Human cystic echinococcosis in South Africa

The epidemiology of cystic echinococcosis in South Africa is unknown, but it is likely to be highly underdiagnosed. [Display omitted] ► At least 137 cases of cystic echinococcosis are to be expected in South Africa annually. ► Numbers are likely to be higher due to high proportions of seronegative cases. ► Prevalences appear to be higher in the Eastern Cape and Western Cape provinces. ► Co-infection with HIV may not lead to more cases of disseminated disease. Cystic echinococcosis is recognised as causing considerable morbidity and even mortality in South Africa, but the epidemiology of the disease is to date unknown. From current evidence there are also concerns that co-infections with HIV and tuberculosis (TB) considerably increase CE-associated morbidity. The aim of this analysis was to characterise clinical features and disease burden of CE in South Africa in preparation for a prospective study. Retrospective case note analysis of patients presenting to two large academic hospitals in Johannesburg, South Africa, for clinical and demographic data was performed. In addition, data of the National Health Laboratory Service were accessed for requested serological and microscopic investigations for CE and the numbers of positive results evaluated. According to a recently published definition, 14 cases of confirmed CE and 9 cases of probable CE were identified at both hospitals. When accessing the national database it became apparent that even with the most conservative estimate at least 137 patients per year present with CE in South Africa. However, numbers are likely to be much higher for a variety of reasons. Further prospective analysis is necessary to shed more light on the epidemiology, clinical presentation and risk factors for CE, which is currently underway.