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-
1.
Deplazes P, Rinaldi L, Rojas CA, Torgerson P, Harandi M, Romig T, Antolova D, Schurer J, Lahmar S, Cringoli G, 2017. Global distribution of alveolar and cystic echinococcosis. Adv Parasitol 95 :315–493.
-
2.
Thompson R, 2017. Biology and systematics of Echinococcus. Adv Parasitol 95 :65–109.
-
3.
Borhani M, Fathi S, Darabi E, Jalousian F, Simsek S, Ahmed H, Kesik HK, Hosseini SH, Romig T, Harandi MF, 2021. Echinococcoses in Iran, Turkey, and Pakistan: Old diseases in the new millennium. Clin Microbiol Rev 34 :e00290-20.
-
4.
Fasihi Harandi M, Budke CM, Rostami S, 2012. The monetary burden of cystic echinococcosis in Iran. PLoS Negl Trop Dis 6 :e1915.
-
5.
Nunnari G, Pinzone MR, Gruttadauria S, Celesia BM, Madeddu G, Malaguarnera G, Pavone P, Cappellani A, Cacopardo B, 2012. Hepatic echinococcosis: Clinical and therapeutic aspects. World J Gastroenterol 18 :1448–1458.
-
6.
Borhani M, Fathi S, Lahmar S, Ahmed H, Abdulhameed MF, Fasihi Harandi M, 2020. Cystic echinococcosis in the Eastern Mediterranean region: Neglected and prevailing! PLoS Negl Trop Dis 14 :e0008114.
-
7.
Kern P, Da Silva AM, Akhan O, Müllhaupt B, Vizcaychipi K, Budke C, Vuitton D, 2017. The echinococcoses: Diagnosis, clinical management and burden of disease. Adv Parasitol 96 :259–369.
-
8.
Budke CM, Deplazes P, Torgerson PR, 2006. Global socioeconomic impact of cystic echinococcosis. Emerg Infect Dis 12 :296–303.
-
9.
Kvascevicius R, Lapteva O, Al Awar O, Audronyte E, Neverauskiene L, Kvasceviciene E, Sokolovas V, Strupas K, Marcinkute A, Deplazes P, 2016. Fatal liver and lung alveolar echinococcosis with newly developed neurologic symptoms due to the brain involvement. Surg J (NY) 2 :e83–e88.
-
10.
WHO Informal Working Group, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85 :253–261.
-
11.
Dziri C, Haouet K, Fingerhut A, 2004. Treatment of hydatid cyst of the liver: Where is the evidence? World J Surg 28 :731–736.
-
12.
Nasibi S et al., 2023. Iranian hydatid disease registry: Establishment and implementation of a neglected tropical disease registry.Arch Iran Med 26 :358–364.
-
13.
Asadi A, Betti G, Gagliardi F, Khoshbakht H, 2019. Multidimensional and fuzzy poverty at regional level in Iran. Department of Economics University of Siena 796 :1–20.
-
14.
Committee RD, 2017. Deprivation Atlas of Iran. Barakat Foundation Tehran, Iran (in Farsi). Available at: https://shorturl.at/IJZ7O. Accessed November 12, 2023.
-
15.
Janati A, Amini A, Adham D, Naseriasl M, 2017. Referral system in Iran’s health sector and world’s leading countries.Rese Jour of Pharm and Technol 10 :1597–1602.
-
16.
Sayek I, Tirnaksiz MB, Dogan R, 2004. Cystic hydatid disease: Current trends in diagnosis and management.Surg Today 34 :987–996.
-
17.
GBD 2019 Iran Collaborators, 2022. Health system performance in Iran: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet 399 :1625–1645.
-
18.
Adeosun II, Adegbohun AA, Adewumi TA, Jeje OO, 2013. The pathways to the first contact with mental health services among patients with schizophrenia in Lagos, Nigeria.Schizophr Res Treatment 2013 :769161.
-
19.
Ebrahimipour M, Budke CM, Harandi MF, 2020. Control of cystic echinococcosis in Iran: Where do we stand? Trends Parasitol 36 :578–581.
-
20.
Ruhaiyem M, Alshehri A, Saade M, Shoabi T, Zahoor H, Tawfeeq N, 2016. Fear of going under general anesthesia: A cross-sectional study. Saudi J Anaesth 10 :317–321.
-
21.
Masroor S, 2020. Collateral damage of COVID-19 pandemic: Delayed medical care.J Card Surg 35 :1345–1347.
-
22.
Ghiasvand H, Sha’baninejad H, Arab M, Rashidian A, 2014. Hospitalization and catastrophic medical payment: Evidence from hospitals located in Tehran. Arch Iran Med 17 :507–513.
-
23.
Pourreza A, Harirchi I, Bazyar M, 2017. Differentiation of out-of-pocket expenditures in cancer patients; a case study in the cancer institute of Iran. EBHPME 1 :65–73.
-
24.
Vujic J, Marsoner K, Lipp-Pump A, Klaritsch P, Mischinger H, Kornprat P, 2019. Non-obstetric surgery during pregnancy - An eleven-year retrospective analysis. BMC Pregnancy Childbirth 19 :382.
-
25.
Rahimitabar P, Kraemer A, Bozorgmehr K, Ebrahimi F, Takian A, 2023. Health condition of Afghan refugees residing in Iran in comparison to Germany: A systematic review of empirical studies.Int J Equity Health 22 :16–14.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 18881 | 18881 | 620 |
| Full Text Views | 52 | 52 | 7 |
| PDF Downloads | 31 | 31 | 11 |
The Management Pathway of Patients with Cystic Echinococcosis in Iran Prior to Definitive Surgical Treatment
Fatemeh Mohtasham
Fatemeh Mohtasham
Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;
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Mohammad Shafiei
eeifahs.tx@gmail.com
Mohammad Shafiei
Research Center for Hydatid Disease in Iran, Department of Surgery, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran;
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Mohammad Reza Lashkarizadeh
mr.lashkarizadeh@gmail.com
Mohammad Reza Lashkarizadeh
Research Center for Hydatid Disease in Iran, Department of Surgery, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran;
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Mehrdad Farokhnia
Mehrdad Farokhnia
Research Center for Hydatid Disease in Iran, Department of Internal Medicine, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran;
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Maysam Yousefi
Maysam Yousefi
Research Center for Hydatid Disease in Iran, Department of Internal Medicine, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran;
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Rana Eftekhar Vaghefi
Rana Eftekhar Vaghefi
Department of Radiology, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran
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Fatemeh Khajehasani
Fatemeh Khajehasani
Department of Radiology, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran
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Saeid Nasibi
Saeid Nasibi
Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;
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Mohammad Ali Mohammadi
Mohammad Ali Mohammadi
Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;
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Majid Fasihi Harandi
majid.fasihi@gmail.com
Majid Fasihi Harandi
Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;
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ABSTRACT.
Patients with cystic echinococcosis (CE) regularly undergo surgery in medical centers in endemic countries. Our understanding of the challenges patients face on the pathway toward the final diagnosis and treatment of CE is poor. The present study was conducted to evaluate the medical care-seeking pathway and the underlying causes of the delayed surgical treatment of CE. Information related to 68 CE patients who underwent surgery in Kerman, Southeast Iran, was collected through face-to-face visits or telephone calls. All the patients were interviewed, and the medical records of each patient were reviewed. The pathway taken by the patient to seek care, the workups performed for diagnosis and management, and the length of time between the onset of symptoms and definitive diagnosis and surgery were evaluated. The patients were visited by at least two physicians; the median number of physicians was four. A total of 47% of the patients were referred to a general practitioner on their first visit. The mean times between the first visit and CE diagnosis and surgery were 1.5 and 3.2 months, respectively. A definitive diagnosis of CE was made for 35.3% of the patients in less than 1 month after the first visit. However, it took 4 months or more for 51.4% of the patients to receive hydatid surgery. The fear of anesthesia and surgery, the cost of management, unsuccessful chemotherapy for CE patients, pregnancy, and issues related to immigrant patients and refugees are among the factors involved in the protraction of CE diagnosis and treatment. Establishing practice guidelines for CE diagnosis and treatment, continuing education for healthcare professionals, and improving access to diagnostic facilities for endemic communities are required to address challenges in the management of CE in endemic regions.
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Author Notes
Financial support: This study was financially supported by the Vice Chancellor of
Disclosure: This study was approved by the KMU Research Review Committee (approval code IR.KMU.REC.1398.524). The data in the present study are available upon request. The authors declare no conflicts of interest.
Author’s contributions: Conceptualization: M.S., M.R.L., M.F., M.Y., S.N., M.A.M., and M.F.H.; data curation: F.M., S.N., and M.F.H.; formal analysis: F.M., S.N., M.A.M., and M.F.H.; funding acquisition: M.F.H.; investigation: F.M., M.S., M.R.L., M.F., M.Y., F.K., and R.E.V.; methodology: F.M. and M.F.H.; project administration: M.F.H.; resources: M.A.M. and S.N.; software: F.M., S.N., and M.F.H.; supervision: M.F.H.; validation: M.S., M.R.L., M.F., M.Y., F.K., R.E.V., and M.F.H.; visualization: F.M., and S.N.; writing—original draft preparation: F.M. and M.F.H.; writing—review and editing: F.M., M.S., M.R.L., M.F., M.Y., F.K., R.E.V., S.N., M.A.M., and M.F.H.
Current contact information: Fatemeh Mohtasham, Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran, E-mail: f.mohtasham90@gmail.com. Mohammad Shafiei and Mohammad Reza Lashkarizadeh, Research Center for Hydatid Disease in Iran, Department of Surgery, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran, E-mails: eeifahs.tx@gmail.com and mr.lashkarizadeh@gmail.com. Mehrdad Farokhnia and Maysam Yousefi, Research Center for Hydatid Disease in Iran, Department of Internal Medicine, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran, E-mails: mehrdad_farrokhnia@yahoo.com and dr.m_yousefi@yahoo.com. Rana Eftekhar Vaghefi and Fatemeh Khajehasani, Research Center for Hydatid Disease in Iran, Department of Radiology, School of Medicine, Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran, E-mails: rana-eftekharvaghefi@yahoo.com and fatemekhajehasani@gmail.com. Saeid Nasibi, Mohammad Ali Mohammadi, and Majid Fasihi Harandi, Research Center for Hydatid Disease in Iran, Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran, E-mails: s.nasibi62@gmail.com, ali.uk.biotech@gmail.com, and majid.fasihi@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Deplazes P, Rinaldi L, Rojas CA, Torgerson P, Harandi M, Romig T, Antolova D, Schurer J, Lahmar S, Cringoli G, 2017. Global distribution of alveolar and cystic echinococcosis. Adv Parasitol 95 :315–493.
-
2.
Thompson R, 2017. Biology and systematics of Echinococcus. Adv Parasitol 95 :65–109.
-
3.
Borhani M, Fathi S, Darabi E, Jalousian F, Simsek S, Ahmed H, Kesik HK, Hosseini SH, Romig T, Harandi MF, 2021. Echinococcoses in Iran, Turkey, and Pakistan: Old diseases in the new millennium. Clin Microbiol Rev 34 :e00290-20.
-
4.
Fasihi Harandi M, Budke CM, Rostami S, 2012. The monetary burden of cystic echinococcosis in Iran. PLoS Negl Trop Dis 6 :e1915.
-
5.
Nunnari G, Pinzone MR, Gruttadauria S, Celesia BM, Madeddu G, Malaguarnera G, Pavone P, Cappellani A, Cacopardo B, 2012. Hepatic echinococcosis: Clinical and therapeutic aspects. World J Gastroenterol 18 :1448–1458.
-
6.
Borhani M, Fathi S, Lahmar S, Ahmed H, Abdulhameed MF, Fasihi Harandi M, 2020. Cystic echinococcosis in the Eastern Mediterranean region: Neglected and prevailing! PLoS Negl Trop Dis 14 :e0008114.
-
7.
Kern P, Da Silva AM, Akhan O, Müllhaupt B, Vizcaychipi K, Budke C, Vuitton D, 2017. The echinococcoses: Diagnosis, clinical management and burden of disease. Adv Parasitol 96 :259–369.
-
8.
Budke CM, Deplazes P, Torgerson PR, 2006. Global socioeconomic impact of cystic echinococcosis. Emerg Infect Dis 12 :296–303.
-
9.
Kvascevicius R, Lapteva O, Al Awar O, Audronyte E, Neverauskiene L, Kvasceviciene E, Sokolovas V, Strupas K, Marcinkute A, Deplazes P, 2016. Fatal liver and lung alveolar echinococcosis with newly developed neurologic symptoms due to the brain involvement. Surg J (NY) 2 :e83–e88.
-
10.
WHO Informal Working Group, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85 :253–261.
-
11.
Dziri C, Haouet K, Fingerhut A, 2004. Treatment of hydatid cyst of the liver: Where is the evidence? World J Surg 28 :731–736.
-
12.
Nasibi S et al., 2023. Iranian hydatid disease registry: Establishment and implementation of a neglected tropical disease registry.Arch Iran Med 26 :358–364.
-
13.
Asadi A, Betti G, Gagliardi F, Khoshbakht H, 2019. Multidimensional and fuzzy poverty at regional level in Iran. Department of Economics University of Siena 796 :1–20.
-
14.
Committee RD, 2017. Deprivation Atlas of Iran. Barakat Foundation Tehran, Iran (in Farsi). Available at: https://shorturl.at/IJZ7O. Accessed November 12, 2023.
-
15.
Janati A, Amini A, Adham D, Naseriasl M, 2017. Referral system in Iran’s health sector and world’s leading countries.Rese Jour of Pharm and Technol 10 :1597–1602.
-
16.
Sayek I, Tirnaksiz MB, Dogan R, 2004. Cystic hydatid disease: Current trends in diagnosis and management.Surg Today 34 :987–996.
-
17.
GBD 2019 Iran Collaborators, 2022. Health system performance in Iran: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet 399 :1625–1645.
-
18.
Adeosun II, Adegbohun AA, Adewumi TA, Jeje OO, 2013. The pathways to the first contact with mental health services among patients with schizophrenia in Lagos, Nigeria.Schizophr Res Treatment 2013 :769161.
-
19.
Ebrahimipour M, Budke CM, Harandi MF, 2020. Control of cystic echinococcosis in Iran: Where do we stand? Trends Parasitol 36 :578–581.
-
20.
Ruhaiyem M, Alshehri A, Saade M, Shoabi T, Zahoor H, Tawfeeq N, 2016. Fear of going under general anesthesia: A cross-sectional study. Saudi J Anaesth 10 :317–321.
-
21.
Masroor S, 2020. Collateral damage of COVID-19 pandemic: Delayed medical care.J Card Surg 35 :1345–1347.
-
22.
Ghiasvand H, Sha’baninejad H, Arab M, Rashidian A, 2014. Hospitalization and catastrophic medical payment: Evidence from hospitals located in Tehran. Arch Iran Med 17 :507–513.
-
23.
Pourreza A, Harirchi I, Bazyar M, 2017. Differentiation of out-of-pocket expenditures in cancer patients; a case study in the cancer institute of Iran. EBHPME 1 :65–73.
-
24.
Vujic J, Marsoner K, Lipp-Pump A, Klaritsch P, Mischinger H, Kornprat P, 2019. Non-obstetric surgery during pregnancy - An eleven-year retrospective analysis. BMC Pregnancy Childbirth 19 :382.
-
25.
Rahimitabar P, Kraemer A, Bozorgmehr K, Ebrahimi F, Takian A, 2023. Health condition of Afghan refugees residing in Iran in comparison to Germany: A systematic review of empirical studies.Int J Equity Health 22 :16–14.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 18881 | 18881 | 620 |
| Full Text Views | 52 | 52 | 7 |
| PDF Downloads | 31 | 31 | 11 |