What do we know about the epidemiology and the management of human echinococcosis in Albania?

Abstract

Abstract Echinococcosis is a life-threatening neglected zoonotic disease. Cystic echinococcosis (CE) due to Echinococcus (E.) granulosus usually involves livestock and dogs, alveolar echinococcosis (AE) due to E. multilocularis involves rodents and canines such as foxes and dogs. Humans hosts are infected accidentally via hand to mouth and/or foodborne/waterborne pathways. Albania is deemed to be endemic for cystic echinococcosis (CE) but there is a scarcity of data to confirm this. A systematic literature search was performed in PubMed, Google Scholar and in other medical sources. Because of the scarcity of existing information data confirming CE cases were reviewed from the medical hospital records Albania`s largest Hospital, the Mother Teresa University Hospital (UHCMT) Tirana and from a large private laboratory in Tirana (Pegasus laboratory). Only 8 eligible publications on 540 CE patients were found. Further 347 cases hospitalized in UHCMT from 2011 to 2020, 36 laboratory cases and 10 Albanian cases notified in Germany were confirmed. Taking all cases into account and considering 162 overlapping cases, 771 cases are documented from 2005 to 2020. The only AE case reported was most likely a multi-organic CE. The most frequent therapy approach used was surgery (84.7%). Autochthonous human CE seems to be common and transmission is ongoing in Albanian. CE patients undergo surgery more frequently as compared with CE cases in other European countries. To enable the control of echinococcosis in Albania, obligatory notification should be re-established. In CE, stage specific therapy enables to reduce therapy cost and mortality by avoiding surgical overtreatment.