Human Cystic Echinococcosis with Special Reference to India – An Overview - Abstract
Cystic echinococcosis (CE) caused by the cestode parasite Echinococcus granulosus is a significant public health problem in India, evident from widely distributed case reports and hospital based studies. The epidemiological reports are limited and the current prevalence/incidence is difficult to interpret. The prevalent age group reported depends upon the time of acquisition of symptoms rather than the period of actual transmission of infection, which is difficult to determine. The clinical manifestations may appear year’s later following infection and thus the age group preponderance may not be truly interpreted. The gender prevalence varies across different regions, probably attributable to differences in socioeconomic and cultural factors in these regions. The clinical features are variable, depending mainly upon organ involved and mimic many other diseases. Thus, the diagnosis of CE is complex and necessitates the use
of clinical, radiological and immunological techniques. The conventional serodiagnostic techniques using crude specific antigens yield low specificity. The identification of diagnostic antigenic fractions aid in more accurate diagnosis, however, variable specific immunoreactive fractions have been reported from different geographical areas worldwide, which may be due to variations in the strain and source of cyst used for antigen preparation. Surgery is the choice of treatment while for inoperable cases medical treatment is advised. Molecular epidemiology studies have revealed presence of G1, G2, G3, G5 and G6 E.granulosus genotypes in north Indian patients. Intersectoral collaboration of medical, veterinary and agricultural sciences, along with integration of CE control program with other control programs is desired. This may
reduce costs, improve participation and facilitate implementation of the program. Research thrusts to develop effective molecular and immunological methods for early diagnosis, identification of newer drugs with higher efficacy and develop an efficient vaccine for dogs and sheep have been suggested to provide a solid platform for effective control programs.