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Original Article

Epidemiological Indicators of the State of Cystic Echinococcosis in Republic of Bulgaria for the Period 2011-2020

Iskra Georgieva Rainova, Rumen Nenkov Harizanov, Nina Dimitrova Tsvetkova, Iskren Tzvetkov Kaftandjiev, Raina Borisova Enikova, Aleksandra Ivanova Ivanova, Mihaela Vanjova Videnova, Eleonora Marinova Kaneva, Ognyan Dariev Mikov.


Objective: Cystic echinococcosis (CE) is one of the most severe parasitoses, which leads to prolonged disability, frequent recurrences, and even to death. In Bulgaria it is one of the most frequently registered and severe helminthic infection..
The aim of this study is to determine the epidemiological indicators as morbidity, mortality and lethality from CE in Bulgaria for the period 2011-2020, as well as a comparative analysis of morbidity in the country with that of other EU member states.
Materials and Methods: The study is a retrospective analysis of confirmed cases of CE, as well as of the deceased from this parasitic disease. Data from several sources were used - the annual analyzes of parasitic morbidity in the country, prepared by the NCIPD, as well as information from the National Center for Public Health and Analysis and the National Statistical Institute.
Statistical methods were used to calculate morbidity and mortality rates
Results: From 2011 to 2020, a total of 2626 cases of CE are registered in Bulgaria (95% Confidence Interval: 263 ± 3.16), with an average incidence for the period of 3.7%₀₀₀ (95% CI: 3.65 ± 0.357). The registered primary cases are 2336 (95% CI: 233.6 ± 3.03) in total and 290 (95% CI: 29 ± 1.04) are recurrences. Cystic echinococcosis is comparatively more prevalent in women than in men, respectively 1397 (95% CI: 139.7 ± 2.39) and 1229 (95% CI: 122.9 ± 2.14) registered cases for the period and for morbidity values are 3,7%₀₀₀ (95% CI: 3.71 ± 0.36) to 3,5%₀₀₀ (95% CI: 3.53 ± 0.343). The most affected is the age group 20–59 years, i.e. people of active working age. The number of affected children aged 1 to 19 (509 cases) is relatively high, which indicates an active transmission of the parasite. During the studied period deceased patients due to echinococcosis are 65 of whom 38 men and 27 women. The average mortality and the lethality are respectively 0.09%₀₀₀ (95% CI: 0.09 ± 0.103) and 2.49% (95% CI: 2.49 ± 0.405).
Conclusion: The results show a reduction in examined indicators regarding cystic echinococcosis compared to data for the 1990s and the studied from us period, but these values are still higher than the established EU averages.

Key words: Cystic echinococcosis, morbidity, mortality, lethality

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