Solomon N, Zeyhle E, Subramanian K, Fields P J, Romig T, Kern P, Carter J Y, Wachira J, Mengiste A, Macpherson C N L
Windward Islands Research and Education Foundation (WINDREF), P.O. Box 7, St. George's, Grenada; St. George's University School of Medicine, P.O. Box 7, St. George's, Grenada.
Meru University of Science and Technology, Mararo Road, Carlton Court, C1, Nairobi, Kenya.
Acta Trop. 2018 Feb;178:182-189. doi: 10.1016/j.actatropica.2017.11.006. Epub 2017 Nov 16.
Cystic echinococcosis (CE), a widespread, complex zoonosis, causes chronic disease associated with high morbidity. The pastoral Turkana people of Kenya have one of the highest prevalence rates of CE in the world. Between 1983 and 2015, a CE control program in the Turkana region used ultrasound (US) screening surveys and surgical outreach visits to evaluate CE prevalence and treat those with the disease. As the gold standard modality for diagnosing CE, US reveals a great deal of information about the disease in affected populations. The aim of this study is to discuss the characteristics of untreated CE in the Turkana people as revealed by US data collected during the CE control program and evaluate disease presentation, factors influencing the risk of transmission, and the timeline of disease progression. Data were obtained from written patient notes from US screenings and images; cysts were classified using the World Health Organization (WHO) standardized US classification of CE. Findings include greater prevalence of cysts, later stages of cysts, and multiple cysts in older age groups, with no multiple cysts occurring in patients under six years of age, which are consistent with the assertion that rates of exposure, transmission, and infection increase with age in endemic regions. Findings also raise questions regarding the timeline of disease progression, and factors potentially influencing disease transmission within this and other endemic populations. A comprehensive survey focusing on cultural and community observations (e.g., changing behaviors, hygienic practices, etc.) may provide more detailed information regarding factors that facilitate transmission.
囊型包虫病（CE）是一种广泛传播的复杂人畜共患病，会引发发病率较高的慢性病。肯尼亚的图尔卡纳牧民是世界上囊型包虫病患病率最高的群体之一。1983年至2015年间，图尔卡纳地区的一项囊型包虫病控制项目采用超声（US）筛查调查和外科外展访视来评估囊型包虫病的患病率并治疗患者。作为诊断囊型包虫病的金标准方法，超声能揭示受影响人群中该疾病的大量信息。本研究的目的是讨论在囊型包虫病控制项目期间收集的超声数据所揭示的图尔卡纳人群中未治疗的囊型包虫病的特征，并评估疾病表现、影响传播风险的因素以及疾病进展的时间线。数据来自超声筛查的书面患者记录和图像；囊肿根据世界卫生组织（WHO）的囊型包虫病超声标准化分类进行分类。研究结果包括囊肿患病率更高、囊肿处于较晚期阶段以及老年人群中存在多个囊肿，而6岁以下患者未出现多个囊肿，这与流行地区暴露、传播和感染率随年龄增长的观点一致。研究结果还引发了关于疾病进展时间线以及可能影响该地区和其他流行人群中疾病传播的因素的问题。一项侧重于文化和社区观察（如行为变化、卫生习惯等）的全面调查可能会提供有关促进传播因素的更详细信息。
