Pulmonary Hydatid Disease in Iraq

A. J. Imari Department of Medicine, University of Baghdad, Baghdad, Republic of Iraq

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Echinococcosis is highly endemic in Iraq, especially in the central section. In Baghdad the incidence of hydatid disease is 1 in 292 patients admitted to hospital during the last 20 years. Figures from private practice give an infection rate of 1 in 187 patients seen during the last 14 years.

In a survey of slaughtered animals at Risafa abattoir in Baghdad during the period July 1959 to March 1960, hydatid cysts were found in 42% of sheep, 12% of yearling lambs, 22% of cattle, 40% of goats, 50% of buffaloes, and 75% of camels. Echinococcus infection occurs in 18 to 85% of stray dogs in Baghdad.

Cough, with or without hemoptysis, the most common symptom noted in pulmonary hydatid disease, was the chief complaint in 269 of 320 cases. The Casoni test was positive in 86% and the complement-fixation test in 20% of the cases studied. Most useful in diagnosis were the X-ray findings.

Although the success rate in surgical treatment is high, and there is no other satisfactory form of treatment, it is believed that when cysts are small or deeply placed, in view of the surgical difficulties and the high rate of spontaneous cure, they should be left alone.

As practical control measures, emphasis is placed on the importance of establishing licensed abattoirs, and the prohibition of unlicensed slaughtering of animals, along with the destruction of all stray dogs.