Human Seroprevalence of Echinococcus granulosus in Sulaimani City

In endemic countries such as Iraq, Echinococcus granulosus (E. granulosus) causes cystic echinococcosis (CE), which is an important zoonotic disease, for which information on epidemiology is needed for adequate monitoring and implementation of prevention programs. A cross-sectional study was performed to assess the seroprevalence of human CE, risk factors associated with it, and abdominal ultrasonographic findings in the residents of Sulaimani City in northern Iraq. A total of 454 participants were recruited, and serum samples were tested for anti-E. granulosus IgG antibodies using an enzyme-linked immunosorbent assay (ELISA). Structured questionnaires were used to collect sociodemographic data and possible exposure factors, and to find independent determinants of seropositivity; binary logistic regression was used. Seropositive participants were invited to undergo an abdominal ultrasound (US). Overall, seroprevalence was 13.4% (61/454). Most demographic, occupational, lifestyle, and exposure-related variables had no significant relationship with seropositivity. However, a family history of hydatid illness was found to be independently linked with infection (OR = 2.75, 95% CI: 1.02-7.38; p = 0.045). Six (27.3%) of the 22 seropositive participants who underwent US had abdominal hydatid cysts. The liver was the most often affected organ (50.0%), followed by the kidney (33.3%). Older age, female sex, and past hydatid illness were significant factors associated with cyst detection. The results of this study indicate that CE is a public health problem in Sulaimani City. Household clustering indicates shared environmental exposure, whereas weak correlation with traditional risk variables indicates high environmental exposure. Enhancing One Health initiatives and combining serological screening with imaging have the potential to improve early detection and reduce transmission in endemic areas.