Echinococcosis quística: epidemiología y control en América del Sur / Cystic echinococcosis: epidemiology and control in Sout America

RESUMO

Hydatidosis is a zoonosis produced by a parasite, Echinococcus granulosus, of high prevalence in Argentina, Uruguay, Chile, Peru and the south of Brazil, producing high losses for cattle raising and for health systems. Man acts as a host for the metacestode and is infected when ingesting fertile eggs adhering to the anus or hair of parasitized dogs or by ingestion of vegetables or water polluted with canine feces. Major epidemiological risk factors are to slaughter sheep in the household, to cohabit with a great number of dogs during the first years of life, to have a history of hydatidosis cases in the family nucleus, to use non-potable water and to be in contact with parasitized dogs. It has been estimated that over 2000 new human cases are reported every year inthe region, with rates of incidence ranging from 41 per 100,000 in the Patagonia in region in southern Argentina, 80 per 100,000 in the XI Region of Chile, up to 100 x 100,000 in the Flores Department of Uruguay. Successful programs based on systematic canine deparasitation with praziquantel have been developed in Uruguay, Chile and Argentina, with diverse organization models. Traditionally, cysticechinococcosis has been regarded as a disease requiring surgical resolution. However, during the last years alternative methods have been developed including chemotherapeutic treatment with albendazol and minimally invasive surgical procedures such as echo-assisted puncture (PAIR). The Ministers of Agriculture and Health attending the XII RIMSA approved Resolution RIMSA12.R7 requesting the Pan American Health Organization (PAHO) to strengthen cooperative actions and coordination among countries and their institutions in matters related to hydatidosis control and prevention. In implementing this directive, the PAHO through the Program of Veterinary Public Health and its specialized center, the Pan American Center of Foot-and-Mouth Disease (PANAFTOSA), initiated actions to consolidate efforts carried out throughout the continent for hydatidosis control, establishing the mechanisms of collaboration among countries that have been developing control actions and drawing up a strategy of joint action aimed to strengthen and to support the actions / overall thrust.