A Summary Of Hydatid Disease In Thailand
V Wiwanitki. A Summary Of Hydatid Disease In Thailand. The Internet Journal of Tropical Medicine. 2004 Volume 2 Number 2.
Context: Hydatid disease is a zoonosis caused by the tapeworm of Echinococcus spp. In Southeast Asia, the human hydatid disease is rare.
Objective: The author performed a literature review on the reports of hydatid diseases in Thailand in order to summarize the characteristics of this infection among those patients.
Design: This study was designed as a descriptive retrospective study. A literature review of the papers concerning hydatid diseases in Thailand was performed.
Results: According to this study, there have been at least 10 reports in the literature of hydatid diseases, with 2 lethal cases. Of these 10 cases, 6 were males and 4 were females. Of 9 cases that documented patients' age, the ages ranged from 16 years to 58 years. Lung cyst is the most common manifestation (6 cases), following by liver cyst (2 cases), kidney cyst (1 case) and peritoneal cyst (1 case), orderly. All cases were accidentally detected from histological examination of surgical or autopsy specimens. Most (90%) were identified as E. granulosus infection; however, there was 1 case with E. multilocularis infection. Surgical removals were performed in all except 1 case. Antiparasitic drugs were prescribed in 5 cases: albendazole in 3 cases and albendazole with praziquantel in 2 case. Concerning the two lethal cases, one had neither surgical removal nor antiparasitic drug, the other had both surgical removal and antiparasitic drug but there was accidental rupture of the cyst during surgery.
Conclusion: In conclusion, the hydatid disease is a rare cestode infection that is sporadically reported in Thailand. The surgical removal seems to be still an effective method for treatment.
Hydatid disease is a zoonosis caused by the tapeworm of
The hydatid disease is prevalence where livestock is raised in association with dogs. Those endemic areas include Australia, Latin America, Europe, Africa and the Middle East. In Southeast Asia, the human hydatid disease is rare. In Thailand, the first case report of hydatid disease was published in 1936. Since the first case report, there have been sporadic case reports of hydatid diseases in Thailand. Here, the author performed a literature review of the reports of hydatid diseases in Thailand in order to summarize the characteristics of this infection among Thai patients.
Materials and Methods
This study was designed as a descriptive retrospective study. A literature review of the papers concerning hydatid disease in Thailand was performed, using the database of published works cited in the Index Medicus and Science Citation Index. The author also reviewed the published works in all 256 local Thai journals, which are not included in the international citation index. The literature review focused on the years 1936 - 2004.
According to the literature review, reports were recruited for further study. The details of clinical presentations of the patients (such as clinical manifestation, diagnosis, treatment, and discharge status) in all included reports were studied. The demographic data of all cases including age, sex, and location were reviewed as well. Descriptive statistics, including range and percentage, were used in analyzing the patient characteristics and laboratory parameters for each group. All the statistical analyses in this study were made using SPSS 7.0 for Windows.
According to this study, there have been at least 10 reports [6,7,8,9,10,11,12,13,14, 15] in the literature of cases of hydatid disease infection in the Thai population, of which 2 case was lethal (Table 1). Of these 10 cases, 6 were males and 4 were females. However, some cases were lacking data on age in the original reports (1 of 10 did not have age listed). Of the 9 cases that documented age, the ages ranged from 16 years to 58 years. Only 2 of 10 cases had the history of traveling to the endemic countries. The other 8 cases are believed to get the infection in Thailand, from different regions. Only 1 case was the sheep farmer , the others had the non-agricultural related occupations and had no history of contact with dogs, cattle or sheep.
Lung cyst is the most common manifestation (6 cases), following by liver cyst (2 cases), kidney cyst (1 case) and peritoneal cyst (1 case), orderly. All cases were accidentally detected from histological examination of surgical or autopsy  specimens. Most (90%) were identified as
Hydatid disease is one of the world's most well known geographically widespread parasitic zoonoses, with transmission occurring in tropical, temperate and arctic biomes [1,2,3,4, 5]. The incidence of hydatid disease varies among different geographical areas with the high incidence in Australia, Latin America, Eastern Europe, the middle East and Africa [1,2,3,4, 5]. Most human infections are due to
According to this study, the incidence of hydatid disease in the Thais is very low, sporadic cases have been reported. The common clinical presentation of the patients is the unexplained cystic mass with pain, swelling or pressure effect from enlarging cysts. In this study, lung cyst is the most common manifestation. This finding is not corresponding with the general findings in the endemic countries, where liver cyst is the most common manifestation [1,2,3,4, 5]. The probable explanation is that the disease might be more prevalent in Thailand, however, they were underdiagnosed.
It should be noted that most of the cases were diagnosed after year 1990. This might reflex the increase in incidence of infection or the increase in awareness of this disease by the practitioners. Concerning the history of travelling to the endemic countries, few cases demonstrated this history. Most cases had only the history of travelling within Thailand, therefore, it can be said that the disease exists in Thailand.
Concerning the treatment, it is no doubt that both surgical removal and antiparasitic drug therapy is useful. However, in this study, the addition of antiparasitic drug or not does not affect the outcome. Praziquantel and benzimidazole compounds such as albendazole have been associated with high treatment failures .The surgical removal seems to be more important factor influencing the outcome. The death cases in this series are due to the non-surgical treatment  or poor surgical practice . Accidental rupture of the cyst and the consequently spillage of the content is a totally unwanted surgical complication . The new recommendation by the World Health Organization is percutaneous puncture under sonographic guidance, aspiration of cystic fluid, injection of a protoscolicidal agent, such as saline or alcohol, and reaspiration of cyst content (PAIR) .
Similar to the epidemiology in the endemic countries,
To fulfill the data of the hydatid disease in Southeast Asia, the data of this disease from the other countries besides Thailand are hereby summarized and presented. Concerning Malaysia, there are fewer case reports. According to the literature search, there are two case reports, one in 1970  and the other in 1989 . The very low incidence is also mentioned for Indonesia. According to the recent study of Palmieri