Cystic echinococcosis in morocco: epidemiology, socio-economic impact and control

Cystic echinococcosis (CE) is a parasitic disease due to infection with the metacestode stage of Echinococcus granulosus in different species of mammals, including humans. The present study is a review of several field investigations carried out in Morocco on its epidemiology as well as its impact on socio-economic status. The analysis of different studies carried out in the country showed that the disease has become highly endemic in the extensive livestock production regions of the country. Varying degrees of prevalence of CE of 3.6 to 90.9% in cattle, 0.1 to 81.1% in sheep, 0 to 25.7% in goats, 8.7 to 23.3% in camels and 17.8% in equines, were recorded in animals slaughtered during the period from 1937 to 2015. In parallel studies, high rates of E. granulosus infection (up to 70%) were observed in dogs in various regions of the country. In humans, the rate of 4.7 surgical cases per 100,000 inhabitants was recorded in 2003–2013. Furthermore, a recent socioeconomic study revealed an estimated nationwide disability-adjusted life-year (DALY) of 0.5 years per 100,000 persons per year, and a total yearly losses (due to organ seizure in slaughterhouses and to healthcare expenses and patients’ lost wages) of 73 million USD (54–92 million USD). Control actions were carried out mainly under international collaborative research projects. However, even with promising results, these actions have not been continued and were limited in time and space. This review stresses the need for a one health based-approach involving all the stakeholders in formulating a sustainable strategy for control of CE in Morocco.