Prevalence of cystic echinococcosis in selected pastoral and agro-pastoral districts of Uganda

Abstract

A cross sectional ultrasound screening survey for human cystic echinococcosis (CE) was undertaken in the pastoral dist ricts of Moroto, Napak, Nakapiripirit and Amudat in Karamoja sub-region; and agro-pastoral communities of Teso region, in the districts of Kumi and Bukedea. Other areas of the survey included: Nakasongola in Central region and Kasese district in the Western region of Uganda. A total of 3,636 participants were screened and 67 cases (1.84%) had CE. The organ most affected was the liver 61.2% (41/67), followed by the kidney 17.9% (12/67), spleen 10.44% (7/67), omentum 8.95% 6/67) and lungs 1.5% (1/67). All districts screened had positive cases with the highest prevalence occurring in Napak (3.9%) and the lowest in Nakapiripirit (0.45%). The prevalence of CE (0.5±0.3%) in South Karamoja (Amudat and Nakapiripirit) was significantly lower (P<0.001, χ2= 18.98) than in Central Karamoja (Napak and Moroto, 3.32±1.3%). The prevalence of CE in Teso region was found to be 1.21±0.8%, Kasese 2.15±1.2 % and Nakasongola 2.7±1.3%. The prevalence in south Karamoja was lowest. Overall, there was no significant difference (P<0.05; χ2= 0.12) in prevalence between males (1.7%) and females (1.9%). However, in Karamoja females (2.2% CI: 0.8-3.6) were more likely to be infected (χ2= 16; P<0.05) with CE than males (0.9% CI: 0.1-1.7). Sixty four percent (n=43) of the cysts detected were viable