Cystic hydatid disease: aspects of the incidence in man in Kuwait, Arabian Gulf.

Cystic hydatid disease (CHD) is endemic in Kuwait, but the exact extent of the disease in man has yet to be determined. The incidence was calculated by serological testing of sera from patients with a presumptive clinical diagnosis of hydatidosis and follow-up until the final diagnosis was determined. During a one-year period, 123 sera were received from two District General Hospitals serving a population of approximately 500,000. Eighteen patients had confirmed CHD, 17 were serologically positive in two tests, indirect haemagglutination (IHA) and counterimmunoelectrophoresis (CIEP), while another positive patient was identified through surgery and histopathology. These cases represent an estimated incidence rate of 3.6 per 100,000. Various factors, however, indicate that this is an underestimation of the true incidence. The infection rate of camels with hydatid cysts and dogs harbouring the adult worm, a possible measure of the true incidence in man, is considered high. Because of the nature of the population structure, the majority of patients were, in fact, non-Kuwaitis. Kuwaitis, who form 40% of the population, constituted about 30% of the CHD patients. Females were in the majority, the 21 to 50 yr. age-group being the most symptomatic. Hydatid cysts were most commonly present in the liver. Finally, compared to other countries at the time when a control programme was instituted, the incidence rate in Kuwait is moderate to high. However, the number of individuals with CHD does not appear alarming as the available capacity of the medical services is adequate.