Volume 88, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence Proportion Ratio: 1.35 [95% Bayesian Credible Interval: 1.16–1.53]) and increased with age. The most common manifestations of hepatic and pulmonary CE were abdominal pain (57.3% [95% confidence interval [CI]: 37.3–76.1%]) and cough (51.3% [95% CI: 35.7–66.7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.


Article metrics loading...

Loading full text...

Full text loading...



  1. DerSimonian R, Lard N, , 1986. Meta-analysis in clinical trials. Control Clin Trials 7: 177188.[Crossref]
  2. De Andrade BB, Carabin H, , 2011. On the estimation of relative risks via log binomial regression. Revista Brasileira de Biometria 29: 115.
  3. Yang YR, Sun T, Li Z, Zhang J, Teng J, Liu X, Liu R, Zhao R, Jones MH, Wang Y, Wen H, Feng X, Zhao Q, Zhao Y, Shi D, Bartholomot B, Vuitton DA, Pleynell D, Giraudoux P, Ito A, Danson MF, Boufana B, Craig PS, Williams GM, McManus DP, , 2006. Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China. Bull World Health Organ 84: 714721.[Crossref]
  4. Yang YR, Ellis M, Sun T, Li Z, Vuitton DA, Bartholomot B, Giraudoux P, Craig PS, Boufana B, Wang Y, Feng X, Wen H, Ito A, McManus DP, , 2006. Unique family clustering of human echinococcosis cases in a Chinese family. Am J Trop Med Hyg 74: 487494.
  5. Wang YH, Rogan MT, Vuitton DA, Wen H, Bartholomot B, Macpherson CN, Zou PF, Ding ZX, Zhou HX, Zhang XF, Luo J, Xiong HB, Fu Y, McVie A, Giraudoux P, Yang WG, Craig PS, , 2001. Cystic echinococcosis in semi-nomadic pastoral communities in north-west China. Trans R Soc Trop Med Hyg 95: 153158.[Crossref]
  6. Zhao Q, Lv YQ, , 2003. Investigation on prevalence of human hepatic hydatid disease diagnosed by ultrasound in two counties of Xinjiang. Endemic Dis Bull 18: 4142 [article in Chinese].
  7. Qiu JM, Liu FJ, Schantz PM, Ito A, Delker C, He JG, Zhang Y, Chen XW, , 2000. Epidemiological study on human hydatidosis in Tibetan region of Western Sichuan. Chin J Zoonoses 10: 7780 [article in Chinese].
  8. Li T, Qiu J, Yang W, Craig PS, Xingwang C, Xiou N, Ito A, Giraudoux P, Wulamu M, Yank W, Schantz PM, , 2005. Echinococcosis in Tibetan populations, western Sichuan Province, China. Emerg Infect Dis 11: 18661873.[Crossref]
  9. Wang H, Zhang J, Schantz PM, Ito A, Craig PS, Wu X, Han X, , 2006. Epidemiologic survey and analysis on echinococcosis in human and animals from 1995 to 2005. Chin J Zoonoses 22: 11291134 [article in Chinese].
  10. Schantz PM, Wang H, Qiu J, Liu FJ, Saito E, Emshoff A, Ito A, Roberts JM, Delker C, , 2003. Echinococcosis on the Tibetan Plateau: prevalence and risk factors for cystic and alveolar echinococcosis in Tibetan populations in Qinghai Province, China. Parasitology 127: S109S120.[Crossref]
  11. Ma JY, Ma X, Wu XH, Zhang J, He D, Liu Y, Liu B, Liu P, Liu H, Zhao Y, Cai H, Wang H, , 2005. Epidemiological survey on hydatid disease in human in Yushu County. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 23: 452 [article in Chinese].
  12. Wang Y, He T, Wen X, Li T, Waili TT, Zhang W, Zhou H, Zheng H, Wen H, Davaadorj N, Gambolt L, Mukhar T, Rogan MT, Craig PS, , 2005. Human cystic echinococcosis in two Mongolian communities in Hobukesar (China) and Bulgan (Mongolia). Trans R Soc Trop Med Hyg 99: 692698.[Crossref]
  13. Gavidia CM, Gonzalez AE, Zhang W, McManus DP, Lopera L, Ninaquispe B, Garcia HH, Rodríguez S, Verastegui M, Calderon C, Pan WK, Gilman RH, , 2008. Diagnosis of cystic echinococcosis, central Peruvian Highlands. Emerg Infect Dis 14: 260266.[Crossref]
  14. Moro PL, Garcia HH, Gonzales AE, Bonilla JJ, Verastegui M, Gilman RH, , 2005. Screening for cystic echinococcosis in an endemic region of Peru using portable ultrasonography and the enzyme-linked immunoelectrotransfer blot (EITB) assay. Parasitol Res 96: 242246.[Crossref]
  15. Moro PL, McDonald J, Gilman RH, Silva B, Verastegui M, Malqui V, Lescano G, Falcon N, Montes G, Bazalar H, , 1997. Epidemiology of Echinococcus granulosus infection in the central Peruvian Andes. Bull World Health Organ 75: 553561.
  16. Moro PL, Bonifacio N, Gilman RH, Lopera L, Silva B, Takumoto R, Verastegui M, Cabrera L, , 1999. Field diagnosis of Echinococcus granulosus infection among intermediate and definitive host in an endemic focus of human cystic echinococcosis. Trans R Soc Trop Med Hyg 93: 611615.[Crossref]
  17. Macpherson CN, Kachani M, Lyagoubi M, Berrada M, Shepherd M, Fields PF, El Hasnaoui M, , 2004. Cystic echinococcosis in the Berber of the Mid Atlas mountains, Morocco: new insights into the natural history of the disease in human. Ann Trop Med Parasitol 98: 481490.
  18. Elmahdi IE, Ali QM, Magzoub MM, Ibrahim AM, Saad MB, Romig T, , 2004. Cystic echinococcosis of livestock and humans in central Sudan. Ann Trop Med Parasitol 98: 473479.[Crossref]
  19. Frider B, Moguilensky J, Salvitti JC, Odriozola M, Cantoni G, Larrieu E, , 2001. Epidemiological surveillance of human hydatidosis by means of ultrasonography: its contribution to the evaluation of control programs. Acta Trop 79: 219223.[Crossref]
  20. Larrieu E, Del Carpio M, Salvitti JC, Mercapide C, Sustersic J, Panomarenko H, Costa M, Bigatti R, Labanchi J, Herrero E, Cantoni G, Perez A, Odriozola M, , 2004. Ultrasonographic diagnosis and medical treatment of human cystic echinococcosis in asymptomatic school carriers: 5 years of follow-up. Acta Trop 91: 513.[Crossref]
  21. Del Carpio M, Moguilansky S, Costa M, Panomarenko H, Bianchi G, Bendersky S, Lazcano M, Frider B, Larrieu E, , 2000. Diagnosis of human hydatidosis. Predictive value of a rural ultrasonographic survey in an apparently healthy population. Medicina (B Aires) 60: 466468.
  22. Mata-Miranda P, Osnaya-Palma I, Rodríguez-Prado U, Gutiérrez-Marin A, Tawil M, Hernández-González S, Solano-Ceh M, Villalvaso L, Martínez-Maya JJ, García-de-la-Torre G, Flisser A, , 2007. Epidemiologic and ultrasonographic study of echinococcosis in a community in the state of Mexico. Am J Trop Med Hyg 77: 500503.
  23. Ozkol M, Kilimcioğlu AA, Girginkardeşler N, Balcioğlu IC, Sakru N, Korkmaz M, Ok UZ, , 2005. A discrepancy between cystic echinococcosis confirmed by ultrasound and seropositivity in Turkish children. Acta Trop 93: 213216.[Crossref]
  24. Ok UZ, Ozkol M, Kilimcioglu AA, Dinc G, Bayindir P, Ostan I, Pabuscu Y, Ozcan C, Kormaz M, Coskun S, Yuksel H, Girginkardesler N, , 2007. A province-based study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, Turkey. Acta Trop 103: 116122.[Crossref]
  25. Bchir A, Larouze B, Soltani M, Hamdi A, Bouhaouala H, Ducic S, Bouden L, Ganouni A, Achour H, Gaudebout C, Rousset JJ, Jemmali M, , 1991. Echotomographic and serological population-based study of hydatidosis in central Tunisia. Acta Trop 49: 149153.[Crossref]
  26. Shambesh MA, Macpherson CN, Beesley WN, Gusbi A, Elsonosi T, , 1992. Prevalence of human hydatid disease in northwestern Libya: a cross-sectional ultrasound study. Ann Trop Med Parasitol 86: 381386.[Crossref]
  27. Shambesh MA, Craig PS, Macpherson CN, Rogan MT, Gusbi AM, Echtuish EF, , 1999. An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya. Am J Trop Med Hyg 60: 462468.
  28. Klungsøyr P, Courtright P, Hendrikson TH, , 1993. Hydatid disease in the Hamar of Ethiopia: a public health problem for women. Trans R Soc Trop Med Hyg 87: 254255.[Crossref]
  29. Shambesh MK, Craig PS, Ibrahem MM, Gusbi AM, Echyuish EF, , 1997. A high prevalence of cystic hydatid disease in North Africa. Ann Trop Med Parasitol 91: 957959.[Crossref]
  30. Carmona C, Perdomo R, Carbo A, Alvarez C, Monti J, Grauert R, Stern D, Perera G, Lloyd S, Bazini R, Gemmell MA, Yarzabal L, , 1998. Risk factors associated with human cystic echinococcosis in Florida, Uruguay: results of a mass screening study using ultrasound and serology. Am J Trop Med Hyg 58: 599605.
  31. Cohen H, Paolillo E, Bonifacino R, Botta B, Parada L, Cabrera P, Snowden K, Gasser R, Tessier R, Dibarboure L, Wen K, Allan JC, Soto del Alfaro H, Rogan MT, Craig PS, , 1998. Human cystic echinococcosis in a Uruguayan community: a sonographic, serologic, and epidemiologic study. Am J Trop Med Hyg 59: 620627.
  32. Karimov SI, Nishanov KT, Eshanov AT, Durmanov BD, , 1998. Epidemiologic aspects of echinococcosis. Khirurgiia (Mosk) 7: 3739 [in Russian].
  33. Kovalev NG, Nazarova EO, Shamraeva GV, Pugacheva ON, Vafin AZ, Sletkov NA, Mnatsakanian EG, Parakhin VM, Sorokin VV, , 2003. Human and animal echinococcosis in the Stavropol territory. Med Parazitol (Mosk) 3: 4748 [article in Russian].
  34. Kandeel A, Ahmed ES, Helmy H, El Setouhy M, Craig PS, Ramzy RM, , 2004. A retrospective hospital study of human cystic echinococcosis in Egypt. East Mediterr Health J 10: 349357.
  35. Moro PL, Lopera L, Cabrera M, Cabrera G, Silva B, Gilman RH, Moro MH, , 2004. Short report: endemic focus of cystic echinococcosis in a coastal city of Peru. Am J Trop Med Hyg 71: 327329.
  36. Torgerson PR, Karaeva RR, Corkeri N, Abdyjaparov TA, Kuttubaev OT, Shaikenov BS, , 2003. Human cystic echinococcosis in Kygystan: an epidemiological study. Acta Trop 85: 5161.[Crossref]
  37. Abu-Hasan N, Daragmeh M, Adwan K, Al-Qaoud K, Abdel-Hafez SK, , 2002. Human cystic echinococcosis in the West Bank of Palestine: surgical incidence and seroepidemiological study. Parasitol Res 88: 107112.[Crossref]
  38. Todorov T, Boeva V, , 2000. Echinococcosis in children and adolescents in Bulgaria: a comparative study. Ann Trop Med Parasitol 94: 135144.[Crossref]
  39. Caremani M, Maestrini R, Occhini U, Sassoli S, Accorsi A, Giorgio A, Filice C, , 1993. Echographic epidemiology of cystic hydatid disease in Italy. Eur J Epidemiol 9: 401404.[Crossref]
  40. Maida A, Castiglia P, Solinas G, , 1994. Epidemiology of hydatidosis in Sardinia. Ann Ital Chir 65: 615623 [article in Italian].
  41. Mahjour J, El Idrissi L, Ayoujil M, Barkia A, , 1996. Enquete retrospective sur l'hyhatidose au Maroc (période 1980–1992). Bull Epidemiol 21: 213 [article in French].
  42. Pardo J, Muro A, Galindo I, Cordero M, Carpio M, Carpio A, Siles-Lucas M, , 2005. Hydatidosis in the province of Salamanca (Spain): should we let down our guard? Enferm Infecc Microbiol Clin 23: 266269 [article in Spanish].[Crossref]
  43. Saeed I, Kapel C, Saida LA, Willingham L, Nansen P, , 2000. Epidemiology of Echinococcus granulosus in Arbil province, northern Ira1, 1990–1998. J Helminthol 74: 8388.[Crossref]
  44. Ernst S, Núñez C, Ramírez G, , 1994. Human hydatidosis in Valdivia, Chile: retrospective survey at the Valdivia Regional Hospital. 1987–1991. Bol Chil Parasitol 49: 3137 [article in Spanish].
  45. Yazar S, Tayan Ozkan A, Hokelek M, Polat E, Yilmaz H, Ozbilge H, Ustun S, Koltas IS, Ertek M, Sakru N, Alver O, Cetinkaya Z, Koc Z, Demirci M, Aktas H, Parsak CK, Ozerdem D, Sakman G, Tas Cengiz Z, Ozer A, Keklik K, Yemenici N, Turan M, Dastan A, Kaya E, Sonmez Tamer G, Girginkardesler N, Turk M, Sinirtas M, Evci C, Kilicturgay N, Mutlu F, Artis T, , 2008. Cystic echinococcosis in Turkey from 2001–2005. Turkiye Parazitol Derg 32: 208220 [article in Turkish].
  46. Al-Qaoud KM, Craig PS, Abdel-Hafez SK, , 2003. Retrospective surgical incidence and case distribution of cystic echinococcosis in Jordan between 1994 and 2000. Acta Trop 87: 207214.[Crossref]
  47. Tashani OA, Zhang LH, Boufana B, Jegi A, McManus DP, , 2002. Epidemiology and strain characteristics of Echinococcus granulosus in the Benghazi are of eastern Libya. Ann Trop Med Parasitol 96: 369381.[Crossref]
  48. FAOSTAT database, 2012. Available at: http://faostat.fao.org. Accessed October 22, 2012.
  49. El Malki HO, Mejdoubi Y, Souadka A, Mohsine R, Ifrine L, Abouqal R, Belkouchi A, , 2008. Predictive factors of deep abdominal complications after operation for hydatid cyst of the liver: 15 years of experience with 672 patients. J Am Coll Surg 206: 629637.[Crossref]
  50. Memon AS, Memon JM, Memon N, , 1999. Hydatid disease of the liver: a ten years experience. J Surg Pak Int 4: 24.
  51. Agaoglu N, Türkyilmaz S, Arslan MK, , 2003. Surgical treatment of hydatid cysts of the liver. Br J Surg 90: 15361541.[Crossref]
  52. Mergen H, Genç H, Tavusbay C, , 2007. Assessment of liver hydatid cyst cases- ten years experience in Turkey. Trop Doct 37: 5456.[Crossref]
  53. Hammad A, Oussedik T, Hadjem K, , 1997. Liver hydatid cysts: clinical aspects. Tunis Med 75: 2730 [article in French].
  54. Daradkeh S, El-Muhtaseb H, Farah G, Sroujieh AS, Abu-Khalaf M, , 2006. Hydatid liver disease: long term results of a surgical management. J Med J 40: 114120.
  55. Mamishi S, Sagheb S, Pourakbari B, , 2007. Hydatid disease in Iranian children. J Microbiol Immunol Infect 40: 428431.
  56. Darwish B, , 2006. Clinical and radiological manifestations of 206 patients with pulmonary hydatidosis over a ten-year period. Prim Care Respir J 15: 246251.[Crossref]
  57. Sersar SI, Elnahas HA, Saleh AB, Moussa SA, Ghafar WA, , 2006. Pulmonary parasitosis: applied clinical and therapeutic issues. Heart Lung Circ 15: 2429.[Crossref]
  58. Aghajanzadeh M, , 2004. Evacuation and bronchial opening closure “the result of 100 surgeries for lung hydatid cyst”. Med J Iran Hosp 6: 2629.
  59. Kavukcu S, Kilic D, Tokat AO, Kutlay H, Cangir AK, Enon S, Okten I, Ozdemir N, Gungor A, Akal M, Akay H, , 2006. Parenchyma-preserving surgery in the management of pulmonary hydatid cysts. J Invest Surg 19: 6168.[Crossref]
  60. Salih OK, Topcuoğlu MS, Celik SK, Tokcan A, , 1998. Surgical treatment of hydatid cysts of the lung: analysis of 405 patients. Can J Surg 41: 131135.
  61. Tor M, Atasalihi A, Altuntas N, Sulu E, Senol T, Kir A, Baran R, , 2000. Review of cases with cystic hydatid lung disease in a tertiary referral hospital located in an endemic region: a 10 years' experience. Respiration 67: 539542.[Crossref]
  62. Hasdiraz L, Oğuzkaya F, Bilgin M, , 2006. Is lobectomy necessary in the treatment of pulmonary hydatid cysts? ANZ J Surg 76: 488490.[Crossref]
  63. Saglam L, Akgun M, Kaynar H, Gorguner M, Mirici A, Polat P, , 2003. Human, pulmonary, cystic echinococcosis in eastern Turkey. Ann Trop Med Parasitol 97: 531533.[Crossref]
  64. Ulku R, Yilmaz HG, Onat S, Ozcelik C, , 2006. Surgical treatment of pulmonary hydatid cysts: report of 139 cases. Int Surg 91: 7781.
  65. Elburjo M, Gani EA, , 1995. Surgical management of pulmonary hydatid cysts in children. Thorax 50: 396398.[Crossref]
  66. Durakbasa CU, Sander S, Sehiralti V, Tireli GA, Tosyali AN, Mutus M, , 2006. Pulmonary hydatid disease in children: outcome of surgical treatment combined with perioperative albendazole therapy. Pediatr Surg Int 22: 173178.[Crossref]
  67. Kurcuoglu IC, Eroglu A, Karaoglanoglu N, Turkyilmaz A, Tekinbas C, Basoglu A, , 2005. Surgical approach of pulmonary hydatidosis in childhood. Int J Clin Pract 59: 168172.[Crossref]
  68. Erdem CZ, Erdem LO, , 2003. Radiological characteristics of pulmonary hydatid disease in children: less common radiological appearances. Eur J Radiol 45: 123128.[Crossref]
  69. Cangir AK, Sahin E, Enön S, Kavukçu S, Akay H, Okten I, Yavuzer S, , 2001. Surgical treatment of pulmonary hydatid cysts in children. J Pediatr Surg 36: 917920.[Crossref]
  70. Kabiri EH, Kabiri M, Atoini F, Zidane A, Arsalane A, , 2006. Surgical treatment of pulmonary hydatid cysts in childhood. Arch Pediatr 13: 14951499 [article in French].[Crossref]
  71. Kuzucu A, Soysal O, Ozgel M, Yologlu S, , 2004. Complicated hydatid cysts of the lung: clinical and therapeutic issues. Ann Thorac Surg 77: 12001204.[Crossref]
  72. Rebhandl W, Turnbull J, Felberbauer FX, Tasci E, Puig S, Auer H, Paya K, Kluth D, Tasci O, Horcher E, , 1999. Pulmonary echinococcosis (hydatidosis) in children: results of surgical treatment. Pediatr Pulmonol 27: 336340.[Crossref]
  73. Budke CM, Qiu J, Wang Q, Zinsstag J, Torgerson PR, , 2004. Use of disability adjusted life years in the estimation of the disease burden of echinococcosis for a high endemic region of the Tibetan plateau. Am J Trop Med Hyg 71: 5664.

Data & Media loading...

Supplementary Data

Supplementary PDF

  • Received : 16 Nov 2012
  • Accepted : 19 Feb 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error