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Summary In Turkey, cyst hydatid disease (CHD) or cystic echinococcosis (CE) is publicly known as “dog cyst”, a fatal and serious disease not only affects livestock husbandry and human health but also brings about economic loss to our country. According to the data of the Ministry of Health; number of annual cases was 408 in 2008, and this number reached 1,867 by the end of 2019. Cystic echinococcosis is especially taken up during childhood and emerged at an older age. They become exposed to the eggs of the tapeworm after close contact with an infected dog or its contaminated environment. The infected dogs also pass in their feces E. granulosus eggs that adhere to the dogs’ hairs, and pass on to the children who are in the course of playful and intimate contact with the infected dogs. This study was to create the awareness of risk factors of CE among 10 different districts of Izmir province. Awareness raising seminars are essential component of this study because local people living in CE endemic areas, are crucial to continue and sustain the long-time effort that is needed to tackle this disease. In each district, 3 awareness raising seminars were held to the target groups: (a) in schools for students, teachers, administrators, (b) for general public, (c) for healthcare professionals. 4090 students attended to the trainings, 242 administrators and teachers who attended to the presentations together with the students, 524 people were attended to the trainings and 327 health workers attended to the trainings from different institutions. This study helped improving this situation by organising educational events for the rural populations for preventing transmission of the disease. This is the first educational intervention study regarding creating awareness on CE in Izmir Province which includes 10 districts between January 2019 to January 2020.

Human cystic echinococcosis (CE) is the most prevalent disease in Europe, and probably accounts for more than 95% of the estimated 2-3 million global cases. CE is a fatal and serious disease. Turkey is among the countries where this problem still poses a public threat. This study was a pilot study to create the awareness of CE among 10 different districts of Izmir province, Turkey. Awareness raising seminars are essential component of this study for students and schoolteachers. Questionnaire forms were created and applied before and after the presentations. Printed materials, posters and brochures were disseminated and posters put on the walls or boards where students can see continuously. Even 4090 students attended to the trainings, questionnaires were filled by 3793 of the students. Out of 3793 students, 1978 (52.1%) were female and 1815 (47.9%) were male. The majority of students (94.2%) did not know anything about this disease. 93.1% students were stated that there were stray dogs in their environment. More than half of the students were playing with stray dogs. Nearly 90% of the students answered correctly the questions which were asked after presentation.The total number of administrators and teachers who attended to the seminars were 242. This is the first pilot study regarding creating awareness on CE in the Izmir Province, Turkey that covers the big sample-size of children including schoolteachers. This study helped them understand the importance of the problem and how it can be solved by protecting themselves while respecting human and animal rights. It will be used for establishing nationwide control programme.

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Amaç: Çalışmada, kistik ekinokokkozisli (KE) hastaların takibi, enfeksiyonun prognozu ve tekrarlayan kistlerin mümkün olan en kısa sürede tespiti konularında değerlendirme imkanı sunulmaktadır. Ayrıca, yeni multiepitop rekombinant peptit (recDipol) antijeninin cerrahi veya perkütan aspirasyon enjeksiyon reaspirasyon işlemi uygulanan KE'li hastaların takibindeki performansının değerlendirilmesi amaçlanmıştır.Yöntemler: Çalışmamızda, 28 KE hastasına ait toplam 137 kan örneği IgG-ELISA yöntemi ile, recDipol ve kist sıvısı (KS) antijenleri kullanılarak değerlendirilmiştir. Hastalar eş zamanlı olarak girişimsel radyoloji bölümünde ultrasonografi ile nüks açısından kontrol edilmiştir.Bulgular: Takip süreleri boyunca 28 takip hastasının seropozitivite oranları aylara göre değişkenlik göstermiştir. Bu hastaların operasyon sırasında alınan kan örnekleri incelendiğinde, 4'ünün (%14,28) KS-ELISA ile, 9'unun (%32,14) recDipol-ELISA ile seronegatif olduğu tespit edilmiştir. Tüm takip süresi boyunca seronegatif hasta sayısı ise KS-ELISA ile 1 (%3,5), recDipol ELISA ile 6 (%21,4) olarak kaydedilmiştir. Sonuç:RecDipol ELISA ile hastalardan ilk tanıda ve tüm takip boyunca alınan kan örneklerinde belirlenen seronegatif hasta sayısının, KS-ELISA ile belirlenenden fazla olması, recDipol antijeninin hasta takibinde beklenen performansı göstermediği şeklinde değerlendirilmiştir. Çalışmada elde edilen bu sonuçlar, KE hastalarının tanısında ve takibinde altın standardın görüntüleme yöntemleri olduğu ve paralelinde tanı performansı geliştirilmiş rekombinant antijenlerle daha uzun süreli hasta takibinin yapılması gerektiği şeklinde yorumlanmıştır.

Objective: The aim of the study is to determine the prevalence of Echinococcus granulosus sensu lato by molecular analysis with Real Time PCR (RT-PCR) method by collecting stool samples from stray animals that can be reached in 9 of the 10 determined districts of Izmir province (Aliaga, Menemen, Bornova, Urla, Selcuk, Bayindir, Odemis, Tire, Kiraz). Materials and Methods: Thirty samples from Aliaga, 41 samples from Menemen, 35 samples from Bornova, 10 samples from Urla, 40 samples from Selcuk, 40 samples from Bayındır, 33 samples from Odemis, 45 samples from Tire, 26 samples from Kiraz, totally 300 stool samples were collected. The samples were left at −80°C for 5 days for inactivate. Afterwards, all inactivated stool samples were kept at -20°C until they were taken into the study. DNA isolation from stool samples was carried out with DNA extraction kit. The purity of all isolated samples was measured by spectrophotometer. The analysis of the RT-PCR results was performed with the Rotor-Gene Q series software 2.3.1 program and the samples were evaluated for E. granulosus s.l. positive/negativeness. Results: According to the results of RT-PCR analysis, E. granulosus s.l. positive sample was not found in stool samples collected from stray dogs in the study area. Conclusion: Since no molecular studies have been carried out in the districts included in our study, the results obtained could not be compared. It also can be thought that the number of samples is insufficient. Therefore, a larger sample pool should be examined to find out the prevalence of E. granulosus s.l. Since there is limited data about the prevalence of E.granulosus s.l. in stray dogs, it also is important to investigate the prevalence of E. granulosus s.l. in different regions of Turkey.

Objective: To date, many studies have been performed on genotyping of E. granulosus s.l. in Turkey. However, a systematically analysis of the data human E. granulosus s.l. genotypes in Turkey is lacking. In this context, the aim of this study is to provide summary information about the distribution of E.granulosus s.l. genotypes which have been detected with molecular methods in human isolates in Turkey. Materials and Methods: Both English and Turkish studies in four international and national databases up to September 2022 were searched with keywords related “Echinococcus” to access the eligible articles for our study. The selected articles were transferred StatsDirect software for performing meta-analysis. Results: Out of 3497 articles from literature search, 24 records were eligible for inclusion in this meta-analysis. All data were obtained from 34 cities in all regions of Turkey. Total of 815 human cases whose genotypes were sequenced and identified. With the present study, identified species of E. granulosus s.l in Turkey were determined as follows, from most common to the least: E.granulosus sensu stricto (G1-G3): 97.8%, E.equinus (G4): 0.12%, E.canadensis (G6-G10): 2.0%. In addition, according to proportion of the genotypes, while G1(48%; 95%CI: 40-49%) and G1-G3 complex genotype (47%; 95%CI:41-48%) were detected in all regions of the country, G3 (2.8%; 95%CI:1-3%) was detected in Southeast and Eastern Anatolia, G4 (0.12%; 95%CI:0.1-1%) only in Central Anatolia, G6 (0.25%; 95%CI:0.2-1%) only in Eastern Anatolia, G7 (0.25% ; 95%CI: 0.2-1%) in Aegean and Marmara regions, and G6/G7 ( 1.5% ; 95%CI: 0.7-2%) in Aegean, Central Anatolia and Eastern Anatolia. Conclusion: With this meta-analysis study, it has been revealed that the most predominant E.granulosus genotypes of humans cystic echinococcosis in Turkey were G1 and G1-G3 complex. The present study will be a guide for genotyping studies have not been performed in the other regions of the country. The more in-depth meta-analysis studies are needed to better understand the molecular characterization of E.granulosus s.l in other hosts such as dogs, sheep and cattle in Turkey.

SummaryThe aim of this study was to investigate whether Enzyme-Linked Immunosorbent Assays (ELISA) and Western Blotting (WB) methods could contribute to the assessment of clinical outcomes in genotype-defined cystic echinococcosis (CE) patients. Twenty-nine human isolates and blood samples have been taken from patients who underwent surgery or percutaneous aspiration (PAIR) for therapeutic purposes at Ege University and Manisa Celal Bayar University Hospitals. All sera of patients were screened for the presence of E. granulosus IgG antibodies using in-house approved ELISA and WB methods. According to the ELISA results, five patients had high, thirteen patients had medium and eight patients had low specific antibody level response which ranged 1/640 -1/5000. Despite confirmed WB positivity three patients were found to be negative by ELISA. Immunoblot analysis of EgAg showed many protein bands with size of 8, 12, 20, 22, 24, 36, 75 and 90 kDa. Among of them, 8 – 12 kDa bands (90 %), 20 – 22 kDa and 36 kDa bands presented strong reactivity against human serum specimens. No serum samples from healthy control reacted with EgAg. Phylogenetic analysis of resulting COX1 and NAD1sequences has revealed that all patients in our study were infected with the E. granulosus G1-G3 genotype. There was no consistent correlation between results of ELISA and WB, the number or size of cysts and genotype. Our study brings a unique contribution in terms of relationship between serological investigation, disease genotypes and clinical outcomes.