{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:50:31Z","timestamp":1789084231818,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["773830"],"award-info":[{"award-number":["773830"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Human cystic echinococcosis (CE) is a worldwide-distributed parasitic zoonotic disease, which represents a threat for both human and animals. The current study aimed at estimating the prevalence of human CE in Khyber Pakhtunkhwa (KPK) province of Pakistan. Clinical records from four major hospitals in this region were reviewed for CE human cases during the period of 2006\u20132021. Out of 251 (0.00071%) CE patients identified during the considered period, 142 (56.6%) were females, and 109 (43.4%) were males. The highest number of CE cases was recorded in the 21\u201330 (27.9%) age group, followed by 31\u201340 (23.1%) and 41\u201350 (16.3%). Most of the CE patients in KPK province were members of the Afghani ethnic group (17.1%); secondarily, they were Pakistani (6.4%), while for 76.5% ethnicity data were not available. The liver (41%) and the lungs (4.8%) were the most infected organs identified among CE patients in KPK province. The present study identified CE as a significant public health problem in KPK province, and the current findings demonstrated a constant endemicity of CE during the last 15 years. Further filed studies on the active search of CE carriers by means of ultrasound population-based surveys are needed to fill knowledge gaps on clinical and molecular epidemiology of human CE in Pakistan.<\/jats:p>","DOI":"10.3390\/pathogens11020194","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T22:16:18Z","timestamp":1643753778000},"page":"194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A Retrospective Cohort Study on Human Cystic Echinococcosis in Khyber Pakhtunkhwa Province (Pakistan) Based on 16 Years of Hospital Discharge Records"],"prefix":"10.3390","volume":"11","author":[{"given":"Huma","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 4550, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-7591","authenticated-orcid":false,"given":"Adriano","family":"Casulli","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"},{"name":"European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid Fasihi","family":"Harandi","sequence":"additional","affiliation":[{"name":"Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, Kerman University of Medical Sciences, Kerman 761, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Sohail","family":"Afzal","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore 54782, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Arif Nadeem","family":"Saqib","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, National Skills University Islamabad, Islamabad 4550, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 4550, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,1]]},"reference":[{"key":"ref_1","first-page":"13","article-title":"New global targets for NTDs in the WHO roadmap 2021\u20132030","volume":"5","author":"Casulli","year":"2021","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S1473-3099(07)70134-2","article-title":"Prevention and control of cystic echinococcosis","volume":"7","author":"Craig","year":"2007","journal-title":"Lancet Inf. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3201\/eid1202.050499","article-title":"Global socioeconomic impact of cystic echinococcosis","volume":"12","author":"Budke","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_4","first-page":"518","article-title":"Cystic echinococcosis","volume":"54","author":"Brunetti","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"106026","DOI":"10.1016\/j.actatropica.2021.106026","article-title":"Estimation of the monetary burden of treated human cystic echinococcosis in Pakistan","volume":"222","author":"Basinger","year":"2021","journal-title":"Acta Trop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1017\/S0031182003004384","article-title":"Echinococcosis: Disease, detection and transmission","volume":"127","author":"Craig","year":"2003","journal-title":"Parasitology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.pt.2020.02.004","article-title":"Reinventing the wheel of Echinococcus granulosus sensu lato transmission to humans","volume":"36","author":"Tamarozzi","year":"2020","journal-title":"Trends Parasitol."},{"key":"ref_8","first-page":"339","article-title":"Occurrence of massively enlarged multiple hydatid cysts in the lung and liver of a pediatric patient in Pakistan","volume":"16","author":"Khan","year":"2021","journal-title":"Iran J. Parasitol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijpara.2013.08.008","article-title":"Echinococcus granulosus sensu lato genotypes infecting humans\u2014Review of current knowledge","volume":"44","author":"Romig","year":"2014","journal-title":"Int. J. Parasitol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s40249-017-0309-z","article-title":"Why more research needs to be done on echinococcosis in Pakistan","volume":"6","author":"Ahmed","year":"2017","journal-title":"Infect. Dis. Poverty"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3347\/kjp.2018.56.4.385","article-title":"A retrospective analysis on the cystic echinococcosis (CE) cases occurred in northeastern Punjab Province, Pakistan","volume":"56","author":"Khan","year":"2018","journal-title":"Korean J. Parasitol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105709","DOI":"10.1016\/j.actatropica.2020.105709","article-title":"Cystic echinococcosis in Pakistan: A review of reported cases, diagnosis, and management","volume":"212","author":"Khan","year":"2020","journal-title":"Acta Trop."},{"key":"ref_13","unstructured":"Finance Division Government of Pakistan (2021). Pakistan Economic Survey 2020\u20132021, Economic Adviser\u2019s Wing, Finance Division Government of Pakistan."},{"key":"ref_14","first-page":"324","article-title":"Poverty-associated emerging infection of cystic echinococcosis in population of Northern Pakistan: A hospital based study","volume":"36","author":"Khan","year":"2019","journal-title":"Trop. Biomed."},{"key":"ref_15","first-page":"58","article-title":"The significance (socio-economic impact) and control of Echinococcosis\/Hydatidosis: A review","volume":"9","author":"Nur","year":"2017","journal-title":"Eur. J. Biol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1017\/S0031182013000516","article-title":"The emergence of echinococcosis in central Asia","volume":"140","author":"Torgerson","year":"2013","journal-title":"Parasitology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.actatropica.2014.03.014","article-title":"Epidemiology and control of echinococcosis in central Asia, with particular reference to the People\u2019s Republic of China","volume":"141","author":"Zhang","year":"2015","journal-title":"Acta Trop."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e0029020","DOI":"10.1128\/CMR.00290-20","article-title":"Echinococcoses in Iran, Turkey, and Pakistan: Old diseases in the new millennium","volume":"34","author":"Borhani","year":"2021","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Harandi, F.M., Budke, C.M., and Rostami, S. (2012). The monetary burden of cystic echinococcosis in Iran. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001915"},{"key":"ref_20","first-page":"633","article-title":"Parasitic zoonotic disease in Turkey","volume":"44","author":"Altintas","year":"2008","journal-title":"Vet. Ital."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/j.1863-2378.2008.01186.x","article-title":"The retrospective annual surgical incidence of cystic echinococcosis in Sivas, Turkey","volume":"56","author":"Gonlugur","year":"2009","journal-title":"Zoonoses Public Health"},{"key":"ref_22","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":"8","author":"Tamarozzi","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Wang, L.Y., Qin, M., Liu, Z., Wu, W.P., Xao, N., Zhou, X.N., Manguin, S., Gavotte, L., and Frutos, R. (2021). Prevalence and spatial distribution characteristic of human echinococcosis in China. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009996"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Khan, A., Ahmed, H., Simsek, S., Liu, H., Yin, J., Wang, Y., Shen, Y., and Cao, J. (2020). Molecular characterization of human Echinococcus isolates and the first report of E. canadensis (G6\/G7) and E. multilocularis from the Punjab Province of Pakistan using sequence analysis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-04989-6"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"866","DOI":"10.2478\/s11686-019-00109-w","article-title":"Retrospective study of cystic echinococcosis (CE) based on hospital record from five major metropolitan cities of Pakistan","volume":"64","author":"Muqaddas","year":"2019","journal-title":"Acta Parasitol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105559","DOI":"10.1016\/j.actatropica.2020.105559","article-title":"First report of Echinococcus canadensis (G6\/G7) by sequence analysis from the Khyber Pakhtunkhwa province of Pakistan","volume":"209","author":"Khan","year":"2020","journal-title":"Acta Trop."},{"key":"ref_27","first-page":"39","article-title":"Echinococcosis is an emerging public health problem in Pakistan","volume":"3","author":"Ali","year":"2013","journal-title":"Int. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"937","DOI":"10.26719\/2010.16.9.937","article-title":"Retrospective survey of human hydatidosis in Bahir Dar, northwestern Ethiopia","volume":"16","author":"Kebede","year":"2010","journal-title":"East. Med. Health J."},{"key":"ref_29","first-page":"349","article-title":"A 14 years hospital based study on clinical and morphological spectrum of hydatid disease","volume":"52","author":"Ghartimagar","year":"2013","journal-title":"J. Nepal Med. Assoc."},{"key":"ref_30","first-page":"130","article-title":"A retrospective study of human cystic echinococcosis in Basrah province, Iraq","volume":"178","author":"Habib","year":"2017","journal-title":"Acta Trop."},{"key":"ref_31","first-page":"323","article-title":"Human cystic echinococcosis in West Azerbaijan, Northwest Iran: A retrospective hospital-based survey from 2000 to 2009","volume":"8","author":"Hajipirloo","year":"2013","journal-title":"Iran J. Parasitol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zhang, T., Zhao, W., Yang, D., Piao, D., Huang, S., and Mi, Y. (2015). Human cystic echinococcosis in Heilongjiang Province, China: A retrospective study. BMC Gastroenterol., 15.","DOI":"10.1186\/s12876-015-0256-8"},{"key":"ref_33","first-page":"4837234","article-title":"Intra-abdominal hydatid cyst: Sociodemographic, clinical profiles, and outcomes of patients operated on at a tertiary hospital in Addis Ababa, Ethiopia","volume":"2017","author":"Abebe","year":"2017","journal-title":"J. Parasitol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sharma, M., Sehgal, R., Fomda, B.A., Malhotra, A., and Malla, N. (2013). Molecular characterization of Echinococcus granulosus cysts in north Indian patients: Identification of G1, G3, G5 and G6 genotypes. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002262"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Possenti, A., Manzano-Rom\u00e1n, R., S\u00e1nchez-Ovejero, C., Boufana, B., La Torre, G., Siles-Lucas, M., and Casulli, A. (2016). Potential risk factors associated with human cystic echinococcosis: Systematic review and meta-analysis. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0005114"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1186\/s13071-019-3634-1","article-title":"Epidemiological factors associated with human cystic echinococcosis: A semi-structured questionnaire from a large population-based ultrasound cross-sectional study in eastern Europe and Turkey","volume":"12","author":"Tamarozzi","year":"2019","journal-title":"Parasit. Vectors"},{"key":"ref_37","unstructured":"Kern, S. (2021, July 12). The Infectious Disease Epidemiology Annual Report. Available online: https:\/\/www.gatestoneinstitute.org\/10676\/germany-migrants-Infectious."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.2478\/helm-2021-0017","article-title":"Demographics of cystic echinococcosis patients treated surgically in Lahore, Pakistan: A single centre study from 2007\u20132018","volume":"58","author":"Rasib","year":"2021","journal-title":"Helminthologia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3347\/kjp.2018.56.4.385","article-title":"A retrospective analysis on the cystic echinococcosis cases occured in Northeastern Punjab Province, Pakistan","volume":"56","author":"Khan","year":"2018","journal-title":"Korean J. Parasitol."},{"key":"ref_40","first-page":"450","article-title":"Human hydatidosis in Tehran, Iran: A retrospective epidemiological study of surgical cases between 1999 and 2009 at two university medical centers","volume":"28","author":"Ahmadi","year":"2011","journal-title":"Trop. Biomed."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.actatropica.2014.08.011","article-title":"Retrospective study of human cystic echinococcosis in Italy based on the analysis of hospital discharge records between 2001 and 2012","volume":"140","author":"Brundu","year":"2014","journal-title":"Acta Trop."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/2\/194\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:12:19Z","timestamp":1760134339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/2\/194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":41,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["pathogens11020194"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11020194","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,1]]}}}