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Human echinococcosis in Bulgaria: a comparative epidemiological analysis
1Department of Infectious Diseases, Parasitology and Epidemiology, Faculty of Medicine, University of Medicine, Sofia, Bulgaria.
Bulletin of the World Health Organization
|March 20, 1999
Summary
Human echinococcosis control in Bulgaria showed success, but reduced efforts led to a resurgence of this public health problem. Sustained control is vital to prevent increased transmission of Echinococcus granulosus.
Area of Science:
- Veterinary Public Health
- Epidemiology
- Parasitology
Background:
- Human echinococcosis poses a significant public health challenge in Bulgaria.
- Echinococcosis was endemic with high infestation rates in animals and dogs from 1950-1962.
Purpose of the Study:
- To evaluate the impact of control measures on human echinococcosis in Bulgaria over 46 years (1950-1995).
- To analyze trends in echinococcosis incidence and endemicity in relation to control campaign activities.
Main Methods:
- Comparative analysis of echinococcosis incidence and endemicity across three distinct periods: 1950-1962, 1971-1982, and 1983-1995.
- Assessment of control measure implementation, funding, and structural integrity over the study duration.
Main Results:
- The incidence of human echinococcosis decreased from 6.5 to 2.0 per 100,000 population during the active control period (1971-1982).
- Reduced funding and dismantling of control structures from 1983-1995 led to a rise in incidence to 3.3 per 100,000 and a return to endemic and hyperendemic states.
- Infestation rates in domestic animals and dogs also mirrored the trends in human incidence.
Conclusions:
- Cessation or reduction of control measures against Echinococcus granulosus can result in intensified transmission and a resurgence of echinococcosis.
- Sustained and comprehensive control programs are essential for managing human echinococcosis as a public health issue.