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1
Pathophys.
1
Phenotypes
2
Medical Actions
14
References
1
Deep Research

Pathophysiology

1
Hepatic cyst formation
Larval cysts commonly develop in the liver.
Show evidence (1 reference)
PMID:27047771 SUPPORT
"Upon infection with CE, cyst formation mainly occurs in the liver (70%)."
The abstract reports predominant liver cyst formation.

Phenotypes

1
Hepatic cysts FREQUENT Hepatic HP:0001407
Show evidence (1 reference)
PMID:27047771 SUPPORT
"Upon infection with CE, cyst formation mainly occurs in the liver (70%)."
The abstract indicates liver cyst formation is common.
💊

Medical Actions

2
Benzimidazole chemotherapy
Action: Pharmacotherapy NCIT:C15986
Benzimidazole carbamates are used as chemotherapy.
Show evidence (1 reference)
PMID:27047771 SUPPORT
"Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration."
The abstract lists benzimidazole chemotherapy among treatments.
Surgical and percutaneous approaches
Action: surgical procedure MAXO:0000004
Surgical approaches including percutaneous aspiration are used.
Show evidence (1 reference)
PMID:27047771 SUPPORT
"Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration."
The abstract lists surgical and percutaneous approaches.
{ }

Source YAML

click to show
name: Cystic echinococcosis
creation_date: '2026-01-26T15:56:41Z'
updated_date: '2026-04-11T01:06:52Z'
category: Infectious Disease
description: >-
  Cystic echinococcosis is a helminthic disease caused by the larval stage of
  Echinococcus granulosus.
disease_term:
  term:
    id: MONDO:0018408
    label: cystic echinococcosis
  preferred_term: Cystic echinococcosis
parents:
- Helminth infection
- Neglected tropical disease
infectious_agent:
- name: Echinococcus granulosus
  infectious_agent_term:
    preferred_term: Echinococcus granulosus
    term:
      id: NCBITaxon:6210
      label: Echinococcus granulosus
  description: Tapeworm whose larval stage causes cystic echinococcosis.
  evidence:
  - reference: PMID:27047771
    reference_title: "Hepatic Echinococcal Cysts: A Review."
    supports: SUPPORT
    snippet: "Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm."
    explanation: The abstract identifies E. granulosus metacestodes as the cause of CE.
transmission:
- name: Dog-associated egg transmission
  description: Tapeworm eggs from dogs and other canids can infect humans.
  evidence:
  - reference: PMID:40944955
    reference_title: "Hydatid Disease."
    supports: SUPPORT
    snippet: "Dogs and other canids harboring gut-resident tapeworms readily transmit the tapeworm eggs (and subsequent formation of larval cysts) to humans in close contact with them."
    explanation: The abstract describes transmission of eggs from dogs and other canids to humans.
pathophysiology:
- name: Hepatic cyst formation
  description: Larval cysts commonly develop in the liver.
  evidence:
  - reference: PMID:27047771
    reference_title: "Hepatic Echinococcal Cysts: A Review."
    supports: SUPPORT
    snippet: "Upon infection with CE, cyst formation mainly occurs in the liver (70%)."
    explanation: The abstract reports predominant liver cyst formation.
phenotypes:
- name: Hepatic cysts
  category: Hepatic
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Hepatic cysts
    term:
      id: HP:0001407
      label: Hepatic cysts
  evidence:
  - reference: PMID:27047771
    reference_title: "Hepatic Echinococcal Cysts: A Review."
    supports: SUPPORT
    snippet: "Upon infection with CE, cyst formation mainly occurs in the liver (70%)."
    explanation: The abstract indicates liver cyst formation is common.
treatments:
- name: Benzimidazole chemotherapy
  description: Benzimidazole carbamates are used as chemotherapy.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
  evidence:
  - reference: PMID:27047771
    reference_title: "Hepatic Echinococcal Cysts: A Review."
    supports: SUPPORT
    snippet: "Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration."
    explanation: The abstract lists benzimidazole chemotherapy among treatments.
- name: Surgical and percutaneous approaches
  description: Surgical approaches including percutaneous aspiration are used.
  treatment_term:
    preferred_term: surgical procedure
    term:
      id: MAXO:0000004
      label: surgical procedure
  evidence:
  - reference: PMID:27047771
    reference_title: "Hepatic Echinococcal Cysts: A Review."
    supports: SUPPORT
    snippet: "Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration."
    explanation: The abstract lists surgical and percutaneous approaches.
references:
- reference: DOI:10.1007/s11259-024-10375-3
  title: Human and camel cystic echinococcosis – a polyclonal antibody-based sandwich ELISA for its serodiagnosis with molecular identification
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence.
    supporting_text: Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence.
    evidence:
    - reference: DOI:10.1007/s11259-024-10375-3
      reference_title: Human and camel cystic echinococcosis – a polyclonal antibody-based sandwich ELISA for its serodiagnosis with molecular identification
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1007/s11686-024-00840-z
  title: Comparison of Methods in the Serologic Diagnosis of Cystic Echinococcosis
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus.
    supporting_text: Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus.
    evidence:
    - reference: DOI:10.1007/s11686-024-00840-z
      reference_title: Comparison of Methods in the Serologic Diagnosis of Cystic Echinococcosis
      supports: SUPPORT
      evidence_source: OTHER
      snippet: Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1007/s44197-025-00429-3
  title: 'Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: 'Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen'
    supporting_text: 'Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen'
- reference: DOI:10.1017/s0031182024001069
  title: 'The burden and distribution of cystic echinococcosis in Bhutan: a retrospective study'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge.
    supporting_text: Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge.
    evidence:
    - reference: DOI:10.1017/s0031182024001069
      reference_title: 'The burden and distribution of cystic echinococcosis in Bhutan: a retrospective study'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1101/2024.09.12.24313559
  title: Clinical management, epidemiology, and recurrence of human cystic echinococcosis in a secondary care level hospital in an endemic area of the Andes in Sicuani, Cusco, Peru
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region.
    supporting_text: Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region.
    evidence:
    - reference: DOI:10.1101/2024.09.12.24313559
      reference_title: Clinical management, epidemiology, and recurrence of human cystic echinococcosis in a secondary care level hospital in an endemic area of the Andes in Sicuani, Cusco, Peru
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1159/000547623
  title: 'The Role of Interventional Radiology for the Treatment of Liver CE and AE Lesions: Current Concepts'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely.
    supporting_text: Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely.
    evidence:
    - reference: DOI:10.1159/000547623
      reference_title: 'The Role of Interventional Radiology for the Treatment of Liver CE and AE Lesions: Current Concepts'
      supports: SUPPORT
      evidence_source: OTHER
      snippet: Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1177/20499361231171478
  title: 'Liver cystic echinococcosis: a parasitic review'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato.
    supporting_text: Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato.
    evidence:
    - reference: DOI:10.1177/20499361231171478
      reference_title: 'Liver cystic echinococcosis: a parasitic review'
      supports: SUPPORT
      evidence_source: OTHER
      snippet: Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1186/s12879-024-09539-y
  title: Follow up study of symptomatic human cystic echinococcosis treatment with albendazole and praziquantel, in Uruguay
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE) is a chronic disease considered a neglected one.
    supporting_text: Cystic echinococcosis (CE) is a chronic disease considered a neglected one.
    evidence:
    - reference: DOI:10.1186/s12879-024-09539-y
      reference_title: Follow up study of symptomatic human cystic echinococcosis treatment with albendazole and praziquantel, in Uruguay
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE) is a chronic disease considered a neglected one.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.1186/s13071-025-06900-1
  title: Design and evaluation of a novel direct hemagglutination test based on a recombinant protein for diagnosis of cystic echinococcosis
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans.
    supporting_text: Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans.
    evidence:
    - reference: DOI:10.1186/s13071-025-06900-1
      reference_title: Design and evaluation of a novel direct hemagglutination test based on a recombinant protein for diagnosis of cystic echinococcosis
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.3329/bjz.v53i1.82673
  title: 'Understanding Echinococcosis: A review of its epidemiological outlook'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: 'Understanding Echinococcosis: A review of its epidemiological outlook'
    supporting_text: Echinococcosis is an ignored silent cyclozoonotic illness in many resource-poor pastoral regions impacting a variety of animal species, such as wildlife and cattle, causes of substantial morbidity and mortality and it also has zoonotic implications.
    evidence:
    - reference: DOI:10.3329/bjz.v53i1.82673
      reference_title: 'Understanding Echinococcosis: A review of its epidemiological outlook'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Echinococcosis is an ignored silent cyclozoonotic illness in many resource-poor pastoral regions impacting a variety of animal species, such as wildlife and cattle, causes of substantial morbidity and mortality and it also has zoonotic implications.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.3390/pathogens13060477
  title: Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms.
    supporting_text: Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms.
    evidence:
    - reference: DOI:10.3390/pathogens13060477
      reference_title: Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.3390/tropicalmed9020036
  title: 'Cystic Echinococcosis in the Early 2020s: A Review'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus.
    supporting_text: Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus.
    evidence:
    - reference: DOI:10.3390/tropicalmed9020036
      reference_title: 'Cystic Echinococcosis in the Early 2020s: A Review'
      supports: SUPPORT
      evidence_source: OTHER
      snippet: Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.3390/tropicalmed9040087
  title: 'Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: 'Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019'
    supporting_text: Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now.
    evidence:
    - reference: DOI:10.3390/tropicalmed9040087
      reference_title: 'Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
- reference: DOI:10.3390/tropicalmed9070163
  title: 'The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia'
  found_in:
  - Cystic_Echinococcosis-deep-research-falcon.md
  findings:
  - statement: Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management.
    supporting_text: Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management.
    evidence:
    - reference: DOI:10.3390/tropicalmed9070163
      reference_title: 'The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management.
      explanation: Deep research cited this publication as relevant literature for Cystic Echinococcosis.
📚

References & Deep Research

References

14
Human and camel cystic echinococcosis – a polyclonal antibody-based sandwich ELISA for its serodiagnosis with molecular identification
1 finding
Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence.
"Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence."
Show evidence (1 reference)
DOI:10.1007/s11259-024-10375-3 SUPPORT Human Clinical
"Cystic echinococcosis (CE) is an emergent neglected disease affecting human and animals in Egypt with a wide distribution and incidence."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Comparison of Methods in the Serologic Diagnosis of Cystic Echinococcosis
1 finding
Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus.
"Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus."
Show evidence (1 reference)
"Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen
1 finding
Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen
"Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana’a, Yemen"
The burden and distribution of cystic echinococcosis in Bhutan: a retrospective study
1 finding
Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge.
"Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge."
Show evidence (1 reference)
DOI:10.1017/s0031182024001069 SUPPORT Human Clinical
"Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Clinical management, epidemiology, and recurrence of human cystic echinococcosis in a secondary care level hospital in an endemic area of the Andes in Sicuani, Cusco, Peru
1 finding
Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region.
"Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region."
Show evidence (1 reference)
DOI:10.1101/2024.09.12.24313559 SUPPORT Human Clinical
"Peru has the highest incidence of human cystic echinococcosis (CE) in South America and most cases are reported in the Central and Southern Peruvian Andes, including the Cusco region."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
The Role of Interventional Radiology for the Treatment of Liver CE and AE Lesions: Current Concepts
1 finding
Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely.
"Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely."
Show evidence (1 reference)
DOI:10.1159/000547623 SUPPORT Other
"Although they are evaluated in the same disease spectrum, the physiopathologies, diagnoses, treatment management strategies, and prognoses of AE and CE differ completely."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Liver cystic echinococcosis: a parasitic review
1 finding
Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato.
"Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato."
Show evidence (1 reference)
"Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Follow up study of symptomatic human cystic echinococcosis treatment with albendazole and praziquantel, in Uruguay
1 finding
Cystic echinococcosis (CE) is a chronic disease considered a neglected one.
"Cystic echinococcosis (CE) is a chronic disease considered a neglected one."
Show evidence (1 reference)
DOI:10.1186/s12879-024-09539-y SUPPORT Human Clinical
"Cystic echinococcosis (CE) is a chronic disease considered a neglected one."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Design and evaluation of a novel direct hemagglutination test based on a recombinant protein for diagnosis of cystic echinococcosis
1 finding
Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans.
"Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans."
Show evidence (1 reference)
DOI:10.1186/s13071-025-06900-1 SUPPORT Human Clinical
"Cystic echinococcosis (CE), one of the most important parasitic diseases, threatens global health for animals and, occasionally, humans."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Understanding Echinococcosis: A review of its epidemiological outlook
1 finding
Understanding Echinococcosis: A review of its epidemiological outlook
"Echinococcosis is an ignored silent cyclozoonotic illness in many resource-poor pastoral regions impacting a variety of animal species, such as wildlife and cattle, causes of substantial morbidity and mortality and it also has zoonotic implications."
Show evidence (1 reference)
DOI:10.3329/bjz.v53i1.82673 SUPPORT Human Clinical
"Echinococcosis is an ignored silent cyclozoonotic illness in many resource-poor pastoral regions impacting a variety of animal species, such as wildlife and cattle, causes of substantial morbidity and mortality and it also has zoonotic implications."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis
1 finding
Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms.
"Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms."
Show evidence (1 reference)
DOI:10.3390/pathogens13060477 SUPPORT Human Clinical
"Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Cystic Echinococcosis in the Early 2020s: A Review
1 finding
Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus.
"Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus."
Show evidence (1 reference)
"Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019
1 finding
Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019
"Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now."
Show evidence (1 reference)
DOI:10.3390/tropicalmed9040087 SUPPORT Human Clinical
"Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.
The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia
1 finding
Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management.
"Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management."
Show evidence (1 reference)
DOI:10.3390/tropicalmed9070163 SUPPORT Human Clinical
"Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management."
Deep research cited this publication as relevant literature for Cystic Echinococcosis.

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1. Disease Information
Edison Scientific Literature 59 citations 2026-04-04T13:50:11.304993

1. Disease Information

1.1 Overview and current understanding

CE is defined as human infection by the larval stage of E. granulosus s.l. producing unilocular, fluid-filled hydatid cysts that most often localize in liver and lungs; cyst rupture can disseminate protoscolices and trigger allergic/anaphylactic reactions. (jahan2025understandingechinococcosisa pages 3-7, akbulut2025hydatiddisease pages 6-8)

1.2 Key identifiers and controlled vocabularies

  • ICD-10: CE was captured using ICD-10 B67.1–B67.9 (within the B67.* echinococcosis block) in Mongolia surveillance work. (bold2024thediagnosticchallenge pages 2-4)
  • WHO-IWGE classification (ultrasound-based): cysts are categorized into active (CE1, CE2), transitional (CE3a, CE3b), and inactive (CE4, CE5) stages, which guide treatment selection. (akbulut2025hydatiddisease pages 8-11)
  • MeSH / MONDO / Orphanet: not explicitly reported in the retrieved full-text evidence and therefore cannot be asserted here without additional targeted retrieval.

1.3 Synonyms and alternative names

  • Hydatid disease / hydatid cyst disease is used interchangeably with CE in recent clinical literature. (akbulut2025hydatiddisease pages 6-8, akbulut2025hydatiddisease pages 11-13)

1.4 Evidence source type

Information in this report is derived from aggregated disease-level resources (reviews, burden analyses) and multiple primary clinical/epidemiologic studies; several surveillance estimates explicitly note under-ascertainment when relying on surgical case series alone. (bold2024thediagnosticchallenge pages 5-7, bold2024thediagnosticchallenge pages 1-2)

2. Etiology

2.1 Disease causal factors

  • Infectious agent: Echinococcus granulosus s.l. (larval stage in humans). (akbulut2025hydatiddisease pages 6-8, jahan2025understandingechinococcosisa pages 3-7)
  • Life cycle context: transmission is maintained between canid definitive hosts (e.g., dogs) and herbivorous intermediate hosts (e.g., sheep/goats/cattle), with humans as accidental intermediate hosts. (jahan2025understandingechinococcosisa pages 3-7, akbulut2025hydatiddisease pages 6-8)

2.2 Risk factors (human)

Evidence from recent reviews and national studies supports the following as key risk factors: - Rural residence and dog ownership (higher exposure probability); drinking commercially sourced water was associated with lower infection risk in pooled evidence summarized in a 2024 review. (hogea2024cysticechinococcosisin pages 6-7) - Practices enabling dog infection and environmental egg contamination: dog access to infected offal and feeding dogs raw offal are repeatedly emphasized as key drivers of transmission; insufficient dog deworming is highlighted as a persistence factor in endemic settings. (jahan2025understandingechinococcosisa pages 7-10, tenzin2024theburdenand pages 2-3) - Bhutan risk context: rural living, dog ownership, feeding dogs, home slaughtering, being a farmer, and unsafe drinking water were identified as relevant risk exposures in Bhutan’s national retrospective assessment. (tenzin2024theburdenand pages 2-3)

2.3 Protective factors

Direct quantitative protective-factor evidence was limited in retrieved sources; however, reduced exposure to infected dogs/offal and improved sanitation are consistently framed as protective measures (see Prevention section). (hogea2024cysticechinococcosisin pages 6-7)

2.4 Gene–environment interactions

No validated human host genetic susceptibility or explicit gene–environment interaction findings were identified in the retrieved evidence.

3. Phenotypes

3.1 Core clinical phenotypes (symptoms/signs/lab)

  • Asymptomatic or nonspecific symptoms for years due to slow cyst growth. (akbulut2025hydatiddisease pages 6-8)
  • Hepatic CE phenotypes: abdominal discomfort/pain, mass effect, cholestatic/biliary complications; rupture can trigger fever/urticaria/eosinophilia/anaphylaxis. (akbulut2025hydatiddisease pages 8-11)
  • Pulmonary CE phenotypes: respiratory symptoms varying by size/location; lung is the second most common organ in population data. (tenzin2024theburdenand pages 1-2)

Suggested HPO terms (non-exhaustive; mapped to typical CE manifestations): - Abdominal pain HP:0002027 - Hepatomegaly HP:0002240 - Liver cysts HP:0001407 - Pulmonary cysts HP:0033149 (or related pulmonary lesion terms depending on ontology version) - Eosinophilia HP:0001880 - Anaphylaxis HP:0100845

Phenotype timing: disease is typically chronic/insidious with prolonged asymptomatic periods. (akbulut2025hydatiddisease pages 6-8)

3.2 Frequency and organ distribution (recent data)

  • Bhutan (2015–2019, n=159): liver 78%, lungs 13%; small fractions in other sites; 4 patients had both liver and lung involvement. (tenzin2024theburdenand pages 1-2, tenzin2024theburdenand pages 4-5)
  • A 2024 review reiterates that hepatic disease is dominant (>70% in many summaries). (hogea2024cysticechinococcosisin pages 6-7)

3.3 Quality-of-life impact

Specific QoL instrument results (e.g., SF-36/EQ-5D) were not present in the retrieved evidence; nevertheless, CE contributes to substantial morbidity and prolonged hospitalization in national series (e.g., >47% hospitalized >4 days in Bhutan). (tenzin2024theburdenand pages 1-2)

4. Genetic/Molecular Information

4.1 Causal genes (human)

Not applicable in the Mendelian sense: CE is not a human genetic disease.

4.2 Parasite genotypes and molecular identification

The retrieved evidence included mention that isolates can be identified as E. granulosus s.l. genotypes via PCR-based methods in research settings, but systematic genotype–phenotype associations in humans were not extracted here. (mehdi2025designandevaluation pages 8-9)

4.3 Host genetic susceptibility / protective variants

No ClinVar/ClinGen/OMIM-style host causal variants were identified in the retrieved evidence.

5. Environmental Information

5.1 Environmental and lifestyle factors

Environmental contamination with parasite eggs is central; exposures are linked to rural pastoral settings, dog ownership, and slaughter/offal-handling practices. (jahan2025understandingechinococcosisa pages 3-7, tenzin2024theburdenand pages 2-3)

5.2 Infectious agent (taxonomy)

  • Agent: Echinococcus granulosus sensu lato (cestode). (akbulut2025hydatiddisease pages 6-8)

6. Mechanism / Pathophysiology

6.1 Causal chain (from trigger to clinical manifestations)

  1. Exposure/entry: ingestion of eggs shed in canid feces. (jahan2025understandingechinococcosisa pages 3-7)
  2. Early development: eggs release oncospheres that penetrate the intestinal wall and disseminate (predominantly to liver via portal circulation; also lungs). (jahan2025understandingechinococcosisa pages 3-7)
  3. Lesion formation: development of slowly enlarging hydatid cysts; growth has been described around ~1–5 cm/year and may be clinically silent for years. (akbulut2025hydatiddisease pages 6-8)
  4. Host response and tissue remodeling: formation of a host-derived pericyst/adventitia and variable immune infiltration; organ dysfunction is mainly from mass effect, biliary/vascular involvement, or complications. (akbulut2025hydatiddisease pages 8-11, petrone2024evaluationofthe pages 1-2)
  5. Complications: rupture can release antigenic material causing urticaria/eosinophilia/anaphylaxis and can seed secondary echinococcosis. (jahan2025understandingechinococcosisa pages 3-7, akbulut2025hydatiddisease pages 8-11)

6.2 Immune system involvement (recent human evidence; 2024)

A 2024 human study analyzing tissue and blood immune responses reported that CE lesions can persist for decades due to immune modulation. In pericyst and adjacent liver tissue, aggregates of CD3+ T cells (predominantly CD4+) and B-cell aggregates were observed; monocytes/granulocytes were rare. Tissue cytokine staining showed scarce Th2 cytokines (IL-4/IL-13) but moderate IFN-γ. In contrast, peripheral whole-blood stimulation with parasite antigen B (AgB) showed increased IL-4 responses in CE patients (p=0.003 in larger cohort confirmation), while IFN-γ responses were similar between cases and controls. (petrone2024evaluationofthe pages 1-2, petrone2024evaluationofthe pages 7-9)

Suggested ontology mappings: - GO biological processes: immune response (GO:0006955); T cell activation (GO:0042110); cytokine-mediated signaling pathway (GO:0019221); response to interferon-gamma (GO:0034341); type 2 immune response (GO:0042092). - Cell Ontology (CL) terms (examples): CD4-positive, alpha-beta T cell (CL:0000624); B cell (CL:0000236); fibroblast (CL:0000057) (for pericyst/adventitia context).

6.3 Molecular profiling / omics

No transcriptomic/proteomic/metabolomic datasets were directly extracted from the retrieved human CE evidence.

7. Anatomical Structures Affected

7.1 Organ-level involvement

  • Primary: liver (dominant), lungs (second). (tenzin2024theburdenand pages 1-2)
  • Other possible sites: wide anatomic range has been described (bone, kidney, spleen, soft tissue, thyroid, breast, adrenal, CNS), though frequencies vary across series; such dissemination supports broad differential consideration in endemic patients. (akbulut2025hydatiddisease pages 6-8)

Suggested UBERON terms (examples): liver (UBERON:0002107), lung (UBERON:0002048), spleen (UBERON:0002106).

7.2 Tissue/cell level

  • Host-derived pericyst/adventitia and surrounding parenchyma are key sites of immune infiltration, dominated by CD4+ lymphocytes in examined hepatic cases. (petrone2024evaluationofthe pages 1-2)

7.3 Subcellular localization

Not directly addressed in retrieved evidence.

8. Temporal Development

8.1 Onset and course

  • Typically chronic and insidious with long asymptomatic phases. (akbulut2025hydatiddisease pages 6-8)
  • Cyst growth over years contributes to delayed diagnosis and late-stage complications in many endemic settings. (akbulut2025hydatiddisease pages 6-8)

8.2 Progression and staging

  • WHO-IWGE staging divides cysts into active, transitional, and inactive categories that correspond to viability/activity and guide treatment. (akbulut2025hydatiddisease pages 8-11)

9. Inheritance and Population

9.1 Epidemiology and burden (recent quantitative data)

Key recent burden statistics include: - GBD 2019 analysis (published 2024): global ASIR changed from 2.65/100,000 (1990) to 2.60/100,000 (2019) with EAPC −0.18%; deaths and DALYs declined overall 1990–2019, but projections suggest ASIR declines while ASMR and age-standardized DALY rates may rise 2020–2030. (tian2024globalregionaland pages 1-2) - GBD 2021 figures cited in a 2025 textbook chapter: 148,521 new cases, 633,404 prevalent cases, 1,364 deaths, 105,072 DALYs with age-standardized incidence 1.82/100,000 and prevalence 7.69/100,000. (akbulut2025hydatiddisease pages 6-8) - Bhutan national retrospective burden (published 2024; 2015–2019): average annual incidence 4.4/100,000; estimated ~39 DALYs/year for treatment-seeking cases and possibly ~80 DALYs/year including non-treatment-seeking cases; liver 78%, lungs 13%. (tenzin2024theburdenand pages 1-2) - Mongolia underreporting (published 2024): predicted diagnosed burden 15.9/100,000 vs surgical-case prevalence 2.2/100,000 (i.e., surgical cases represent ~one-eighth of diagnosed burden). (bold2024thediagnosticchallenge pages 5-7, bold2024thediagnosticchallenge pages 1-2) - Population ultrasound screening synthesis (2024 review): pooled sample 130,093, 2,077 CE cases, with mean prevalence around 0.0160 (95% CI 0.0153–0.0166) in collated studies. (hogea2024cysticechinococcosisin pages 6-7)

9.2 Demographics

  • Bhutan data show higher incidence among females vs males (6.11 vs 2.79 per 100,000; p<0.001) and concentration among farmers. (tenzin2024theburdenand pages 3-3)

9.3 Genetic inheritance

Not applicable.

10. Diagnostics

10.1 Imaging

  • Ultrasound: primary modality for abdominal CE and the basis of WHO-IWGE staging. (akbulut2025hydatiddisease pages 8-11)
  • CT/MRI/MRCP/ERCP: CT useful for calcification/anatomy; MRI for soft tissue; MRCP/ERCP for biliary involvement. (akbulut2025hydatiddisease pages 8-11)
  • PET/CT: may correlate with serology and help guide benzimidazole duration in selected settings. (akbulut2025hydatiddisease pages 11-13)

10.2 Serology (recent comparative performance)

A 2024 head-to-head evaluation in 74 suspected CE sera reported: - ELISA: sensitivity 85.42%, specificity 88.46%. - IFA: sensitivity 83.33%, specificity 88.46%. - Fumouze IHA: sensitivity 70.83%, specificity 96.15%. - Siemens IHA: sensitivity 66.67%, specificity reported ~92.31% in the study summary. - Western blot: sensitivity 72.92%, specificity 88.46%. These findings support combining tests and interpreting serology alongside imaging due to false negatives/positives. (erganis2024comparisonofmethods pages 4-6)

In Mongolia’s underreporting analysis, practical diagnostic constraints were emphasized; RDTs for active cysts were reported with sensitivity 74% and specificity 96%, contrasted with ELISA 69% sensitivity / 96% specificity in that local context. (bold2024thediagnosticchallenge pages 7-8)

10.3 Molecular diagnostics (recent developments)

Emerging molecular diagnostics include: - Multiplex qPCR (QPCR-Echino): ongoing diagnostic clinical study aims to assess sensitivity of Echinococcus DNA detection in operating specimens/biopsies/puncture fluids and plasma (NCT05824442; start 2023-10-24). (NCT05824442 chunk 1) - ddPCR for circulating cfDNA: exploratory interventional study evaluating ddPCR sensitivity for plasma E. granulosus s.l. cfDNA detection in untreated hepatic CE, with sensitivity stratified by cyst stage (NCT05769790; start 2022-03-21; primary completion estimated 2024-03). (NCT05769790 chunk 1)

10.4 Differential diagnosis

Detailed differential diagnosis lists were not available in the retrieved evidence; in practice, staging-compatible imaging patterns plus serology/molecular confirmation are used to distinguish CE from non-parasitic cysts and other hepatic/pulmonary lesions.

11. Outcome / Prognosis

11.1 Mortality and recurrence

  • A 2024 GBD-linked review reports post-surgical mortality about 2.2% and postoperative recurrence about 6.5% in summarized literature. (tian2024globalregionaland pages 1-2)
  • In a hospital series from an endemic area of Peru (2010–2019), post-surgical recurrence was reported as 16.5% at median 32.3 months in a setting with advanced/complicated disease and incomplete staging-guided management. (akbulut2025hydatiddisease pages 8-11)

11.2 Burden and hospitalization

In Bhutan, >47% of patients were hospitalized for >4 days, and most were treated surgically (>82%). (tenzin2024theburdenand pages 1-2)

12. Treatment

12.1 Stage-based treatment concepts (WHO-IWGE)

  • CE4–CE5 (inactive): typically watch-and-wait (observation). (akhan2025theroleof pages 2-4, akbulut2025hydatiddisease pages 8-11)
  • CE1, CE3a: percutaneous techniques such as PAIR or standard catheterization are recommended options; albendazole is used peri-procedurally. (akhan2025theroleof pages 2-4)
  • CE2, CE3b: modified catheterization (Mo-CAT) is highlighted as effective for multivesicular/daughter-cyst-rich lesions. (akhan2025theroleof pages 6-8)

12.2 Pharmacotherapy

  • Albendazole (ABZ): first-line benzimidazole, typically 10–15 mg/kg/day with fatty meal; duration varies and lacks global consensus. (akbulut2025hydatiddisease pages 11-13)
  • Real-world outcome (Uruguay, 2024): among 36 adults completing 5-year follow-up, ABZ-only achieved 93.75% success; ABZ+PZQ achieved 100% success in 4 patients; no deaths occurred. (rosa2024followupstudy pages 1-2)

Suggested MAXO terms (examples): albendazole therapy (MAXO term for antiparasitic drug therapy), praziquantel therapy.

12.3 Interventional radiology (real-world implementation)

A 2025 interventional radiology review emphasizes stage-specific percutaneous management: - CE1/CE3a: PAIR or catheterization; reported success up to 96% and recurrence as low as 4% overall. A meta-analysis cited found percutaneous therapy vs surgery for CE1/CE3a had lower mortality (0.1% vs 0.7%), fewer major complications (7.9% vs 25.1%), fewer minor complications (13.1% vs 33%), lower recurrence (1.6% vs 6.3%), and shorter hospital stay (2.4 vs 15 days). (akhan2025theroleof pages 6-8) - CE2/CE3b: Mo-CAT long-term series (132 cysts) reported 0 mortality, major complications 10%, recurrence 4.5%, mean hospital stay 3.8 days, mean follow-up 52 months. (akhan2025theroleof pages 6-8) A table summarizing stage-specific recurrence bands (<5% for CE1/CE3a; <5–7% for CE2/CE3b) is available in the cited review. (akhan2025theroleof media 3452c1f5)

12.4 Surgery

Surgery remains necessary for complicated disease (e.g., rupture into peritoneal/pleural cavities, complex biliary communication, infected cysts, or when percutaneous resources are unavailable). (akhan2025theroleof pages 2-4)

12.5 Ongoing/recent clinical trials (selected)

  • Adjuvant ABZ after pulmonary hydatid resection: randomized trial ABZ vs placebo; primary endpoint recurrence at 6 months; start 2024-02-01 (NCT06483880). (NCT06483880 chunk 1)
  • Laparoscopic vs open liver surgery: randomized non-inferiority trial, n=350, recurrence endpoint at 24 months (NCT01643018). (NCT01643018 chunk 1)
  • Molecular diagnostics trials: multiplex qPCR (NCT05824442) and ddPCR cfDNA (NCT05769790) as described above. (NCT05824442 chunk 1, NCT05769790 chunk 1)

13. Prevention

13.1 Primary prevention (One Health)

A 2024 review synthesizing prevention measures emphasizes: - Preventing canid access to infected offal. - Controlling stray dogs and discouraging home slaughter. - Regular deworming of dogs with praziquantel. - Improved sanitation and public education to reduce fecal–oral exposure. - Sheep vaccination is described as used in Argentina and China (recombinant vaccine) as part of control strategies. (hogea2024cysticechinococcosisin pages 6-7)

13.2 Secondary prevention (screening/early detection)

Ultrasound-based population screening is used in endemic programs and can detect early-stage hepatic cysts; this is also relevant for burden estimation given long asymptomatic periods. (hogea2024cysticechinococcosisin pages 6-7)

13.3 Tertiary prevention

Long-term follow-up after treatment is emphasized; for example, pharmacologically treated cohorts were followed for ≥5 years under WHO-IWGE guidance in Uruguay, and percutaneous therapy reviews advocate long-term monitoring (≥10 years). (rosa2024followupstudy pages 1-2, akhan2025theroleof pages 4-6)

14. Other species / Natural disease

14.1 Species affected and zoonotic cycle

  • Definitive hosts: canids (not exhaustively enumerated in retrieved evidence).
  • Intermediate hosts: livestock such as sheep/goats/cattle; other domestic animals implicated in some settings.
  • Humans: accidental intermediate hosts. Transmission is driven by egg shedding in canid feces and ingestion by intermediate hosts; dog infection is reinforced by consumption of infected viscera/offal. (jahan2025understandingechinococcosisa pages 3-7, tenzin2024theburdenand pages 2-3)

14.2 Veterinary relevance

CE is a One Health problem affecting humans, livestock production, and the food chain; economic burden estimates include treatment and livestock losses. (hogea2024cysticechinococcosisin pages 6-7)

15. Model organisms

Specific laboratory model organism systems for CE pathogenesis and therapy testing were not directly described in the retrieved evidence. The literature does reference experimental and animal-model immunology observations (e.g., sheep tissue regulatory cytokines), but detailed model cataloging (mouse strains, in vitro systems, etc.) was not available in the extracted full texts. (petrone2024evaluationofthe pages 2-3)

Recent developments and expert analysis (2023–2024 prioritized)

  1. Burden quantification and forecasting: A 2024 GBD 2019-based analysis provides updated global incidence trends and projections to 2030, highlighting persistent burden in low-SDI regions and among women/older adults. (tian2024globalregionaland pages 1-2)
  2. Surveillance and underreporting: A 2024 Mongolia analysis shows surgical-case reporting captures only ~1/8 of diagnosed burden and identifies operational weaknesses (laboratory capacity, reporting workflows, insufficient albendazole supply, limited percutaneous availability). This supports expert consensus that CE burden is often underestimated. (bold2024thediagnosticchallenge pages 5-7, bold2024thediagnosticchallenge pages 7-8)
  3. Human immunopathology: A 2024 study comparing local tissue vs peripheral immune responses indicates discordant local (Th1-leaning/low Th2) vs peripheral (AgB-specific IL-4) signatures and emphasizes the adventitia/pericyst as an immunopathogenic interface. (petrone2024evaluationofthe pages 7-9)
  4. Treatment effectiveness of percutaneous interventions: Stage-stratified percutaneous outcomes compiled in 2025 (with cited meta-analysis) show lower recurrence, complications, and hospital stay compared with surgery in selected CE1/CE3a cysts, and strong Mo-CAT outcomes for CE2/CE3b—supporting ongoing practice shift toward minimally invasive management when expertise is available. (akhan2025theroleof pages 6-8)

Evidence excerpts (abstract-quotable statements)

  • Mongolia underreporting estimate: “the prevalence could be approximately 16 cases per 100,000 people, which is eight times higher than the number of reported surgical cases.” (bold2024thediagnosticchallenge pages 7-8)
  • Bhutan incidence and burden: average annual incidence 4.4 per 100,000 and estimated ~39 DALYs/year (treatment-seeking), ~80 DALYs/year including non-treatment-seeking. (tenzin2024theburdenand pages 1-2)

Summary artifacts

The following structured tables are provided for knowledge-base ingestion.

Category Item Details Study/Source Setting Years Quantitative metrics Publication year URL Evidence
Identifier / classification ICD-10 Echinococcosis is classified under ICD-10 code block B67.; Mongolia study used B67.1–B67.9* for case capture Bold et al. Mongolia hospital reporting / surveillance methods 2006–2016 case capture; published 2024 ICD-10 range B67.1–B67.9 used to identify CE records 2024 https://doi.org/10.3390/tropicalmed9070163 (bold2024thediagnosticchallenge pages 2-4)
Identifier / classification Disease name / synonym Cystic echinococcosis (CE); related common name hydatid disease / hydatid cyst disease Akbulut; Govindasamy et al. General disease overview Published 2023–2025 CE described as hydatid disease caused by larval Echinococcus 2025; 2023 https://doi.org/10.1007/978-3-031-97277-5; https://doi.org/10.1177/20499361231171478 (akbulut2025hydatiddisease pages 6-8, akbulut2025hydatiddisease pages 11-13)
Identifier / classification Causative agent Echinococcus granulosus sensu lato (larval/metacestode stage in humans) Akbulut; Jahan et al. General disease overview Published 2025 Humans are accidental intermediate hosts infected by eggs from canid feces 2025 https://doi.org/10.1007/978-3-031-97277-5; https://doi.org/10.3329/bjz.v53i1.82673 (akbulut2025hydatiddisease pages 6-8, jahan2025understandingechinococcosisa pages 3-7)
Identifier / classification MeSH / controlled vocabulary related term Closely aligned controlled-vocabulary term used in literature: Echinococcosis / Hydatid Disease; exact MeSH identifier not extracted in retrieved evidence Recent reviews/books General Published 2023–2025 Controlled-vocabulary style naming consistent across sources, but MeSH ID not directly reported in retrieved context 2023–2025 https://doi.org/10.3390/tropicalmed9020036; https://doi.org/10.1177/20499361231171478 (hogea2024cysticechinococcosisin pages 16-17, akbulut2025hydatiddisease pages 11-13)
Classification WHO-IWGE cyst stage groups Active: CE1, CE2; Transitional: CE3a, CE3b; Inactive: CE4, CE5 Akbulut General clinical classification Published 2025 WHO-IWGE stage grouping guides treatment selection 2025 https://doi.org/10.1007/978-3-031-97277-5 (akbulut2025hydatiddisease pages 8-11)
Epidemiology / burden Global burden (GBD 2019) Human CE burden remained high globally with only slight ASIR decline Tian et al. Global 1990–2019 ASIR 2.65/100,000 (1990) to 2.60/100,000 (2019); EAPC −0.18%; deaths, DALYs, ASMR declined overall; projected ASIR decline but ASMR and age-standardized DALY rise through 2030 2024 https://doi.org/10.3390/tropicalmed9040087 (tian2024globalregionaland pages 1-2)
Epidemiology / burden Global burden (GBD 2021 figures cited in book excerpt) Updated global CE burden from GBD 2021 Akbulut Global 2021 148,521 new cases, 633,404 prevalent cases, 1,364 deaths, 105,072 DALYs; age-standardized incidence 1.82/100,000 and prevalence 7.69/100,000 2025 https://doi.org/10.1007/978-3-031-97277-5 (akbulut2025hydatiddisease pages 6-8, akbulut2025hydatiddisease pages 8-11)
Epidemiology / burden Global pooled ultrasound prevalence Population-based ultrasound data compiled across continents Hogea et al. Multi-continent pooled survey data Not uniform; review published 2024 130,093 individuals screened; 2,077 CE patients; mean prevalence ~0.0160 (95% CI 0.0153–0.0166) 2024 https://doi.org/10.3390/tropicalmed9020036 (hogea2024cysticechinococcosisin pages 6-7)
Epidemiology / burden Bhutan national retrospective study First burden/distribution estimate from hospital data Tenzin et al. Bhutan 2015–2019 159 cases; average annual incidence 4.4/100,000; estimated burden ~39 DALYs/year for treatment-seeking cases and ~80 DALYs/year including non-treatment-seeking cases; liver 78%, lungs 13% 2024 https://doi.org/10.1017/s0031182024001069 (tenzin2024theburdenand pages 1-2)
Epidemiology / burden Bhutan demographic/risk pattern Higher incidence in women and farmers; central/western districts most affected Tenzin et al. Bhutan 2015–2019 Female incidence 6.11/100,000 vs male 2.79/100,000; majority farmers; >82% surgical treatment 2024 https://doi.org/10.1017/s0031182024001069 (tenzin2024theburdenand pages 3-3, tenzin2024theburdenand pages 4-5)
Epidemiology / burden Mongolia underreporting estimate Surgical reporting captures only a fraction of diagnosed CE Bold et al. Mongolia Surgical data 2006–2016; extrapolated prevalence for 2018 / diagnosed burden Predicted diagnosed burden 15.9/100,000 vs surgical 2.2/100,000; non-surgical 13.6/100,000; surgical cases represent about one-eighth of diagnosed cases 2024 https://doi.org/10.3390/tropicalmed9070163 (bold2024thediagnosticchallenge pages 5-7, bold2024thediagnosticchallenge pages 1-2)
Epidemiology / burden Mongolia management gaps Underreporting linked to weak reporting and low staging use Bold et al. Mongolia Published 2024 Cyst classification usage and disease monitoring scored 1.86–1.95; ultrasound availability relatively strong (3.60–3.97) 2024 https://doi.org/10.3390/tropicalmed9070163 (bold2024thediagnosticchallenge pages 7-8, bold2024thediagnosticchallenge pages 5-7)
Epidemiology / burden Endemic community burden In highly exposed rural communities CE incidence/prevalence can be much higher than global averages Jahan et al.; Tian et al. Endemic rural hotspots globally Various; published 2024–2025 Incidence may range from <1 to >200/100,000 in highly exposed rural communities; hotspot prevalence may reach 5–10% 2025; 2024 https://doi.org/10.3329/bjz.v53i1.82673; https://doi.org/10.3390/tropicalmed9040087 (jahan2025understandingechinococcosisa pages 3-7, tian2024globalregionaland pages 1-2)

Table: This table compiles key disease identifiers, terminology, classification, and recent epidemiology/burden estimates for cystic echinococcosis. It is useful as a quick reference for mapping the disease concept and anchoring a knowledge-base entry with current quantitative data.

Domain Modality / strategy WHO-IWGE stage / indication When used Key performance / outcomes Source (year) URL Evidence
Diagnosis Ultrasound (US) All suspected abdominal/hepatic CE; staging into CE1–CE5 First-line imaging; classification and treatment planning Primary imaging modality for CE; pooled population screening review compiled 130,093 screened individuals with 2,077 CE cases; WHO-IWGE staging used for management decisions rather than a single sensitivity estimate (hogea2024cysticechinococcosisin pages 6-7, akbulut2025hydatiddisease pages 8-11) Hogea et al. 2024; Akbulut 2025 https://doi.org/10.3390/tropicalmed9020036 ; https://doi.org/10.1007/978-3-031-97277-5 (hogea2024cysticechinococcosisin pages 6-7, akbulut2025hydatiddisease pages 8-11)
Diagnosis CT Complex hepatic CE; calcified cysts; preoperative mapping; complications Second-line / complementary imaging Useful for calcified walls (especially CE5), anatomy, and complications; Yemen retrospective CT series found CE1 38.56% and CE3 34.02% among 1,669 cysts, with mass effect 38%, intrabiliary rupture 4%, intraperitoneal rupture 1.4% (akbulut2025hydatiddisease pages 8-11) Akbulut 2025; Al-Shehari et al. 2025 https://doi.org/10.1007/978-3-031-97277-5 ; https://doi.org/10.1007/s44197-025-00429-3 (akbulut2025hydatiddisease pages 8-11)
Diagnosis MRI / MRCP Soft-tissue definition; biliary tree involvement Complementary imaging when US/CT insufficient Superior soft-tissue characterization; MRCP/ERCP useful for biliary communication assessment (akbulut2025hydatiddisease pages 8-11) Akbulut 2025 https://doi.org/10.1007/978-3-031-97277-5 (akbulut2025hydatiddisease pages 8-11)
Diagnosis PET/CT Selected cases to assess lesion activity / treatment follow-up Specialized follow-up, especially activity assessment PET/CT metabolic activity correlates with serology and may help guide benzimidazole duration; negative PET/CT plus low serology may support stopping therapy (akbulut2025hydatiddisease pages 11-13) Akbulut 2025 https://doi.org/10.1007/978-3-031-97277-5 (akbulut2025hydatiddisease pages 11-13)
Diagnosis ELISA (IgG) serology Adjunct across stages; best interpreted with imaging Supportive diagnosis, especially liver CE; screening/confirmation workflows In comparative study of 74 sera: positivity 58.1% (43/74); sensitivity 85.42%; specificity 88.46%. Highest sensitivity among compared assays in that study (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 1-2) Erganis et al. 2024 https://doi.org/10.1007/s11686-024-00840-z (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 1-2)
Diagnosis Indirect fluorescent antibody (IFA) Adjunct serology Alternative serology / confirmatory combination Positivity 56.7% (42/74); sensitivity 83.33%; specificity 88.46% (erganis2024comparisonofmethods pages 4-6) Erganis et al. 2024 https://doi.org/10.1007/s11686-024-00840-z (erganis2024comparisonofmethods pages 4-6)
Diagnosis Indirect hemagglutination assay (IHA) – Fumouze Adjunct serology Practical routine serology Positivity 47.3% (35/74); sensitivity 70.83%; specificity 96.15%; highest specificity in the comparison study (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 1-2) Erganis et al. 2024 https://doi.org/10.1007/s11686-024-00840-z (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 1-2)
Diagnosis Indirect hemagglutination assay (IHA) – Siemens Adjunct serology Practical routine serology Positivity 44.6% (33/74); sensitivity 66.67%; specificity reported inconsistently in excerpts, likely ~92.31% in full study; lower sensitivity than ELISA/IFA (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 6-8) Erganis et al. 2024 https://doi.org/10.1007/s11686-024-00840-z (erganis2024comparisonofmethods pages 4-6, erganis2024comparisonofmethods pages 6-8)
Diagnosis Western blot (WB) Confirmatory serology Confirmation of equivocal serology / species banding Positivity 51.3% (38/74); sensitivity 72.92%; specificity 88.46%; near-100% specificity is cited in review/book context for confirmatory use, but head-to-head study showed lower real-world specificity (erganis2024comparisonofmethods pages 4-6, akbulut2025hydatiddisease pages 11-13) Erganis et al. 2024; Akbulut 2025 https://doi.org/10.1007/s11686-024-00840-z ; https://doi.org/10.1007/978-3-031-97277-5 (erganis2024comparisonofmethods pages 4-6, akbulut2025hydatiddisease pages 11-13)
Diagnosis Rapid diagnostic test (RDT) for active cysts Active cysts, especially field/rural use Point-of-care option where access is limited Mongolia review context reported sensitivity 74% and specificity 96% for active cyst RDTs; contrasted with ELISA 69% sensitivity / 96% specificity in the cited local context (bold2024thediagnosticchallenge pages 7-8) Bold et al. 2024 https://doi.org/10.3390/tropicalmed9070163 (bold2024thediagnosticchallenge pages 7-8)
Diagnosis Sandwich ELISA for circulating antigen Investigational / research-supported serodiagnosis Serum antigen detection Human sensitivity 98.25% (56/57) and specificity 100% in a human/camel study; requires further external validation before routine adoption (mehdi2025designandevaluation pages 8-9) Maher et al. 2024 https://doi.org/10.1007/s11259-024-10375-3 (mehdi2025designandevaluation pages 8-9)
Diagnosis Multiplex quantitative PCR (QPCR-Echino) Confirmed CE/AE; tissue, puncture fluid, plasma Investigational molecular diagnosis Prospective diagnostic study, enrollment 43; designed to evaluate sensitivity of Echinococcus DNA detection in tissue/plasma, especially useful when routine diagnosis is difficult or immunocompromise present (NCT05824442 chunk 1) NCT05824442 (2023 record) https://clinicaltrials.gov/study/NCT05824442 (NCT05824442 chunk 1)
Diagnosis ddPCR for circulating cell-free DNA Untreated hepatic CE, stage-stratified Investigational liquid biopsy Exploratory multicenter study, enrollment ~20; primary endpoint is ddPCR sensitivity for plasma cfDNA detection, including stratification by active vs inactive cyst stage (NCT05769790 chunk 1) NCT05769790 (2022 record) https://clinicaltrials.gov/study/NCT05769790 (NCT05769790 chunk 1)
Treatment Watch-and-wait CE4–CE5 (inactive cysts) Observation for inactive uncomplicated cysts Standard stage-based strategy; inactive cysts are generally managed with observation rather than intervention (akbulut2025hydatiddisease pages 8-11, akhan2025theroleof pages 2-4) Akbulut 2025; Akhan & Ciftci 2025 https://doi.org/10.1007/978-3-031-97277-5 ; https://doi.org/10.1159/000547623 (akbulut2025hydatiddisease pages 8-11, akhan2025theroleof pages 2-4)
Treatment Albendazole (ABZ) monotherapy Mainly small uncomplicated CE1 / CE3a; adjunct peri-procedurally First-line benzimidazole; also pre/post surgery or percutaneous treatment First-line dose 10–15 mg/kg/day with fatty meal; in Uruguay cohort of adults completing 5-year follow-up, ABZ-alone achieved 93.75% success (32 patients), 0 deaths (akbulut2025hydatiddisease pages 11-13, rosa2024followupstudy pages 1-2) Akbulut 2025; Rosa et al. 2024 https://doi.org/10.1007/978-3-031-97277-5 ; https://doi.org/10.1186/s12879-024-09539-y (akbulut2025hydatiddisease pages 11-13, rosa2024followupstudy pages 1-2)
Treatment Albendazole + praziquantel (PZQ) Selected difficult / multi-cyst or perioperative cases Combination pharmacotherapy when surgery impractical or adjunct desired Uruguay cohort: 100% success in 4 patients receiving ABZ/PZQ, with 5-year follow-up; evidence is small and non-randomized (rosa2024followupstudy pages 1-2) Rosa et al. 2024 https://doi.org/10.1186/s12879-024-09539-y (rosa2024followupstudy pages 1-2)
Treatment PAIR (puncture–aspiration–injection–reaspiration) CE1, CE3a Preferred percutaneous therapy for uncomplicated active/transitional liver cysts Review reports percutaneous success rates up to 96% and recurrence as low as 4% overall for liver CE; meta-analysis for CE1/CE3a found mortality 0.1% vs 0.7% for surgery, major complications 7.9% vs 25.1%, minor complications 13.1% vs 33%, recurrence 1.6% vs 6.3%, hospital stay 2.4 vs 15 days (percutaneous vs surgery) (akhan2025theroleof pages 1-2, akhan2025theroleof pages 6-8) Akhan & Ciftci 2025 https://doi.org/10.1159/000547623 (akhan2025theroleof pages 1-2, akhan2025theroleof pages 6-8)
Treatment Standard catheterization (S-CAT) CE1, CE3a, especially giant cysts >10 cm or when PAIR inadequate Percutaneous drainage alternative / modification Used when membranes obstruct aspiration or cystobiliary communication develops; recurrence for CE1/3a in table reported <5%; catheter left until drainage <10 mL/day (akhan2025theroleof pages 4-6, akhan2025theroleof pages 2-4, akhan2025theroleof media 3452c1f5) Akhan & Ciftci 2025 https://doi.org/10.1159/000547623 (akhan2025theroleof pages 4-6, akhan2025theroleof pages 2-4, akhan2025theroleof media 3452c1f5)
Treatment Modified catheterization (Mo-CAT) CE2, CE3b Preferred percutaneous option for multivesicular / daughter-cyst-rich lesions Long-term series of 132 cysts: 0 mortality, major complications 10% (managed non-surgically), recurrence 4.5%, mean hospital stay 3.8 days, mean follow-up 52 months; table summary gives CE2/3b recurrence roughly <5–7% (akhan2025theroleof pages 6-8, akhan2025theroleof pages 4-6, akhan2025theroleof media 3452c1f5) Akhan & Ciftci 2025 https://doi.org/10.1159/000547623 (akhan2025theroleof pages 6-8, akhan2025theroleof pages 4-6, akhan2025theroleof media 3452c1f5)
Treatment Surgery (open or laparoscopic; radical or conservative depending case) Large, complicated, superficial, ruptured, infected, biliary-communicating, multi-daughter cysts; extrahepatic or non-percutaneous candidates Definitive treatment when complications/anatomy preclude medical or percutaneous options Historical mainstay; global review cites post-surgical mortality about 2.2% and postoperative recurrence about 6.5% (GBD review context). In Peru hospital series, post-surgical recurrence 16.5% at median 32.3 months in advanced/complicated disease (tian2024globalregionaland pages 1-2, akbulut2025hydatiddisease pages 8-11) Tian et al. 2024; Akbulut 2025; Peru medRxiv 2024 https://doi.org/10.3390/tropicalmed9040087 ; https://doi.org/10.1007/978-3-031-97277-5 ; https://doi.org/10.1101/2024.09.12.24313559 (tian2024globalregionaland pages 1-2, akbulut2025hydatiddisease pages 8-11)
Treatment Laparoscopic vs open liver surgery Adults with limited hepatic CE amenable to conservative surgery Comparative operative strategy Registered randomized non-inferiority trial enrolled 350 participants; primary outcome was recurrence at 24 months with secondary outcomes including mortality, complications, pain, hospital stay, operation time, QoL. Results not provided in retrieved chunk (NCT01643018 chunk 1) NCT01643018 (2006 record) https://clinicaltrials.gov/study/NCT01643018 (NCT01643018 chunk 1)
Treatment Adjuvant albendazole after pulmonary hydatid cyst resection Completely resected pulmonary hydatid disease Postoperative recurrence prevention Randomized trial with planned enrollment 24; ABZ 15 mg/kg/day in two 15-day postoperative cycles vs placebo; primary outcome recurrence at 6 months by imaging; includes AST/ALT safety monitoring (NCT06483880 chunk 1) NCT06483880 (2024 record) https://clinicaltrials.gov/study/NCT06483880 (NCT06483880 chunk 1)

Table: This table summarizes evidence-based diagnostic and treatment options for cystic echinococcosis, organized by modality and WHO-IWGE cyst stage. It highlights recent quantitative performance and outcome data, plus ongoing molecular and therapeutic clinical studies.

Limitations of this report (evidence gaps)

  • MONDO, Orphanet, and exact MeSH identifiers were not found in the retrieved full-text evidence and therefore are not asserted.
  • Differential diagnosis and standardized QoL instrument outcomes were not extracted from the retrieved sources.
  • Model organism details were limited in available evidence.

References

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