Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Isaev Institute for Medical Parasitology, Samarkand, Uzbekistan.
Am J Trop Med Hyg. 2021 Dec 13;106(2):724-728. doi: 10.4269/ajtmh.21-0261.
Cystic echinococcosis (CE) is a zoonosis with a cosmopolitan distribution caused by Echinococcus granulosus sensu lato tapeworms. Although Uzbekistan and other countries in Central Asia are considered endemic, estimates of disease burden are lacking. We present data regarding surgically managed cases of CE obtained from Uzbekistan's national disease surveillance registry. These data are from medical centers in Uzbekistan authorized to treat the disease and reported to the Uzbek Center for Sanitation and Epidemiology from the period 2011 to 2018. Information included patient age class (children 14 years or younger versus adults 15 years and older), but no data regarding cyst location. Incidence rates were calculated using data from the national population registry, and the Cuzick nonparametric test for trends was used to test for differences in the incidence over time at the country and regional levels. A total of 7,309 CE cases were reported. Of these, 857 (11.73%) involved pediatric patients. The mean incidence rates were 4.4 per 100,000 population in 2011 and 2.3 per 100,000 population in 2018 (P = 0.016). One region (Republic of Karalpakistan) showed a nonstatistically significant increase (P = 0.824). All other regions except three showed a statistically significant decrease. We present data showing a decrease in the overall incidence of surgically treated CE in Uzbekistan from 2011 to 2018. However, the presence of cases involving children suggests ongoing parasite transmission. The absence of clinical information (starting with cyst stage and localization) needs to be addressed to improve the national surveillance system. Field studies are also needed to further explore the epidemiology of CE in the country.
囊性包虫病 (CE) 是一种具有世界性分布的人畜共患疾病，由细粒棘球绦虫引起。尽管乌兹别克斯坦和中亚其他国家被认为是地方性疾病，但缺乏疾病负担的估计。我们展示了从乌兹别克斯坦国家疾病监测登记处获得的关于手术治疗的 CE 病例的数据。这些数据来自乌兹别克斯坦授权治疗该病的医疗中心，并向乌兹别克斯坦卫生和流行病学中心报告了 2011 年至 2018 年期间的数据。信息包括患者年龄类别（14 岁或以下的儿童与 15 岁及以上的成年人），但没有关于囊肿位置的数据。发病率使用国家人口登记处的数据计算，Cuzick 非参数趋势检验用于检验国家和地区水平随时间的发病率差异。共报告了 7309 例 CE 病例。其中，857 例（11.73%）涉及儿科患者。2011 年的平均发病率为每 100,000 人口 4.4 例，2018 年为每 100,000 人口 2.3 例（P = 0.016）。一个地区（卡拉卡尔帕克斯坦共和国）的发病率呈非显著增加（P = 0.824）。除三个地区外，所有其他地区的发病率均呈显著下降。我们提供的数据显示，2011 年至 2018 年期间，乌兹别克斯坦手术治疗的 CE 总发病率有所下降。然而，儿童病例的存在表明寄生虫仍在传播。需要解决缺乏临床信息（从囊肿阶段和定位开始）的问题，以改善国家监测系统。还需要进行实地研究，以进一步探讨该国的 CE 流行病学。
