Findings of a community screening programme for human cystic echinococcosis in Bungoma County, western Kenya

Mutwiri, Titus, Magambo, Japheth, Zeyhle, Eberhard, Muigai, Ann, Alumasa, Lorren, Amanya, Fredrick, Fevre, Eric ORCID: and Falzon, Laura ORCID: (2021) Findings of a community screening programme for human cystic echinococcosis in Bungoma County, western Kenya. [Data Collection]


Introduction: Cystic Echinococcosis (CE) is a zoonosis caused by infection with the larval stages of taeniid cestodes of Echinococcus granulosus. It is prevalent among transhumant communities in East Africa, including in northern Kenya. The movement of livestock from these regions of high incidence to areas of low incidence creates an indirect risk of disease spill-over to humans. To assess possible establishment of the CE life cycle outside known endemic regions, we screened for the presence of human CE in Bungoma County of western Kenya, an area which imports substantial numbers of cattle for slaughter from pastoralist areas. Materials and Methods: Eight sentinel sites were purposively selected based on proximity to slaughterhouses handling animals introduced from pastoralist regions and necessary permissions were sought to conduct the study. At each site, the research team set up at a central location, sensitized and invited the local population to attend the screening. Those who consented to participate were asked questions on their age, occupation, and income and screened using a portable ultrasound scanner. Ultrasound images were printed, and findings were discussed with the patient. Regression analyses were conducted to identify risk factors associated with the presence of abdominal and cystic lesions (CL). Results: In total, 1002 participants were screened; of these, 654 (65.3%) were female and the median age was 43. Farming (n=403; 43.43%) was the most frequent occupation, followed by profession (n=215; 23.1%) and business (n=207; 22.3%) categories. Sixty-seven participants (6.7%) had abnormal ultrasound findings and, of these, 7 (1.07%) had simple liver cysts/CL using WHO classification. As such, their outcome was inconclusive and they were not put on treatment but advised to attend follow-up investigations in a referral facility. Other abnormal findings included splenomegaly (n=14), ovarian cysts (n=14), uterine fibroids (n=10), polycystic kidneys (n=6) and benign prostatic hyperplasia (n=6). Age was univariably associated with the presence of presumptive CL. Monthly income was inversely associated with the presence of abdominal lesions. Conclusion: These results contribute to baseline data while providing insights on the implementation of ultrasound diagnosis in the field, as recommended by the WHO for targeted control of echinococcosis by 2030.

Keywords: Echinococcus granulosus, abdominal ultrasound, cystic lesion, liver cyst, regression analyses, WHO classification
Divisions: Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Eric Fevre
Date Deposited: 17 Dec 2021 10:42
Last Modified: 17 Dec 2021 10:42
DOI: 10.17638/
Geography: Kenya, East Africa

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