and socioeconomic determinants. The data was analyzed based upon
different risk factors along with the different socioeconomic parameters that has an important
impact on the distribution of disease. A total of 228 cases were presented in the selected
hospitals of different cities during the study period. Out of total 228 patients, 59.21% were
males and 40.78% were females (P<0.001). Most infections have been recorded in young
adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing
10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134)
followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities
(84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an
important impact on the intensity of disease (P<0.001). The occurrence of cases in children
and young adults was an important finding as it indicated an active transmission of the
parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan
showed that emerging health issues in Pakistan could bring the disease to limelight for future
research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years
325
underlines the need for a program for prevention/control of this disease in Pakistan. The
timely measure needs to be taken to hamper the disease development and establishment. In
order to control the disease, complete surveillance should be done which in turn weighs down
the disease progress.