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Table of Contents   
LETTER TO EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 737-738
Upscaling of interventions for the control of Echinococcosis and its associated complications


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

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Date of Web Publication21-Aug-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Upscaling of interventions for the control of Echinococcosis and its associated complications. Ann Trop Med Public Health 2017;10:737-8

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Upscaling of interventions for the control of Echinococcosis and its associated complications. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 15];10:737-8. Available from: http://www.atmph.org/text.asp?2017/10/3/737/188496


Dear Sir,

Human echinococcosis is a zoonotic and a neglected tropical disease caused by species from the genus Echinococcus spp.[1] Though, the disease occurs in four different forms, the cystic and alveolar forms of the disease have the maximum medical and public health importance, owing to their magnitude and worldwide distribution.[2] In fact, the global estimates suggest that in excess of 1 million individuals are suffering from the disease at any one specific time.[1],[2] In addition, the cystic form of the disease has been isolated universally, except in Antarctica; while the alveolar form remains restricted to the Northern hemisphere, with the disease being most common in rural areas where older animals are slaughtered.[1],[2]

The disease has been associated with serious clinical syndromes, which are life threatening if not treated timely; impairment in the quality of life; risk of fatality or relapse despite appropriate interventions; financial burden on the families and the health system, as often extensive surgeries and/or long duration treatment therapy is essential; and loss in livestock production among the involved species.[2],[3]

Ultrasonography remains the diagnostic tool for the cystic and alveolar forms of the disease, while from the treatment perspective, the decision for an appropriate approach (viz., percutaneous approach, surgery, anti-infective therapy, etc.) is made based on the size of the cyst and availability of infrastructure.[2],[3],[4]

However, most of the cases of alveolar type present in advanced stages and often relapse of the condition have been reported due to the absence of complete drug therapy.[1]

For cystic form, surveillance is often not recommended as the infection has no obvious clinical presentation among the infected animal species.[2],[5] In fact, interventions like periodic deworming, better hygiene in slaughter homes, awareness campaigns for the general population, sheep/lamb vaccination, and so on have been found to be quite effective in preventing the transmission and ensuring reduction in the burden of the disease.[1],[2] For alveolar form, the prevention and control strategies are quite complex as the life cycle involves different wild animal species and thus sustainability and cost-benefit effectiveness of measures (like deworming of animals, use of anthelminthic baits, culling, etc.) is debatable.[2],[5]

Acknowledging the burden of the disease, the World Health Organization is aiding nations in the validation of the effective cystic control strategies by the end of the second decade.[1] However, there is a great need to involve various stakeholders like the veterinary and food safety authorities to ensure reduction in the burden of disease and safeguarding the food chain.[1],[2] At the same time, it is essential to ensure capacity building through training health professionals, especially in the rural areas; plan for integration of prevention, control, and treatment options; promote early detection of infection; and expand the option of vaccination.[1],[2],[3],[4]

To conclude, echinococcosis is a major public health concern and it is high time that multisectoral efforts are targeted toward the prevention and control of the disease, especially in low-resource settings.

ACKNOWLEDGEMENT

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Echinococcosis - Fact sheet; 2016. Available from: http://who.int/mediacentre/factsheets/fs377/en/[Accessed 2016 April 14]  Back to cited text no. 1
    
2.
Agudelo Higuita N, Brunetti E, McCloskey C. Cystic Echinococcosis. J Clin Microbiol 2016;54:518-23.  Back to cited text no. 2
    
3.
Bingham GM, Larrieu E, Uchiumi L, Mercapide C, Mujica G, Del Carpio M. The economic impact of cystic echinococcosis in Rio Negro Province, Argentina. Am J Trop Med Hyg 2016;94:615-25.  Back to cited text no. 3
    
4.
El Berbri I, Ducrotoy MJ, Petavy AF, Fassifihri O, Shaw AP, Bouslikhane M. Knowledge, attitudes and practices with regard to the presence, transmission, impact, and control of cystic echinococcosis in Sidi Kacem Province, Morocco. Infect Dis Poverty 2015;4:48.  Back to cited text no. 4
    
5.
Lopez-Bernus A, Belhassen-García M, Alonso-Sardón M, Carpio-Perez A, Velasco-Tirado V, Romero-Alegria Á. Surveillance of Human Echinococcosis in Castilla-Leon (Spain) between 2000-2012. PLoS Negl Trop Dis 2015;9:e0004154.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
3rd floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kanchipuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.188496

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