Hydatidosis in Morocco: review of literature and epidemiology

Hydatidosis or hydatid cyst is a prevalent zoonosis all over the world due to larval forms of the tapeworm of the genus Echinococcus. Echinococcus granulosus is the most frequent form of echinococcal infection in humans. The disease generally results from an oral ingestion of the parasite ova eliminated with feces of dogs leading to the emergence of hydatid cysts.Hydatidosis is a health problem that may remain asymptomatic for several years. This disease is endemic in Morocco and is recorded to be a serious problem that requires great caution

Hydatid disease of the liver

Echinococcus granulosus remains a clinical problem in sheep and subsistence farming communities in South Africa. The most commonly affected organs are the liver and the lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. Clinical examination is unreliable in making the diagnosis. Serological testing has a broad range of sensitivity and specificity and is dependent on the purity of the antigens utilised. Ultrasound examination of the abdomen is both sensitive and cost effective. Computed tomography and endoscopic retrograde cholangiopancreatography (ERCP) are reserved for complicated cases. The differential diagnosis includes any cystic lesion of the liver. Liver hydatid cysts can be treated by medical or minimally invasive (laparoscopic and percutaneous) means or by conventional open surgery. The most effective chemotherapeutic agents against the parasite are the benzimidazole carbamates; albendazole and mebendazole. Albendazole is more efficacious; but recommended treatment regimens differ widely in terms of timing; length of treatment and dose. Medical treatment alone is not an effective and durable treatment option. PAIR (puncture; aspiration; injection; reaspiration) is the newest and most widely practised minimally invasive technique with encouraging results; but it requires considerable expertise. Open surgery remains the most accessible and widely practised method of treatment in South Africa. The options are either radical (pericystectomy and hepatic resection) or conservative (deroofing and management of the residual cavity). Various scolicidal agents are used intraoperatively (Eusol; hypertonic saline and others); although none have been tested in a formal randomised controlled trial. Laparoscopic surgery trials are small and unconvincing at present and should be limited to centres with expertise. Complicated cysts (intrabiliary rupture and secondary infection) may require ERCP to obtain biliary clearance before surgery; and referral to a specialist centre may be indicated

Prevalence of Human Hydatid Disease in Southern Sudan

A total of 3443 people were screened by ultrasound to determine the prevalence of hydatid disease in southern Sudan. Hydatid cysts were found in 16 (0.5) of the people screened. Thirteen of the 16 hydatid cases were from among the Bouya people who showed an overall hydatid prevalence of 2by ultrasound. All ultra-sound positive cases were further confirmed by dot-blot ELISA. At the time of the survey; Chukudum Hospital had five cases with histories and clinical manifestations consistent with hydatidosis. However; on scan examination only three of them were confirmed to be cases of hydatid disease. The proportion of hydatid infected women in south-western Sudan was almost twice that of men (M:F ratio of 1:1.7); with most of those infected being women in the child-bearing age bracket. Dogs are common in this area and they could be the main reservoirs of Echinococcus granulosus in the Sudan. Due to the low prevalence of hydatid in humans in the study area; and the dispersed nature of the population; it is recommended that hydatid control measures for south-western Sudan include an educational component coupled with treatment of the infected people