Echinococcosis in children and adolescents in Bulgaria: a comparative study

Between 1971 and 1995, 5874 patients underwent surgery in Bulgaria because of cystic echinococcosis caused by Echinococcus granulosus. Of these 5874, 10.6% were children aged < 15 years and 5.25% adolescents aged 15-19 years, giving annual incidences of 1.25 and 2.03/100 000 inhabitants, respectivel y. Although the annual incidence of surgery for echinococcosis among adults (3.12/100 000) was higher than the combined value for children and adolesc ents (1.48/100 000), the data indicate that most human infections with E. g ranulosus occur during childhood and adolescence. In evaluating the epidemi ology of echinococcosis or the effectiveness of a control programme, theref ore, reductions or increases in the incidence of clinical disease among chi ldren and adolescents indicate an improving or worsening situation, respect ively. The incidence of surgical treatment for echinococcosis was higher in males than females in all but the youngest subjects (< 5 years) and adults (> 19 years). It was also higher in rural populations than in urban populations, particularly among children and adolescents. Whereas cysts were found more frequently in the lungs of children and adolescents than their livers (51.8 % v. 38.3% of the patients), most cysts found in the adults were hepatic (7 3.5% of patients) and relatively few were in the lungs (14.4% of patients).