title: Abdominal cystic echinococcosis in Bangladesh: a hospital-based study.
abstract: BACKGROUND
  Cystic echinococcosis (CE) is reported from nearly all geographic areas of Bangladesh, but little information is available on its epidemiologic and clinical features. The aim of this study was to describe the clinical manifestations of hepatic and abdominal CE cases presenting to tertiary referral hospitals in Dhaka, Bangladesh.
  
  
  METHODS
  A retrospective study was conducted via chart reviews of hepatic and abdominal CE patients under care at tertiary referral hospitals in Dhaka, Bangladesh, between 2002 and 2011. Age, sex, education level, occupation, urban versus rural residence, drinking water source, history of dog ownership, cyst type and location, and clinical manifestations were recorded for all patients.
  
  
  RESULTS
  Of the 130 patients enrolled, 92 (70.8%) were female and 38 (29.2%) were male. The majority of patients were from rural (76.2%) rather than urban (23.8%) areas. All cases were from the northern part of the country, with no cases reported from the south or southeast. Most patients were between 21 and 40 years of age. A total of 119 patients (91.5%) had cysts only in the liver, with the remaining 8.5% having cysts in both the liver and lungs or in the abdominal cavity. Seventy-six (58.5%) of the hepatic cysts were stage CE1, indicating recent infection.
  
  
  CONCLUSIONS
  Active transmission of Echinococcus granulosus appears to be occurring in Bangladesh, as indicated by the high number of CE1 hepatic cysts seen at tertiary care hospitals. Community ultrasound screening studies are warranted to better define the distribution of cases and risk factors for parasite transmission.
authors.affiliation: Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. drfazalkarim@gmail.com.
authors.forename: Mohammad Fazal
authors.initials: MF
authors.lastname: Karim
authors.forename: Enrico
authors.initials: E
authors.lastname: Brunetti
authors.forename: Salimur
authors.initials: S
authors.lastname: Rahman
authors.forename: Christine M
authors.initials: CM
authors.lastname: Budke
authors.forename: Abu Saleh Mohammad Areef
authors.initials: AS
authors.lastname: Ahsan
authors.forename: Mamun
authors.initials: M
authors.lastname: Al-Mahtab
authors.forename: Khandaker Mahabub Jamal
authors.initials: KM
authors.lastname: Zaki
authors.forename: Mohammad Jamshed
authors.initials: MJ
authors.lastname: Alam
authors.forename: Sheikh Mohammad Fazle
authors.initials: SM
authors.lastname: Akbar
authors.forename: M A
authors.initials: MA
authors.lastname: Jalil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D004444:Echinococcosis, Hepatic / Q000453:epidemiology*; D048209:Echinococcus granulosus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult