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Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Infectious diseases are a matter of concern worldwide, as recently evidenced by the COVID-19 pandemic. However, in many instances, pathogens develop slowly, and patients discover they are ill even years after they were infected. This is the case of diseases caused by tapeworm parasites, such as alveolar (AE) and cystic (CE) echinococcosis. Both AE and CE are produced by the growth of parasite larvae in organs of the host, mainly the liver. Despite the life cycles of these pathogens having been elucidated over 100 years ago, current diagnostic techniques cannot determine parasite viability during infection or treatment follow-up. Recently, a novel group of diagnostic molecules, namely small RNAs (sRNAs), have emerged with promising results in several pathologies. sRNAs are short nucleic acids expressed and secreted by cells; they can be detected in fluids such as serum, and their circulating levels are altered during diverse pathological states. Here, we characterized the profile of circulating sRNAs in patients with AE and CE to identify novel biomarkers that may aid in medical decisions. As a result, a panel of 20 candidate markers related to each pathogen and/or liver lesion were identified, which resulted in valuable knowledge to improve the diagnosis of these parasitic diseases. Alveolar (AE) and cystic (CE) echinococcosis are two parasitic diseases caused by the tapeworms Echinococcus multilocularis and E. granulosus sensu lato (s. l.), respectively. Currently, AE and CE are mainly diagnosed by means of imaging techniques, serology, and clinical and epidemiological data. However, no viability markers that indicate parasite state during infection are available. Extracellular small RNAs (sRNAs) are short non-coding RNAs that can be secreted by cells through association with extracellular vesicles, proteins, or lipoproteins. Circulating sRNAs can show altered expression in pathological states; hence, they are intensively studied as biomarkers for several diseases. Here, we profiled the sRNA transcriptomes of AE and CE patients to identify novel biomarkers to aid in medical decisions when current diagnostic procedures are inconclusive. For this, endogenous and parasitic sRNAs were analyzed by sRNA sequencing in serum from disease negative, positive, and treated patients and patients harboring a non-parasitic lesion. Consequently, 20 differentially expressed sRNAs associated with AE, CE, and/or non-parasitic lesion were identified. Our results represent an in-depth characterization of the effect E. multilocularis and E. granulosus s. l. exert on the extracellular sRNA landscape in human infections and provide a set of novel candidate biomarkers for both AE and CE detection. [ABSTRACT FROM AUTHOR]

• Cystic echinococcosis (CE) is a neglected zoonotic disease in Pakistan • CE is becoming a serious public health concern in many parts of the world, including Pakistan. • The current review highlights the epidemiology, diagnosis, and treatment of CE in Pakistan. Cystic echinococcosis (CE) is a zoonotic disease that occurs in humans and ungulates due to infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato. It has been estimated that approximately one million people are infected annually, resulting in US$3 billion in human and livestock-associated direct and indirect losses per year. CE is a serious public health concern in many parts of the world, including Pakistan. This review discusses the causative agent as well as the epidemiology, diagnosis, and treatment of CE in Pakistan. [ABSTRACT FROM AUTHOR]