Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts
Cystic echinococcosis (CE) is a neglected worldwide distributed parasitic disease caused by the <i>Echinococcus</i><i>granulosus</i> <i>sensu lato</i> (<i>s.l.</i>) species complex. For a better understanding of the pathways of transmission of this par...
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MDPI AG
2022-03-01
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| Online Access: | https://www.mdpi.com/2076-0817/11/4/408 |
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| author | Araz Ramadhan Issa Sardar Hassan Arif Ayad Ahmad Mohammed Federica Santolamazza Azzurra Santoro Wijdan Mohammed Salih Mero Adriano Casulli |
| author_facet | Araz Ramadhan Issa Sardar Hassan Arif Ayad Ahmad Mohammed Federica Santolamazza Azzurra Santoro Wijdan Mohammed Salih Mero Adriano Casulli |
| author_sort | Araz Ramadhan Issa |
| collection | DOAJ |
| description | Cystic echinococcosis (CE) is a neglected worldwide distributed parasitic disease caused by the <i>Echinococcus</i><i>granulosus</i> <i>sensu lato</i> (<i>s.l.</i>) species complex. For a better understanding of the pathways of transmission of this parasite, clinical and molecular epidemiological studies are particularly needed from endemic areas where data are scant, such as in the Middle East. The study aimed to identify the characteristics, location, cyst stage and species/genotypes of <i>E.</i> <i>granulosus s.l.</i> complex in humans from the Kurdistan region, Iraq. To this aim, from June 2019 to February 2021, 64 echinococcal cysts were surgically removed from 62 patients in Azadi and Vajeen reference Hospitals at Duhok city, Duhok governorate (Kurdistan region, Iraq). The results confirmed the liver as the most common anatomical site of CE with 72.58% of the cases, followed by the lungs in 19.35%, while 66.13% of CE cases were females. The highest rate of infections occurred in the age class 21–30 (27.42%). High rates of CE were reported among patients living in rural areas and housewives, which were 54.84% and 43.55% of the CE patients, respectively. The fertility of echinococcal cysts was 82.81%, and the viability of fertile protoscoleces was 70.53%. Cysts were staged with ultrasound according to the WHO-IWGE classification as 32.8% CE1, 32.8% CE2, 7.8% CE3a, 9.4% CE3b, 15.6% CE4 and 1.6% CE5. Molecular analyses using mitochondrial NAD5 gene showed that all analyzed samples (<i>n</i> = 59) belonged to the genotypes G1 or G3 of <i>E. granulosus</i><i>sensu stricto</i> (<i>s.s.</i>), thus, confirming sheep–dog–human transmission in the Kurdistan region, Iraq. No statistically significant correlation was found between the genotypes G1–G3 of <i>E. granulosus s.s.</i> and variables, such as the fertility, location and cyst stage classification. Based on the present findings, it is necessary to implement monitoring and control programs in sheep and dog populations to decrease the odds of human infections. Public health education campaigns are required to be implemented at the community level to reduce the risk of acquiring CE in humans in the Kurdistan region, Iraq. |
| first_indexed | 2024-03-09T13:10:57Z |
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| language | English |
| last_indexed | 2024-03-09T13:10:57Z |
| publishDate | 2022-03-01 |
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| spelling | doaj.art-c986c4909b134fe2a2a665b5f329dd432023-11-30T21:42:02ZengMDPI AGPathogens2076-08172022-03-0111440810.3390/pathogens11040408Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of CystsAraz Ramadhan Issa0Sardar Hassan Arif1Ayad Ahmad Mohammed2Federica Santolamazza3Azzurra Santoro4Wijdan Mohammed Salih Mero5Adriano Casulli6Department of Biology, Faculty of Science, University of Zakho, Zakho 42002, Kurdistan Region, IraqDepartment of Surgery, College of Medicine, University of Duhok, Duhok 42001, Kurdistan Region, IraqDepartment of Surgery, College of Medicine, University of Duhok, Duhok 42001, Kurdistan Region, IraqWHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, 00161 Rome, ItalyWHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, 00161 Rome, ItalyDepartment of Biology, Faculty of Science, University of Zakho, Zakho 42002, Kurdistan Region, IraqWHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, 00161 Rome, ItalyCystic echinococcosis (CE) is a neglected worldwide distributed parasitic disease caused by the <i>Echinococcus</i><i>granulosus</i> <i>sensu lato</i> (<i>s.l.</i>) species complex. For a better understanding of the pathways of transmission of this parasite, clinical and molecular epidemiological studies are particularly needed from endemic areas where data are scant, such as in the Middle East. The study aimed to identify the characteristics, location, cyst stage and species/genotypes of <i>E.</i> <i>granulosus s.l.</i> complex in humans from the Kurdistan region, Iraq. To this aim, from June 2019 to February 2021, 64 echinococcal cysts were surgically removed from 62 patients in Azadi and Vajeen reference Hospitals at Duhok city, Duhok governorate (Kurdistan region, Iraq). The results confirmed the liver as the most common anatomical site of CE with 72.58% of the cases, followed by the lungs in 19.35%, while 66.13% of CE cases were females. The highest rate of infections occurred in the age class 21–30 (27.42%). High rates of CE were reported among patients living in rural areas and housewives, which were 54.84% and 43.55% of the CE patients, respectively. The fertility of echinococcal cysts was 82.81%, and the viability of fertile protoscoleces was 70.53%. Cysts were staged with ultrasound according to the WHO-IWGE classification as 32.8% CE1, 32.8% CE2, 7.8% CE3a, 9.4% CE3b, 15.6% CE4 and 1.6% CE5. Molecular analyses using mitochondrial NAD5 gene showed that all analyzed samples (<i>n</i> = 59) belonged to the genotypes G1 or G3 of <i>E. granulosus</i><i>sensu stricto</i> (<i>s.s.</i>), thus, confirming sheep–dog–human transmission in the Kurdistan region, Iraq. No statistically significant correlation was found between the genotypes G1–G3 of <i>E. granulosus s.s.</i> and variables, such as the fertility, location and cyst stage classification. Based on the present findings, it is necessary to implement monitoring and control programs in sheep and dog populations to decrease the odds of human infections. Public health education campaigns are required to be implemented at the community level to reduce the risk of acquiring CE in humans in the Kurdistan region, Iraq.https://www.mdpi.com/2076-0817/11/4/408<i>Echinococcus granulosus</i>G1/G3 genotypeshuman cystic echinococcosisclinical and molecular epidemiologyKurdistan regionIraq |
| spellingShingle | Araz Ramadhan Issa Sardar Hassan Arif Ayad Ahmad Mohammed Federica Santolamazza Azzurra Santoro Wijdan Mohammed Salih Mero Adriano Casulli Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts Pathogens <i>Echinococcus granulosus</i> G1/G3 genotypes human cystic echinococcosis clinical and molecular epidemiology Kurdistan region Iraq |
| title | Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts |
| title_full | Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts |
| title_fullStr | Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts |
| title_full_unstemmed | Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts |
| title_short | Insights into Human Cystic Echinococcosis in the Kurdistan Region, Iraq: Characteristics and Molecular Identification of Cysts |
| title_sort | insights into human cystic echinococcosis in the kurdistan region iraq characteristics and molecular identification of cysts |
| topic | <i>Echinococcus granulosus</i> G1/G3 genotypes human cystic echinococcosis clinical and molecular epidemiology Kurdistan region Iraq |
| url | https://www.mdpi.com/2076-0817/11/4/408 |
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