Human Cystic Echinococcosis in Lebanon: A Retrospective Study and Molecular Epidemiology

Abstract

Purpose Human cystic echinococcosis (CE) is a zoonotic parasitic disease that constitutes a public health challenge and a socio-economic burden in endemic areas worldwide. No specific surveillance system of CE infections in humans exists in Lebanon. The incidence and trends over time have not been documented. The current study aimed to assess the demographic and epidemiologic features of human CE surgical cases over a 14-year period in the five main regions of Lebanon. Methods From 2005 to 2018, a total of 894 surgically confirmed cases of hydatidosis were recorded from five anatomy and pathology laboratories. Results The mean annual surgical incidence was 1.23/100,000 inhabitants. Over the span of these years, the incidence increased from 0.53 to 1.94 cases/100,000 inhabitants in 2005 and 2018, respectively. CE is present in Lebanon with an uneven distribution from one region to the other with higher prevalence in Bekaa (29.0%), a rural area where sheep raising is widespread. Human CE cases were more common in females (60.1%) than in males (39.9%) and a high burden of infection was reported for the age group of 30–39 years. Besides, 66.7% of the cases expressed only liver complications whereas, 20.5% showed predilection towards lungs. The 7.8% of cases presented cysts in other organs, and 1.3% showed multiple localizations. Additionally, predominant involvement of Echinococcus granulosus sensu stricto was recorded in human infections. Comparison of Echinococcus granulosus s.s. populations from different Mediterranean countries also revealed high gene flow among this region and sharing of alleles. Conclusion The current study is a step forward to fill the gap of knowledge for the hydatidosis in Lebanon where the lack of epidemiological data and control measures have resulted in higher incidence of human CE. Graphic Abstract

Basic Operative Tactics for Pulmonary Echinococcosis in the Era of Endostaplers and Energy Devices

“…According to a study by Khan et al, only 1.19% of cysts were in these two organs [ 7 ]. In a separate study by Joanny et al, the liver and lung were involved in 0.89% of CE cases [ 8 ]. In contrast, an older study by Dogan and colleagues demonstrated that simultaneous involvement of the lung and liver occurs in approximately 10% of cases in a cohort of 1055 patients with hydatidosis treated surgically [ 9 ].…”

“…Furthermore, CE may develop in more than two organs, but these cases occur extremely rarely [ 10 ]. Clinical course is usually asymptomatic, until the lesion starts to compress surrounding structures or the cyst ruptures [ 8 ].…”

Cystic echinococcosis in humans and animals in Egypt: An epidemiological overview

“…In the Egyptian population, residency in rural areas, occupation (farmers and housewives), and age (30–40 years) were significant factors for acquiring CE ( Salama et al., 2014 ). Likewise, high prevalence rates were recorded in the age group of less than 40 years in Iran, Lebanon and Turkey ( Akalin et al, 2014 ; Mahmoudi et al, 2019 ; Joanny et al, 2021 ).…”