{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:33:00Z","timestamp":1767180780708,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013784","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000}}],"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ERANet-LAC 2"},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["ELAC2015\/T08-0544"],"award-info":[{"award-number":["ELAC2015\/T08-0544"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Albania is considered endemic for cystic echinococcosis (CE). Recent data on prevalence and incidence of CE in Europe suggests that the Balkan region is the epicentre of this neglected parasitic disease in Europe. In Albania, a retrospective study has estimated a mean incidence of 1.49 cases\/100,000 people. We aimed to assess the prevalence of CE in eight municipalities across the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/principal findings<\/jats:title>\n                    <jats:p>We enrolled participants aged &gt;5 years in an ultrasound (US)-based screening for CE in 23 villages in eight municipalities from three prefectures. Participants were enrolled in the study after signing an informed consent and underwent a complete abdominal US. CE cysts were classified according to the WHO-IWGE ultrasound classification. A total of 3,710 participants were included in the study, of whom 2,685 (72.4%) were female. The median age of participants was 55 years (interquartile range, 42\u201364). Six confirmed CE cases were identified by US with cysts in the liver (1 CE2, 2 CE3a, 1 CE4 and 2 CE5). The crude prevalence of CE detected by US was 0.16% (95% CI 0.06-0.35), with a standardized prevalence of 0.11% (95% CI 0.02-0.21) according to the reference rural population 2023 in Albania. We calculated that the number of individuals who might currently be infected with CE in the rural area of this country was 908 (95% CI 138-1,678).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This was the first population-based US field survey on CE conducted in Albania. Our screening yielded a lower prevalence than expected. However, the presence of active cysts points to ongoing transmission. Our study had several limitations including the use of a convenience sample that limited the attendance of males and children. In the future, surveillance activities for CE should be strengthened in Albania to better characterize the epidemiology of the disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013784","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T18:49:00Z","timestamp":1764701340000},"page":"e0013784","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-based population survey for abdominal cystic echinococcosis in Albania: Results from the NDTND project"],"prefix":"10.1371","volume":"19","author":[{"given":"Tommaso","family":"Manciulli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Shkjezi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valbona","family":"Gjoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Richter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Lapini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Colpani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"De Vito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Luca","family":"D\u2019Alessandro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armanda","family":"Leka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argjend","family":"Kubolli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armida","family":"Agastra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gjetjon","family":"Gjonaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Fabiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Zappacosta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Brunetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-7591","authenticated-orcid":true,"given":"Adriano","family":"Casulli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"pntd.0013784.ref001","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/bs.apar.2016.11.001","article-title":"Global Distribution of Alveolar and Cystic Echinococcosis","volume":"95","author":"P Deplazes","year":"2017","journal-title":"Adv Parasitol"},{"issue":"1","key":"pntd.0013784.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","article-title":"Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans","volume":"114","author":"Writing Panel for the WHO-IWGE","year":"2010","journal-title":"Acta Trop"},{"issue":"9","key":"pntd.0013784.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011612","article-title":"Primary cerebral cystic echinococcosis in a child from Roman countryside: Source attribution and scoping review of cases from the literature","volume":"17","author":"A Casulli","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0013784.ref004","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3201\/eid1202.050499","article-title":"Global socioeconomic impact of cystic echinococcosis","volume":"12","author":"CM Budke","year":"2006","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"pntd.0013784.ref005","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/QCO.0000000000000943","article-title":"Watch-and-wait approach for inactive echinococcal cysts: scoping review update since the issue of the WHO-IWGE Expert Consensus and current perspectives","volume":"36","author":"E Brunetti","year":"2023","journal-title":"Curr Opin Infect Dis"},{"issue":"7","key":"pntd.0013784.ref006","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S1473-3099(18)30221-4","article-title":"Prevalence of abdominal cystic echinococcosis in rural Bulgaria, Romania, and Turkey: a cross-sectional, ultrasound-based, population study from the HERACLES project","volume":"18","author":"F Tamarozzi","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"pntd.0013784.ref007","doi-asserted-by":"crossref","first-page":"462","DOI":"10.4269\/ajtmh.1999.60.462","article-title":"An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya","volume":"60","author":"MA Shambesh","year":"1999","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0013784.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009370","article-title":"Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis","volume":"15","author":"F Tamarozzi","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0013784.ref009","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3390\/parasitologia1040019","article-title":"The Diagnosis, Treatment, Surveillance and Control of Cystic Echinococcosis in the Province of Rio Negro: The \u201cOne-Health\u201d Model","volume":"1","author":"G Mujica","year":"2021","journal-title":"Parasitologia"},{"issue":"3","key":"pntd.0013784.ref010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010280","article-title":"Prevalence rate and risk factors of human cystic echinococcosis: A cross-sectional, community-based, abdominal ultrasound study in rural and urban north-central Chile","volume":"16","author":"G Acosta-Jamett","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0013784.ref011","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s40475-017-0129-z","article-title":"Cystic Echinococcosis in the Mediterranean","volume":"4","author":"T Manciulli","year":"2017","journal-title":"Curr Trop Med Rep"},{"key":"pntd.0013784.ref012","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.actatropica.2015.01.002","article-title":"Comment on: Retrospective study of human cystic echinococcosis in Italy based on the analysis of hospital discharge records between 2001 and 2012","volume":"144","author":"F Tamarozzi","year":"2015","journal-title":"Acta Trop"},{"key":"pntd.0013784.ref013","doi-asserted-by":"crossref","unstructured":"Casulli A, Abela-ridder B, Petrone D, Fabiani M, Bobi\u0107 B, Carmena D. Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project. 2024.","DOI":"10.1016\/S1473-3099(22)00638-7"},{"key":"pntd.0013784.ref014","doi-asserted-by":"crossref","unstructured":"Luga P, Gjata A, Akshija I, Mino L, Gjoni V, Pilaca A, et al. What do we know about the epidemiology and the management of human echinococcosis in Albania? Parasitol Res. 2023; 1811\u20131818. doi:10.1007\/s00436-023-07878-4","DOI":"10.1007\/s00436-023-07878-4"},{"key":"pntd.0013784.ref015","unstructured":"WHO. Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021\u20132030. Geneva: World Health Organization. . Word Health Organization. 2020. https:\/\/www.who.int\/neglected_diseases\/Revised-DraftNTD-Roadmap-23Apr2020.pdf"},{"issue":"1","key":"pntd.0013784.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0001444","article-title":"Early diagnosis, treatment and follow-up of cystic echinococcosis in remote rural areas in Patagonia: impact of ultrasound training of non-specialists","volume":"6","author":"M Del Carpio","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013784.ref017","doi-asserted-by":"crossref","unstructured":"Manciulli T, Serraino R, D\u2019Alessandro GL, Cattaneo L, Mariconti M, Vola A, et al. Evidence of Low Prevalence of Cystic Echinococcosis in the Catanzaro Province, Calabria Region, Italy. Am J Trop Med Hyg. 2020;103(5):1951\u20134. https:\/\/doi.org\/10.4269\/ajtmh.20-0119 32975181","DOI":"10.4269\/ajtmh.20-0119"},{"key":"pntd.0013784.ref018","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.actatropica.2017.03.018","article-title":"The natural history of cystic echinococcosis in untreated and albendazole-treated patients","volume":"171","author":"N Solomon","year":"2017","journal-title":"Acta Trop"},{"key":"pntd.0013784.ref019","doi-asserted-by":"crossref","first-page":"105982","DOI":"10.1016\/j.actatropica.2021.105982","article-title":"Epidemiological analysis of cystic echinococcosis and alveolar echinococcosis in an extremely high prevalence region: Population-based survey and host animal monitoring in Shiqu County, China","volume":"221","author":"L Liu","year":"2021","journal-title":"Acta Trop"},{"key":"pntd.0013784.ref020","doi-asserted-by":"crossref","unstructured":"Colpani A, Achilova O, D\u2019Alessandro GL, Budke C, Mariconti M, Muratov T, et al. Ultrasound-Based Prevalence of Cystic Echinococcosis in the Samarkand Region of Uzbekistan: Results from a Field Survey. Am J Trop Med Hyg. 2023;109(1):153\u20138. https:\/\/doi.org\/10.4269\/ajtmh.22-0376 37277104","DOI":"10.4269\/ajtmh.22-0376"},{"key":"pntd.0013784.ref021","doi-asserted-by":"crossref","unstructured":"Mustapayeva A, Luca D\u2019Alessandro G, Doszhanova G, Colpani A, Sadybekov N, Baimakhanov Z, et al. Ultrasound-based evaluation of the prevalence of abdominal cystic echinococcosis in the Turkestan region of Kazakhstan. Trans R Soc Trop Med Hyg. 2022;116(3):222\u20136. https:\/\/doi.org\/10.1093\/trstmh\/trab105 34499709","DOI":"10.1093\/trstmh\/trab105"},{"issue":"7","key":"pntd.0013784.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0235399","article-title":"Prevalence and risk factors associated with human cystic echinococcosis in rural areas, Mongolia","volume":"15","author":"T Dorjsuren","year":"2020","journal-title":"PLoS One"},{"issue":"11","key":"pntd.0013784.ref023","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005114","article-title":"Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis","volume":"10","author":"A Possenti","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013784.ref024","doi-asserted-by":"crossref","unstructured":"Colpani A, Achilova O, D\u2019Alessandro GL, Budke CM, Mariconti M, Muratov T, et al. Trends in the Surgical Incidence of Cystic Echinococcosis in Uzbekistan from 2011 to 2018. Am J Trop Med Hyg. 2021;106(2):724\u20138. https:\/\/doi.org\/10.4269\/ajtmh.21-0261 34902836","DOI":"10.4269\/ajtmh.21-0261"},{"issue":"4","key":"pntd.0013784.ref025","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(20)30038-3","article-title":"Epidemic cystic and alveolar echinococcosis in Kyrgyzstan: an analysis of national surveillance data","volume":"8","author":"G Paternoster","year":"2020","journal-title":"Lancet Glob Health"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013784","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T18:38:36Z","timestamp":1765305516000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013784"}},"subtitle":[],"editor":[{"given":"Majid","family":"Fasihi Harandi,","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":25,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013784","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}