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Trends in the Surgical Incidence of Cystic Echinococcosis in Uzbekistan from 2011 to 2018

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  • 1 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
  • | 2 Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan;
  • | 3 Texas A&M University, College Station, Texas;
  • | 4 Unit of Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Pavia, Italy;
  • | 5 Unit of Microbiology and Virology, IRCCS San Matteo Hospital Foundation, Pavia, Italy;
  • | 6 Department of Infectious Diseases, San Bortolo Hospital, Vicenza, Italy;
  • | 7 Center of Sanitation and Epidemiology, Well-Being Sanitary of Population, Payarik District Branch, Samarkand, Uzbekistan;
  • | 8 Biometry and biostatistics unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
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ABSTRACT.

Cystic echinococcosis (CE) is a zoonosis with a cosmopolitan distribution caused by Echinococcus granulosus sensu lato tapeworms. Although Uzbekistan and other countries in Central Asia are considered endemic, estimates of disease burden are lacking. We present data regarding surgically managed cases of CE obtained from Uzbekistan’s national disease surveillance registry. These data are from medical centers in Uzbekistan authorized to treat the disease and reported to the Uzbek Center for Sanitation and Epidemiology from the period 2011 to 2018. Information included patient age class (children 14 years or younger versus adults 15 years and older), but no data regarding cyst location. Incidence rates were calculated using data from the national population registry, and the Cuzick nonparametric test for trends was used to test for differences in the incidence over time at the country and regional levels. A total of 7,309 CE cases were reported. Of these, 857 (11.73%) involved pediatric patients. The mean incidence rates were 4.4 per 100,000 population in 2011 and 2.3 per 100,000 population in 2018 (P = 0.016). One region (Republic of Karalpakistan) showed a nonstatistically significant increase (P = 0.824). All other regions except three showed a statistically significant decrease. We present data showing a decrease in the overall incidence of surgically treated CE in Uzbekistan from 2011 to 2018. However, the presence of cases involving children suggests ongoing parasite transmission. The absence of clinical information (starting with cyst stage and localization) needs to be addressed to improve the national surveillance system. Field studies are also needed to further explore the epidemiology of CE in the country.

Author Notes

Address correspondence to Dr. Tommaso Manciulli, University of Pavia, Viale Brambilla 53, 27100 Pavia. E-mail: tommaso.manciulli01@ ateneopv.it

These authors contributed equally to this work.

Financial support: This research was funded by ERANet LAC (grant ELAC2015/T080544 to EB) and the Italian Ministry of Health–NDTND project.

Authors’ addresses: Agnese Colpani, Mara Mariconti, Ambra Vola, Enrico Brunetti, and Tommaso Manciulli, Department of Clinical, Surgical,Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Viale Brambilla 54, Pavia,Italy, E-mails: colpani.agnese@gmail.com, maramariconti@libero.it, ambra.vola@gmail.com, enrico.brunetti@unipv.it, and tommaso.manciulli01@ateneopv.it. Olesya Achilova, Isaev Institute for Medical Parasitology, Isaev street, Samarkand, Uzbekistan, E-mail: aleska-9090@inbox.ru. Gian Luca D’Alessandro, Viale Brambilla 54, Pavia, Italy, E-mail: gianluca.dalessandro01@universitadipavia.it. Christine M. Budke, Texas A&M University, College Station, TX, E-mail: cbudke@cvm.tamu.edu. Timur Muratov and Arzu Mamedov, Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan, E-mails: tim._stein@inbox.ru and madad_sino_313@mail.ru. Maria Teresa Giordani, Department of Infectious Diseases, San Bortolo Hospital, Vicenza, Italy, E-mail: giordanimt@libero.it. Xusan Urukov, Center of Sanitation and Epidemiology, Well-Being Sanitary of Population, Payarik District Branch, Samarkand, Uzbekistan, E-mail: xusan.urukov@inbox.ru. Annalisa De Silvestri, Biometry and Biostatistics Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy, E-mail: a.desilvestri@smatteo.pv.it. Uktam Suvonkulov, Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan, E-mail: isaevins2@yahoo.com.

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