Global and Local Burden of Hydatid Disease

Global burden of hydatid disease

1. DEPARTMENT OF COMMUNITY MEDICINE FAISALABAD MEDICAL UNIVERSITY FMU/PMC TOPIC : HYDATID DISEASE NAME : AHSAN ALI AKBAR ROLL NO : 75 BATCH A4

2. INTRODUCTION Hydatid disease is a zoonotic infection caused by the tapeworm of the genus echinococcus , hence the disease is also called human echinococcosis . It is a serious parasitic disease exhibiting various forms, each of which may have different presentation depending on the causative species . It is transmitted between animals and humans

3. SITUATIONAL ANALYSIS Echinococcus granulosus and E. multilocularis throughout the world emphasizes the global nature of the problem and the threat of its spread into those countries currently free from it. It is found everywhere other than Antarctica. The disease is hyperendemic in western China because of poor economic development; limited community knowledge of CHD; widespread, small-scale household animal production; home killing of livestock; and the feeding of dogs with uncooked offal. Hydatid disease is a public health problem in Asia, the Mediterranean, South America and Africa. With immigration, the prevalence of the disease has increased in Europe and North America in recent years The main presenting symptom of the study population was pain in abdomen followed by lump in abdomen whereas the infected sheeps had liver cysts

4. PREVALENCE IN PAKISTAN In a research conducted in Central punjab , it was reported that the prevalence was 7.39% in sheep and 10.69% in buffaloes of Multan . These numbers have significantly fallen from previous values of 9-46% in livestock.

5. SUMMARY OF SITUATIONAL ANALYSIS Hydatid disease is a major endemic health problem in certain regions of the world. The disease is endemic to the developing countries. Due to it’s close association with livestock, it has a high prevalence in pastoral communities. No veterinary supervision promotes the transmission of the parasite . Low socioeconomic status, poor sanitation and overall hygiene further contribute to the spread of this disease. Keeping all this in mind, CE is endemic in less developed or resource limited areas over a large part of the globe.

6. CAUSATIONAL MODEL Hydatid disease is a communicable disease i.e. it is transmitted from animals to humans. Such a disease falls under the epidemiological triad (Infectious disease model ).

7. Infectious agent- Echinococcus Host- Dogs, cattle, humans Enviromment - areas with stray dogs

8. TRANSMISSION CHAIN

9. INTERVENTIONS TO BREAK THE CHAIN Reservoir Route of transmission Host • Screening of pet dogs at regular intervals. • Hygienic methods while handling. •Ensure good hygiene. • Deworming of pets with anthelmintic drugs. • Avoid contact with stray dogs. • Awareness and education about CE. •Keep stray dogs in shelters. • Keep children away from dog feces. • Staying away from dogs. • Protection of live stock • Wash edibles well before use. • Undergo routine check up. • Practicing hygienic slaughtering of livestock . •Washing hands after coming in contact with pet or stray dogs. • Improving self immunity . • To make sure that dogs are kept away from slaughter houses and are not allowed to feed upon carcasses. • Making sure dogs do not feed upon raw meat of animals. • Undertake medicinal support if infection occurs. (Surgery followed by chemotherapy)

10. FEASIBILITY MATRIX Interventions Technical Feasibility Resources Cost effectiveness Equity Gender impact Sustainability •Case finding L L L L N M • Awareness among people H M H H H H • Improving nutritional status L L M L N M • Meat inspection before dispatching H M M H N M • Food authority checks at slaughter houses M M L H N H • Screening of dogs   L L L L N L

11. PREVENTIVE GOALS From a control perspective, the main target of all the interventions that will be undertaken is to control and eliminate the disease. Reduction to zero of the incidences of infection caused by a specific pathogen in a defined geographical area. The passage of people, animals and goods across borders results in spread of zoonotic infections, thus screening be employed at every export step. To pay special attention to endemic areas, especially remote areas with limited resources. There are flaws regarding timely reporting to WHO that is mandated to investigate and respond for global health security. A major limitation in controlling zoonotic infections is the lack of effective collaboration between animal and human sectors. Eradication of disease is rather a difficult target to achieve, thus, currently all interventions are directed towards control and elimination of hydatid disease.

12. PROPOSED INTERVENTIONS Identification of cases. Notification of cases. Timely reporting to health authorities. Periodic screening of dogs. Periodic deworming of dogs. Disposal of infected meat. Public awareness. Vaccination of livestock. Practice good hygiene. Preventing dogs from defecating in public areas. Thorough cleaning of edibles before eating. Inspection of meat .

13. FINAL RECOMENDATIONS Hydatid disease is a potentially grave parasitic and zoonotic disease that is endemic in many regions of the world, particularly in pastoral and sheep raising areas and low resource settings. Strategic approach is directed at attacking the reservoir, interrupting chain of transmission and protecting the host. It includes the interventions like periodic deworming of dogs, vaccination of livestock, identification and notification of infection, prompt reporting to authorities mandated to respond to them, proper disposal of carcasses and preventing dogs from scavenging on carcasses of animals, health awareness and hygienic interventions . Currently, all the endeavors are aimed at eliminating the hydatid disease that is reduction of incidence cases to zero in a defined geographical population.

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