Cystic echinococcosis in sub-Saharan Africa

• Published in: The Lancet infectious diseases Vol. 12; no. 11; pp. 871 - 880
• Main Authors: Wahlers, Kerstin, MD, Menezes, Colin N, MD, Wong, Michelle L, MD, Zeyhle, Eberhard, Dipl Agr Biol, Ahmed, Mohammed E, Prof, Ocaido, Michael, Prof, Stijnis, Cornelis, MD, Romig, Thomas, PhD, Kern, Peter, MD, Grobusch, Martin P, Prof
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.11.2012; Lancet Publishing Group; Elsevier Limited
• Subjects: Africa South of the Sahara - epidemiology; Animals; Antiparasitic agents; Biological and medical sciences; Diseases caused by cestodes; Echinococcoses; Echinococcosis - epidemiology; Echinococcosis - prevention & control; Echinococcosis - therapy; Echinococcosis - veterinary; Echinococcus granulosus - pathogenicity; Helminthic diseases; Humans; Infectious Disease; Infectious diseases; Medical sciences; Parasites; Parasitic diseases; Prevalence; Sub-Saharan Africa; Africa; Africa South of the Sahara; Infection; Parasitosis; Hydatid cyst; Echinococciasis; Helminthiasis; Cestode disease
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(12)70155-X

Summary Cystic echinococcosis is regarded as endemic in sub-Saharan Africa; however, for most countries only scarce data, if any, exist. For most of the continent, information about burden of disease is not available; neither are data for the animal hosts involved in the lifecycle of the parasite, thus making introduction of preventive measures difficult. Available evidence suggests that several species or strains within the Echinococcus granulosus complex are prevalent in sub-Saharan Africa and that these strains might be associated with varying virulence and host preference. Treatment strategies (chemotherapy, percutaneous radiological techniques, but mainly surgery) predominantly target active disease. Prevention strategies encompass anthelmintic treatment of dogs, slaughter hygiene, surveillance, and health-educational measures. Existing data are suggestive of unusual clinical presentations of cystic echinococcosis in some parts of the continent, for which the causes are speculative.