Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study

摘要

Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseasesin human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioralrisk factors, the diversity and ecology of animal host interactions and the genetic diversitywithin Echinococcus species which differ in their zoonotic potential and pathogenicity. It isa neglected, economic and socio-cultural problem in Pakistan. The available data about theincidence of CE is very limited and no extensive study has been reported in Pakistan. Thecurrent study was aimed to analyze the hospital reported cases of CE and the associated riskfactors related to the incidence of CE. The hospital-based data of CE for the time period ofJanuary 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. Thedata covered demographic characteristics including age, gender, and cyst localization ofinfected individuals and socioeconomic determinants. The data was analyzed based upondifferent risk factors along with the different socioeconomic parameters that has an importantimpact on the distribution of disease. A total of 228 cases were presented in the selectedhospitals of different cities during the study period. Out of total 228 patients, 59.21% weremales and 40.78% were females (P20-30) showing 22.8% of total infected individuals followed by children (0-10) showing10.5% (n=24), respectively (P0.001). Liver was the most vulnerable organ (58.77%, n=134)followed by lungs (14.47%, n=33) (P0.001). The infection was higher among rural communities(84.2%) than urban (12.8%) (P0.001). Socioeconomic and demographic factors had animportant impact on the intensity of disease (P0.001). The occurrence of cases in childrenand young adults was an important finding as it indicated an active transmission of theparasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistanshowed that emerging health issues in Pakistan could bring the disease to limelight for futureresearch. This finding, together with the fact that 1 hospital reported 214 cases over 6 years underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.