Echinococcus granulosus infections are a major public health problem in livestock-raising regions around the world. The life cycle of this tapeworm is sustained between dogs (definitive host, canine echinococcosis), and herbivores (intermediary host, cystic hydatid disease). Humans may also develop cystic hydatid disease. Echinococcosis is endemic in rural areas of Peru; nevertheless, its presence or the extension of the problem in urban areas is basically unknown. Migration into Lima, an 8-million habitant's metropolis, creates peripheral areas where animals brought from endemic areas are slaughtered without veterinary supervision. We identified eight informal, unlicensed abattoirs in a peripheral district of Lima and performed a cross-sectional study in to assess the prevalence of canine echinococcosis, evaluated by coproELISA followed by PCR evaluation and arecoline purge. Eight of 22 dogs (36%) were positive to coproELISA, and four (18%) were confirmed to be infected with E. granulosus tapeworms either by PCR or direct observation (purge). Later evaluation of the human population living in these abattoirs using abdominal ultrasound, chest X-rays and serology, found 3 out of 32 (9.3%) subjects with echinococcal cysts in the liver (two viable, one calcified), one of whom had also lung involvement and a strongly positive antibody response. Autochthonous transmission of E. granulosus is present in Lima. Informal, unlicensed abattoirs may be sources of infection to neighbouring people in this urban environment.
Introducción. La hidatidosis, zoonosis producida por el estadio larvario de la taenia Echinococcus granulosus, es un problema de salud pública a nivel nacional, en especial en aquellas regiones dedicadas a la crianza de ganado. A la fecha, se han descrito factores, a nivel individual, asociados con la infección por E. granulosus; sin embargo, no se encontró reporte previo que explore la asociación entre características de la vivienda y la presencia de esta enfermedad en alguno de sus miembros. Objetivos. Explorar la asociación entre las características de la vivienda y la presencia de hidatidosis entre las personas que la habitan. Materiales y métodos. Se realizó un estudio transversal en viviendas de tres comunidades rurales de Junín. Se evaluó el grado de asociación entre las características de la vivienda y la presencia de hidatidosis en el hogar mediante un análisis de regresión logística múltiple (RLM). Resultados. De un total de 417 viviendas evaluadas, 56 (13%) de ellas tenían al menos un caso positivo entre sus miembros; luego del análisis de RLM se observó que aquellas viviendas con más de tres miembros, localizadas en la comunidad con quintil de pobreza más bajo, que refirieron crianza de animales, y con una cobertura de evaluación mayor al 25% presentaron una mayor probabilidad de tener al menos un caso de positivo entre sus miembros. Conclusión. Las características observadas deben ser tomadas en cuenta para la determinación preliminar de subgrupos de alto riesgo, optimizando así el uso de los recursos y mejorando la eficacia de los programas de despistaje. Palabras clave: Equinococosis; Asentamientos rurales, Domicilio; Perú (fuente: DeCS BIREME). HOUSEHOLD FACTORS ASSOCIATED WITH THE PRESENCE OF HUMAN HYDATID DISEASE IN THREE RURAL COMMUNITIES OF JUNIN, PERU ABSTRACTIntroduction. Hydatid disease, a zoonosis caused by the larval stage of the parasite Echinococcus granulosus, is a public health problem at national level, especially in those regions dedicated to raising livestock. By now, there are many factors, at individual level, that have been associated to the infection by E. granulosus; nevertheless there is not any previous report that explore the association between household characteristics and the presence of the disease among household members. Objective. To explore the association between household characteristics and the presence of hydatid disease among household members. Material and methods. We performed a cross-sectional study in the households of 3 rural communities located in Junín, we evaluated the association between household characteristics and the presence of hydatid disease by multiple logistic regression (MLR). Results. From 417 evaluated households, 56 (13%) of them had at least one positive case among its members. Multivariate analysis showed that households with three or more members, located in the community with the lowest quintile of poverty, that reported raising livestock, and with evaluation coverage greater than 25% were more likely to have at least one positive cas...
Autopsy continues to be a useful tool to assess quality of clinical diagnosis. The diagnostic errors with therapeutic repercussion are bacterial infections and cardiovascular disease. Patients with a stay less than 24 hours have a higher rate of type I diagnostic errors.
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