RESUMO
INTRODUCTION: Hydatidosis (cystic echinococcosis) is endemic in Rio Negro Province, Argentina. In 1980 started a control program against the disease. In 1984 Frider et al performed the first ultrasound screening in the world at Pilcaniyeu city, later extended to other localities of Rio Negro province. The initial prevalence in asymptomatic people was 7.1% in Pilcaniyeu and 10.1% in Comallo, being all new cases and with surgical indication. OBJECTIVE: The aim of this investigation was to determine the current prevalence and analyze the evolution of the disease across 25 years of the control program. MATERIALS AND METHODS: In 2009 and 2010 ultrasound screening studies were conducted in both locations in all age groups. RESULTS: In 512 ultrasound studies at Pilcaniyeu, the prevalence was 1.5% in children (6 to 14years old) and 4.2% in adults (total 2.5%). In 770 ultrasound studies at Comallo, the prevalence was 1.1 %in children and 6.6% in adults (total 3.0%). The overall reduction in the prevalence reached 67.2%. Regarding the age distribution, rates of 1.6%-1.9% were observed in Pilcaniyeu and of 1.0-1.9% in Comallo between 0 and 30 years old, increasing significantly above 10% after 60 years old in Pilcaniyeu and after 40 years old in Comallo. CONCLUSIONS: The implementation of the program actions reduced the prevalence of the disease but there are still new cases, and that indicates that some bias persists in the control of the epidemiology of the disease and levels of transmission to humans as a consequence of this failures. So the search of asymptomatic cases is still important and also their management based on the follow-up by ultrasound (watch and wait) or in the treatment with albendazol.
Assuntos
Equinococose/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Criança , Pré-Escolar , Equinococose/diagnóstico por imagem , Equinococose/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Ultrassonografia , Adulto JovemRESUMO
INTRODUCTION: Hydatidosis (cystic echinococcosis) is endemic in Río Negro Province, Argentina. In 1980 started a control program against the disease. In 1984 Frider et al performed the first ultrasound screening in the world at Pilcaniyeu city, later extended to other localities of Rio Negro province. The initial prevalence in asymptomatic people was 7.1% in Pilcaniyeu and 10.1% in Comallo, being all new cases and with surgical indication. OBJECTIVE: The aim of this investigation was to determine the current prevalence and analyze the evolution of the disease across 25 years of the control program. MATERIALS AND METHODS: In 2009 and 2010 ultrasound screening studies were conducted in both locations in all age groups. RESULTS: In 512 ultrasound studies at Pilcaniyeu, the prevalence was 1.5% in children (6to 14years old) and 4.2% in adults (total 2.5%). In 770 ultrasound studies at Comallo, the prevalence was 1.1% in children and 66% in adults (total 3.0%). The overall reduction in the prevalence reached 67.2%. Regarding the age distribution, rates of 1.6%-1.9% were observed in Pilcaniyeu and of 1.0-1.9% in Comallo between 0 and 30 years old, increasing significantly above 10% after 60 years old in Pilcaniyeu and after 40years old in Comallo. CONCLUSIONS: The implementation of the program actions reduced the prevalence of the disease but there are still new cases, and that indicates that some bias persists in the control of the epidemiology of the disease and levels of transmission to humans as a consequence of this failures. So the search of asymptomatic cases is still important and also their management based on the follow-up by ultrasound (watch and wait) or in the treatment with albendazol.
Assuntos
Equinococose/diagnóstico por imagem , Equinococose/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Argentina/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Fatores de Tempo , Ultrassonografia , Adulto JovemRESUMO
The usefulness of ultrasonography (US) in the early diagnosis of hydatidosis, applied in large-scale surveys to populations lacking clinical symptoms of the disease, has been amply documented. However, the rate of false positive and negative results is poorly described. Due to this, the present paper is aimed to evaluate the sensitivity, specificity and predictive value of a conventional rural ultrasonographic survey in comparison with higher imaging complexity. Accordingly, during 1997 and 1998 a total of 1054 children from 7 to 14 years of age were evaluated by means of US, in the town of Ingeniero Jacobacci, Province of Rio Negro, Argentina, employing a portable device for population studies. All detected cases were referred to a high complexity center specialized in imaging diagnosis for their re-evaluation with US, CT scanning and X-rays. A control group comprising 3 children negative by US for each positive case in the mass screening survey was selected and reexamined by US and X-rays and CT scanning in doubtful situations. Twenty-seven asymptomatic carriers were referred with images compatible with hydatid cysts, while 66 were classified as disease free. At reexamination, 24 of those diagnosed as carriers and the totality of those classified as healthy were confirmed. On the basis of our results, a sensitivity of 100 percent, a specificity of 95.6 percent and a global test value of 96.7 percent were estimated.