The issues of prevention, diagnosis, and treatment of echinococcosis in Тajikistan

Abstract

Aim. To assess the morbidity, development of complex strategies of prevention, early diagnosis and treatment of echinococcosis in Tajikistan.
Material and methods. The study covers 213 cases of patients with echinococcosis of abdominal cavity organs operated at surgery departments of Dushanbe City Clinical Hospital of Emergency during 2012-2016.
Following instrumental, serology and histology methods were applied: ultrasound, CT, X-ray, immunoferment analysis of antibodies for Echinococcus. The findings were processed by methods of variation statistics.
Results. High risk of infection was found in 116 (54,4%) cases among dog owners, whose dogs had not received deworming. Of 36, 5% of observed patients 30 (38,4%) had specific antibodies for Echinococcus granulosus found by immunoferment analysis.
Hydatid cyst removal, where cyst stays intact was performed in 24 (11,2%) cases of liver resection, in 9 (4,2%) cases of cysto-pericystectomy and in 4 (1,8%) cases of spleen removal. Post operation complications were found in 21 (9,8%) patients, where mortality made 3,7% of cases.
Conclusion. The increase of echinococcosis is observed in Tajikistan during the period of 2012-2016. In 62,9% of cases, the infection has epidemic features. Radical methods of liver hydatid cyst removal like marginal atypical and typical resection of the liver and total cysto-pericystectomy are effective in terms or disease relapse prevention. Organ-preserving operations like aplatisation of a cyst, subtotal pericystectomy and external drainage of the fibrous cavity are also effective approaches that are not inferior to radical operations. A high percentage of disease relapse (19,2%) shows the necessity of anti-relapse therapy after the operation. Specific therapy in the preoperative and postoperative period in patients with echinococcosis of abdominal cavity decreases relapse of the disease.