Two Decades of Living with Echinococcus multilocularis: A Clinical Epidemiology Study on Human Alveolar Echinococcosis in Hungary.

IF 5.3 3区 医学 Q1 INFECTIOUS DISEASES
Eszter Csulak, Damján Pekli, Ágnes Csivincsik, Sibusiso Moloi, Balázs Dezsényi, József Danka, Krisztina Hagymási, Oszkár Hahn, Judit Halász, Norbert Völcsei, Dávid Bárdos, Bálint Kokas, Anna Meltzer, Gábor Nagy, Tamás Sréter, Melinda Kovács, Attila Szijártó, Zsolt Káposztás, Adrienn Biró
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Abstract

Introduction: The zoonotic parasite Echinococcus multilocularis emerged in Hungary in the early 2000s. During the next two decades, it continuously spread in both wildlife and the human population. The first comprehensive epidemiological study on human alveolar echinococcosis (HAE) was carried out in 2018. Then, a remarkable increase in HAE cases was detected in Hungary.

Methods: Our study aimed to identify the potential causes of trend alterations in the epidemiology of HAE. Thus, we compared the terms before (2003-2018) and after (2019-2024) the comprehensive analysis, focusing on disease outcomes and their associated background factors.

Results: We found that, during the latter study period, the prognosis of HAE improved (proportion of improving cases increased from 23.5% to 60.9%, p = 0.0006) owing to the shortening of diagnostic delay (47.1% versus 78.3% of delay within 12 months, p = 0.029), development in surgery (17.6% versus 26.1% of surgeries were R1/R2, p = 0.57) and medication (35.3% versus 73.9% of medications proved adequate, p = 0.015); however, the proportion of advanced-stage cases entering the healthcare system remained high (56.25% versus 56.52%). On the other hand, a non-significant increase in case numbers was experienced in the southwestern part of the country (11.77% versus 26.09% of all cases in Hungary).

Conclusion: We conclude that public interest arose from the first comprehensive HAE study that increased disease awareness within the healthcare system and contributed to better diagnoses and more efficient therapy. However, public awareness needs improvement, since the proportion of advanced-stage HAE did not decrease between the two study periods. Besides, the southwestern hotspot needs more attention and intervention.

与多房棘球蚴共存二十年:匈牙利人肺泡棘球蚴病的临床流行病学研究。
多房棘球绦虫是一种人畜共患寄生虫,于21世纪初在匈牙利出现。在接下来的二十年里,它在野生动物和人类中不断传播。2018年首次开展了人肺泡包虫病(HAE)的综合流行病学研究。然后,在匈牙利发现了HAE病例的显著增加。方法:我们的研究旨在确定HAE流行病学趋势改变的潜在原因。因此,我们比较了2003-2018年前后(2019-2024年)的综合分析,重点关注疾病结局及其相关背景因素。结果:我们发现,在研究后期,由于缩短了诊断延迟(47.1%对78.3%的12个月内延迟,p = 0.029)、手术进展(17.6%对26.1%的手术是R1/R2, p = 0.57)和药物治疗(35.3%对73.9%的药物证明是适当的,p = 0.015), HAE的预后得到改善(改善病例比例从23.5%增加到60.9%,p = 0.0006);然而,进入医疗系统的晚期病例比例仍然很高(56.25%比56.52%)。另一方面,该国西南部的病例数没有显著增加(占匈牙利所有病例的11.77%,占匈牙利所有病例的26.09%)。结论:我们的结论是,首次全面的HAE研究引起了公众的兴趣,该研究提高了医疗系统内的疾病意识,并有助于更好的诊断和更有效的治疗。然而,公众的认识需要提高,因为在两个研究期间,晚期HAE的比例并没有下降。此外,西南热点地区需要更多的关注和干预。
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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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