Purpose

Human cystic echinococcosis (CE) is a zoonotic parasitic disease that constitutes a public health challenge and a socio-economic burden in endemic areas worldwide. No specific surveillance system of CE infections in humans exists in Lebanon. The incidence and trends over time have not been documented. The current study aimed to assess the demographic and epidemiologic features of human CE surgical cases over a 14-year period in the five main regions of Lebanon.

Methods

From 2005 to 2018, a total of 894 surgically confirmed cases of hydatidosis were recorded from five anatomy and pathology laboratories.

Results

The mean annual surgical incidence was 1.23/100,000 inhabitants. Over the span of these years, the incidence increased from 0.53 to 1.94 cases/100,000 inhabitants in 2005 and 2018, respectively. CE is present in Lebanon with an uneven distribution from one region to the other with higher prevalence in Bekaa (29.0%), a rural area where sheep raising is widespread. Human CE cases were more common in females (60.1%) than in males (39.9%) and a high burden of infection was reported for the age group of 30–39 years. Besides, 66.7% of the cases expressed only liver complications whereas, 20.5% showed predilection towards lungs. The 7.8% of cases presented cysts in other organs, and 1.3% showed multiple localizations. Additionally, predominant involvement of Echinococcus granulosus sensu stricto was recorded in human infections. Comparison of Echinococcus granulosus s.s. populations from different Mediterranean countries also revealed high gene flow among this region and sharing of alleles.

Conclusion

The current study is a step forward to fill the gap of knowledge for the hydatidosis in Lebanon where the lack of epidemiological data and control measures have resulted in higher incidence of human CE.

Graphic Abstract

中文翻译：

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黎巴嫩人类囊性棘球蚴病：回顾性研究和分子流行病学

目的

人类囊性棘球蚴病 (CE) 是一种人畜共患寄生虫病，在全球流行地区构成公共卫生挑战和社会经济负担。黎巴嫩没有针对人类 CE 感染的特定监测系统。随着时间的推移，发病率和趋势尚未被记录。目前的研究旨在评估黎巴嫩五个主要地区 14 年内人类 CE 手术病例的人口统计学和流行病学特征。

方法

从 2005 年到 2018 年，五个解剖学和病理学实验室共记录了 894 例手术确诊的包虫病病例。

结果

平均年手术发生率为 1.23/100,000 居民。在这些年里，2005 年和 2018 年的发病率分别从 0.53 例增加到 1.94 例/100,000 名居民。CE 存在于黎巴嫩，从一个地区到另一个地区分布不均，在贝卡 (29.0%) 的流行率较高，这是一个养羊普遍的农村地区。人类 CE 病例在女性 (60.1%) 中比男性 (39.9%) 更常见，据报道，30-39 岁年龄段的感染负担较高。此外，66.7% 的病例仅表现出肝脏并发症，而 20.5% 的病例表现出好发于肺部。7.8%的病例出现其他器官的囊肿，1.3%的病例出现多发性定位。此外，主要累及细粒棘球绦虫sensu stricto 被记录在人类感染中。来自不同地中海国家的细粒棘球绦虫 ss种群的比较也揭示了该地区之间的高基因流动和等位基因的共享。

结论

目前的研究是填补黎巴嫩包虫病知识空白的一步，黎巴嫩缺乏流行病学数据和控制措施导致人类 CE 的发病率更高。

图形摘要