Echotomographic and serological population-based study of hydatidosis in Central Tunisia

Bchir, A.; Larouzé, Bernard; Soltani, Maryam; Hamdi, A.; Bouhaouala, H.; Ducic, Slobodan; Bouden, L.; Ganouni, A; Achour, H.; Gaudebout, C.; Rousset, J; Jemmali, M.

doi:10.1016/0001-706x(91)90062-o

Cited by 29 publications

(15 citation statements)

References 12 publications

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“…This difference is similar to those in studies in other regions of Africa endemic for CE such as Tunisia where females (4.3%) were also at greater risk of infection than males (2.5%)Ͼ 26 In northwestern Kenya, females exhibited approximately twice the CE prevalence rate compared with males (5.6% versus 2.9%). 24 Differences in prevalence rates between the sexes in Kenya were attributed to different behavioral attitudes toward dogs.…”

Section: Discussionsupporting

confidence: 86%

“…The observed pattern of a gradual increase in CE prevalence with age is a general one that has also been observed in other endemic countries. 27 In Tunisia, 7.7% of persons Ͼ 39 years of age had CE 26 , while in east Africa, the prevalence of CE in Turkana, Kenya increased with age from 0.17% in the 0-4-yearold group to 11.1% in the Ͼ 50-year-old group. 24 Since hydatid cysts usually grow very slowly, patients may remain asymptomatic for many years.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Confirmation of between 60% and 90% of ultrasound-detected CE cases can be made serologically. 26,27 A pilot ultrasound-serologic CE survey in five areas in northwest Libya showed a prevalence rate of 1.4% (57 of 4,103). 2 Due to the success of the above survey, 2 a much larger study was implemented in Libya (1994)(1995) to define the geographic extent of human CE along the major coastal regions.…”

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An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya.

Shambesh¹,

Craig²,

Macpherson³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

115

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Abstract. A prevalence study of abdominal cystic echinococcosis (CE) was undertaken in the northwest, northcentral, and northeast regions of Libya. A total of 36 villages along the coast were included, in which 20,220 people were screened by portable ultrasound. Three hundred thirty-nine (1.7%) were diagnosed with CE. There was no significant difference between CE prevalence rates in the three regions of Libya (mean ϭ 1.6%); however, intervillage rates were variable, ranging from 0% to 4.5%. The prevalence of CE increased significantly with age (P Ͻ 0.0001) and females were significantly more affected (2%) than males (1.3%) (P Ͻ 0.0001). Cases of CE were distributed among 3.2% of housewives, 2.6% of farmers, 2.3% of male civil servants, 1.3% of female students, and 1.1% of male students. Housewives (P Ͻ 0.0001) and students (P Ͻ 0.0001) were significantly more at risk for CE. A statistically significant proportion (62% [210 of 339]) of CE cases kept dogs (P Ͻ 0.0001). Of the ultrasound-positive CE cases 69% (233 of 339) were antibody seropositive by ELISA using Echinococcus granulosus hydatid cyst fluid antigen B. Blood samples (n ϭ 10,096) collected onto filter papers were taken randomly from ultrasound-negative people who entered the study, of which 11.2% were found to be seropositive. Seropositivity increased with age (P Ͻ 0.0001), with females exhibiting higher seroprevalence than males for all age groups (P Ͻ 0.0001). Seroprevalence was distributed occupationally among 17.3% of female students, 11.2% of male students, 8.3% of housewives, 7.3% of farmers, and 6.4% of male civil servants. Housewives and students were more likely to be seropositive (P Ͻ 0.0001). Forty-seven percent (526) of the seroreactors kept dogs. All liver hydatid cysts detected by ultrasound during community screening were classified according to morphology and size into six types. Type I (17.5% of all cases) were small univesicular cysts less than 50 mm in diameter with no laminations or daughter cysts. Type II (34%) were univesicular cysts with only laminations. Type IIIa (8.5%) were univesicular cysts with the appearance of laminations and daughter cysts. Type IIIb (13%) were univesicular with laminations and less prominent daughter cysts. Type IV (5.6%) presented as a solid mass. Type V were degenerated calcified or partially calcified cysts (13.2%). Type VI presented as multiple cysts (8% of all cases). The CE cases that exhibited Types II, IIIa, IIIb, IV or VI cysts showed the highest seropositivity (86%, 96%, 95%, 100%, and 96%, respectively), while Types I and V were the least seroreactive (38% and 22%, respectively). Cases of CE occurred in 311 families, with 93% having only one member as a CE case while 7% of the families had two or more cases. However, 25% of the ultrasound-negative persons belonging to families with an index CE case were seropositive for antibodies to Echinococcus. These results confirm the importance of human CE in Libya. They also confirm the usefulness of ultrasound combined with serology as a mass screeni...

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya.

Shambesh¹,

Craig²,

Macpherson³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

115

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“…The general value of LI:LU among general, asymptomatic populations living in areas (of Argentina, China, Kenya, Libya, Tanzania, Tunisia and Uruguay) where CE is endemic was estimated from the results of previous surveys based on ultrasonography and/or chest X-rays (Schantz et al, 1973;Zabert et al, 1979;Frider et al, 1985Frider et al, , 1986Frider et al, , 1988bFrider et al, , 2001Mlika et al, 1986;Macpherson et al, 1987Macpherson et al, , 1989bSaint Martin et al, 1988;Larrieu et al, 1989;Perdomo et al, 1990Perdomo et al, , 1997Bchir et al, 1991;Shambesh et al, 1992Shambesh et al, , 1999Carmona et al, 1998;Cohen et al, 1998;Qiu et al, 1999;Wang et al, 1999) and a review of the results of general autopsy studies in Chile and Argentina (Schenone et al, 1971(Schenone et al, , 1973Frider et al, 1988a). The cyst locations noted in the hospital records of surgical cases of CE in Argentina, Australia, Bulgaria, Chile, Iran, Israel, Jordan, Turkey and Uruguay (Purriel et al, 1975;Varela Diaz et al, 1983;Isaacs et al, 1987;Macpherson et al, 1989a;Goldsmith et al, 1991;Larrieu et al, 1991;Kamhawi, 1995;Jenkins and Power, 1996;Daldal et al, 2001;Kurdova et al, 2001;Naem, 2001) were also investigated.…”

Section: Methodsmentioning

confidence: 99%

Human cystic echinococcosis: contributions to the natural history of the disease

Larrieu¹,

Frider

2001

Annals of Tropical Medicine And Parasitology

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In areas where human cystic echinococcosis (CE) is endemic, the results of ultrasonographic or X-ray examinations have revealed a surprisingly high prevalence of abdominal cysts in asymptomatic individuals. The results of preliminary studies indicate that the ratio of liver infection:lung infection (LI:LU) is much higher in the asymptomatic individuals (9:1 or 7:1) than is usual among symptomatic cases of liver CE (2:1). This difference may indicate that, compared with lung cysts, liver cysts rarely cause morbidity, perhaps because they grow at a slower rate than those in the lungs. In an attempt to explore this possibility, the published results of ultrasonographic and radiological surveys on general populations and the records of autopsies and hospital-based investigations of symptomatic cases of liver CE were reviewed. In general populations, the overall prevalence of cysts in the liver (2.5%) was found to be much higher than that of cysts in the lungs (0.3%), giving a LI:LU ratio of 8.3:1. In the symptomatic cases, however, LI:LU ratios were only 2.5:1 (based on hospital records) or 4.1:1 (based on autopsy records). In addition, the estimated mean growth rate of the cysts in 53 surgical cases of CE from the province of Río Negro in Argentina was found to be significantly higher than that of the cysts in 89 asymptomatic cases detected during ultrasonographic surveys in the same area.

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“…Immuno-diagnostic tests for hydatidosis have been used for mass screening of communities in endemic regions 3 but the sensitivity and specificity of the diagnostic antigen are important 4 . Craig et al 5 used purified antigen obtained from hydatid cyst fluid in a 30-minute dot- ELISA on nitro-cellulose paper impregnated with hydatid antigen.…”

Section: Introductionmentioning

confidence: 99%

Seroepidemiology of human cystic echinococcosis in Basrah governorate

Al-Mounase

Mustafa

Kateh

2012

Qatar Medical Journal

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Echotomographic and serological population-based study of hydatidosis in Central Tunisia

Cited by 29 publications

References 12 publications

An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya.

An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya.

Human cystic echinococcosis: contributions to the natural history of the disease

Seroepidemiology of human cystic echinococcosis in Basrah governorate

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