The objective of this study was to determine some features of cystic echinococcosis among children and adolescents, such as epidemiology, diagnosis, organ localization, treatment, and social and environmental factors favoring transmission of the disease. The 18-year study period (1996-2013) includes officially registered primary cases treated surgically, and/or with drug therapy, and/or with the puncture, aspiration, injection, reaspiration technique. Organ localization of the cysts and the most common diagnostic procedures were studied from the patients' medical records. Groups of diseased and healthy children were surveyed to outline some of the environmental and social factors influencing morbidity. From 1996 to 2013, the average annual incidence of cystic echinococcosis in the country was 6.7 per 100,000, but with significant variations in the incidence between different age groups. The hydatid cysts in children aged 0 to 9 years may most frequently be found in the lungs, in contrast to patients from other age groups. Almost 90% of the affected children had sustained contact with dogs. At present, among the countries of the European Union, Bulgaria holds the highest incidence and prevalence of cystic echinococcosis. Childhood echinococcosis remains a serious health problem for the country. Therefore, the study of cystic echinococcosis in children has important epidemiological significance concerning the intensity of transmission.
Visceral leishmaniasis is a sporadic illness in Bulgaria. However, cases in humans are registered nearly every year. This study describes the geographical distribution of the disease in Bulgaria from 1988 to 2012, over a period of 25 years. Cases were analysed according to age, sex, and place of residence. A total of 122 cases were registered in 25 years, 118 of which were autochthonous and four of which were imported from endemic countries in southern Europe. The average annual incidence for the study period was 0.06 per 100,000 population, or an average of five cases per year (maximum 15 in 1989; no cases notified in 1991, 1995, 1996 and 2008). Cases of visceral leishmaniasis were recorded in 13 out of 28 regions in Bulgaria, mainly in the southern part of the country. The highest number of cases were registered in the regions of Blagoevgrad (n=36) and Stara Zagora (n=34). Data presented in this study show that there is ongoing transmission of visceral leishmaniasis in Bulgaria with a high mortality rate (1:7), affecting mostly children.
SummaryThe aim of the present study is to perform a retrospective analysis of the prevalence of intestinal parasitic infections among the Bulgarian population over the period 2015 – 2017. The study involved all Bulgarians and foreign nationals residing in the country who had been tested for intestinal protozoa and helminths. A total of 23,785 infections have been revealed, of which 17,712 (74.47 %) were helminth and 6,073 (25.53 %) protozoan invasions. Enterobiasis was found to be the most prevalent among patients infected with intestinal helminths (81.75 %), while giardiasis (62.05 %) was the most common among those diagnosed with protozoan infections. In spite of improved living conditions and increasing public health awareness, parasitic diseases in general, and intestinal parasitic infections in particular, still represent a significant part of the overall morbidity in Bulgaria, thus posing a major issue for the public health care system.
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