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Human cystic echinococcosis in Morocco: Ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership.

Abstract：

BACKGROUND:Cystic echinococcosis (CE) is a neglected parasitic zoonosis with considerable socioeconomic impact on affected pastoral communities. CE is endemic throughout the Mediterranean, including Morocco, where the Mid Atlas is the most prevalent area for both human and animal infection. The highest hospital annual incidence of human CE is recorded in the provinces of Ifrane and El Hajeb. However, hospital-based statistics likely underestimate the real prevalence of infection, as a proportion of cases never reach medical attention or official records. METHODOLOGY/PRINCIPAL FINDINGS:In 2012, a project on clinical management of CE in Morocco was launched with the aims of estimating the prevalence of human abdominal CE in selected rural communes of the above mentioned provinces using ultrasound (US) screening and training local physicians to implement US-based focused assessment and rational clinical management of CE according to the WHO-IWGE Expert Consensus. A total of 5367 people received abdominal US during four campaigns in April-May 2014. During the campaigns, 24 local general practitioners received >24 hours of hands-on training and 143 health education sessions were organized for local communities. We found an overall CE prevalence of 1.9%, with significantly higher values in the rural communes of Ifrane than El Hajeb (2.6% vs 1.3%; p<0.001). CE cysts were predominantly in inactive stage, especially in older age groups. However, active cysts were present also in adults, indicating acquisition of infection at all ages. Province of residence was the only risk factor consistently associated with CE infection. CONCLUSIONS/SIGNIFICANCE:Our results show a high prevalence and on-going, likely environmental transmission of CE in the investigated provinces of Morocco, supporting the implementation of control activities in the area by national health authorities and encouraging the acceptance and divulgation of diagnosis and treatment algorithms based on imaging for CE at both national and local level.

journal_name

PLoS Negl Trop Dis

journal_title

PLoS neglected tropical diseases

authors

Chebli H,Laamrani El Idrissi A,Benazzouz M,Lmimouni BE,Nhammi H,Elabandouni M,Youbi M,Afifi R,Tahiri S,Essayd El Feydi A,Settaf A,Tinelli C,De Silvestri A,Bouhout S,Abela-Ridder B,Magnino S,Brunetti E,Filice C,Tamaroz

doi

10.1371/journal.pntd.0005384

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

e0005384

issue

eissn

1935-2727

issn

1935-2735

pii

PNTD-D-16-01338

journal_volume

pub_type

杂志文章

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Human cystic echinococcosis in Morocco: Ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership.