Human Parasitic Diseases in Bulgaria in Between 2013-2014

Abstract

Background: In Bulgaria, more than 20 autochthonoushuman parasitic infections have been described and someof them are widespread. Over 50 imported protozoanand helminthic infections represent diagnostic andtherapeutic challenges and pose epidemiological risksdue to the possibility of local transmission.Aims: To establish the distribution of autochthonousand imported parasitic diseases among the populationof the country over a 2-year period (2013-2014) and toevaluate their significance in the public health system.Study Design: Cross sectional study.Methods: We used the annual reports by regional healthinspectorates and data from the National ReferenceLaboratory at the National Centre of Infectiousand Parasitic Diseases on all individuals infectedwith parasitic diseases in the country. Prevalencewas calculated for parasitic diseases with few orabsent clinical manifestations (oligosymptomatic orasymptomatic infections). Incidence per 100.000 wascalculated for diseases with an overt clinical pictureor those that required hospitalisation and specialisedmedical interventions (e.g. surgery).Results: During the research period, parasitologicalstudies were conducted on 1441.244 persons,and parasitic infections were diagnosed in 22.039individuals. Distribution of various parasitic pathogensamong the population displayed statistically significantdifferences in prevalence for some intestinal parasites(enterobiasis 0.81%, giardiasis 0.34% and blastocystosis0.22%). For certain zoonotic diseases such as cysticechinococcosis (average incidence of 3.99 per 100.000)and trichinellosis (average incidence of 0.8 per 100.000),the incidence exceeds several times the annual incidencerecorded in the European Union.Conclusion: Parasitic diseases still pose a substantialproblem with social and medical impacts on theresidents of our country. Improved efficiency regardingautochthonous and imported parasitic diseases isessential in providing the public health system the toolsit needs to combat these diseases. Attention should befocused on the various imported vector-borne parasiticdiseases (e.g. malaria and cutaneous leishmaniasis) forwhich the country is potentially endemic