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Prevalence and Risk Factors for Human Cystic Echinococcosis in the Cusco Region of the Peruvian Highlands Diagnosed Using Focused Abdominal Ultrasound

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  • 1 Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
  • | 2 WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.
  • | 3 Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts.
  • | 4 Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru.
  • | 5 Infectious and Tropical Diseases Department, San Bortolo Hospital, Vicenza, Italy.
  • | 6 Hospital Alfredo Callo Rodriguez de Sicuani, Cusco, Peru.
  • | 7 Programa de Control de Enfermedades Zoonoticas, Direccion Regional de Salud Cusco, Cusco, Peru.
  • | 8 Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas.
  • | 9 Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy.
  • | 10 Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts.
  • | 11 Harvard Medical School, Boston, Massachusetts.

Latin America is among the highly endemic regions for cystic echinococcosis (CE). In Peru, an estimated 1,139 disability-adjusted life years are lost annually from surgical treatment of CE. This is comparable with the combined total for Argentina, Brazil, Uruguay, and Chile. The prevalence of human infection has been investigated in the central Peruvian Andes, but there are no community-based screening data from other regions of Peru. We carried out a population survey in January 2015 using abdominal ultrasound to estimate the prevalence of abdominal CE in the Canas and Canchis provinces, in the Cusco region of Peru. Among 1,351 subjects screened, 41 (3%) had CE. There was significant variation between communities with similar socioeconomic features in a small geographical area. A history of CE was reported by 4.1% of the screened subjects, among whom 30.3% still had CE on ultrasound. Among patients reporting previous CE treatment, 14.9% had CE in active stages. Limited education, community of residence, and knowing people with CE in the community were associated with CE. These results demonstrate a significant burden of CE in the region and suggest the need for further investigations, control activities, and optimization of clinical management for CE in this area.

Author Notes

* Address correspondence to Miguel M. Cabada, Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, 301 University Boulevard, Route 0435, Galveston, TX 77550. E-mail: micabada@utmb.edu† These authors contributed equally to this work.

Financial support: This study was funded by the Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru; Zoonotic Diseases Office, Direccion Regional de Salud del Cusco, Cusco, Peru; Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX; and the Department of Medicine, Mount Auburn Hospital, Cambridge, MA.

Authors' addresses: Francesca Tamarozzi, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, and WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy, E-mail: f_tamarozzi@yahoo.com. Amy Hou, Department of Medicine, Mount Auburn Hospital, Cambridge, MA, E-mail: ahou@mah.harvard.edu. Maria Luisa Morales and Karen Mozo, Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru, E-mail: malu.morales.fernandez@gmail.com and karenzit@hotmail.com. Maria Teresa Giordani, Infectious and Tropical Diseases Department, San Bortolo Hospital, Vicenza, Italy, E-mail: giordanimt@gmail.com. Freddy Vilca, Hospital Alfredo Callo Rodriguez de Sicuani, Cusco, Peru. Ruben Bascope, Programa de Control de Enfermedades Zoonoticas, Direccion Regional de Salud Cusco, Cusco, Peru, E-mail: bascopeq@gmail.com. A. Clinton White, Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, E-mail: acwhite@utmb.edu. Enrico Brunetti, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy, and Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy, E-mail: enrico.brunetti@unipv.it. Lin Chen, Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA, and Harvard Medical School, Boston, MA, E-mails: lchen@hms.harvard.edu. Miguel M. Cabada, Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, TX, and Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center in Cusco, Cusco, Peru, E-mail: micabada@utmb.edu.

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