Ultrasound-Based Prevalence of Cystic Echinococcosis in the Samarkand Region of Uzbekistan: Results from a Field Survey

Agnese Colpani Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;

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Olesya Achilova Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan;

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Gian Luca D’Alessandro Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;

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Christine Budke Texas A&M University, College Station, Texas;

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Mara Mariconti Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy;

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Timur Muratov Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan;

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Ambra Vola Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy;

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Arzu Mamedov Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan;

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Maria Teresa Giordani Department of Infectious Diseases, San Bortolo Hospital, Vicenza, Italy

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Uktam Suvonkulov Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan;

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Enrico Brunetti Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy;

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Tommaso Manciulli Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy;

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ABSTRACT.

Cystic echinococcosis (CE) is a zoonosis caused by Echinococcus granulosus. Uzbekistan is endemic for CE, but estimates of disease burden are lacking. We present findings from a cross-sectional, ultrasound-based survey evaluating the prevalence of human CE in the Samarkand region, Uzbekistan. The survey was conducted between September and October 2019 in the Payariq district, Samarkand. Study villages were selected based on sheep breeding and reported human CE. Residents aged 5–90 years were invited to receive a free abdominal ultrasound examination. The WHO Informal Working Group on Echinococcosis classification was used for cyst staging. Information regarding CE diagnosis and treatment was collected. Of 2,057 screened subjects, 498 (24.2%) were male. Twelve (0.58%) had detectable abdominal CE cysts. In total, five active/transitional (N = 1 CE1, N = 1 CE2, N = 3 CE3b) and 10 inactive cysts (N = 8 CE4, N = 2 CE5) were identified. Two participants had cystic lesions with no pathognomonic features of CE and were given a 1-month course of albendazole for diagnostic purposes. Twenty-three additional individuals reported previous surgery for CE in the liver (65.2%), lungs (21.6%), spleen (4.4%), liver and lungs (4.4%), and brain (4.4%). Our findings confirm the presence of CE in the Samarkand region, Uzbekistan. Additional studies are needed to assess the burden of human CE in the country. All patients with a history of CE reported surgery, even though most cysts found during the current study were inactive. Therefore, it appears there is a lack of awareness by the local medical community of the currently accepted stage-specific management of CE.

Author Notes

Address correspondence to Tommaso Manciulli, Viale Brambilla, 54, 27100 Pavia, Italy. 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) and the Italian Ministry of Health - NDTND project.

Authors’ addresses: Agnese Colpani and Gian Luca D’Alessandro, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, E-mails: colpani.agnese@gmail.com and gianluca.d’alessandro01@ateneopv.it. Olesya Achilova, Timur Muratov, Arzu Mamedov, and Uktam Suvonkulov, Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan, E-mails: aleska-9090@inbox.ru, aleska-9090@inbox.ru, aleska-9090@inbox.ru, and aleska-9090@inbox.ru. Christine Budke, Texas A&M University, College Station, TX, E-mail: CBudke@cvm.tamu.edu. Mara Mariconti and Ambra Vola, Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy, E-mails: maramariconti@libero.it and ambra.vola@gmail.com. Maria Teresa Giordani, Department of Infectious Diseases, San Bortolo Hospital, Vicenza, Italy, E-mail: giordanimt@libero.it. Enrico Brunetti and Tommaso Manciulli, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and Unit of Infectious Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy. E-mails: enrico.brunetti@unipv.it and tommaso.manciulli01@ateneopv.it.

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