Investigator(s)
| Submitter |
Pema Wangchuk Swiss Tropical and Public Health Institute, University of Basel Pema Wangchuk 
|
| Principal Investigator |
Pema Wangchuk Swiss Tropical and Public Health Institute, University of Basel Pema Wangchuk
|
| Co-Investigator(s) |
Thomas Junghanns University of Heidelberg, Germany Thomas Junghanns
|
| Co-Investigator(s) |
Peter Deplazes University of Zurich, Switzerland Peter Deplazes
|
| Co-Investigator(s) |
Peter Odermatt Swiss Tropical and Public Health Institute Peter Odermatt
|
| Co-Investigator(s) |
Sonam Penjor Jigme Dorji Wangchuck National Referral Hospital, National Medical Services, Ministry of Health, Royal Government of Bhutan Sonam Penjor
|
| Co-Investigator(s) |
Sonam Jamtsho Jigme Dorji Wangchuck National Referral Hospital, National Medical Services, MoH, RGoB Sonam Jamtsho
|
| Co-Investigator(s) |
Pushpa Maya Sharma National Center for Animal Health, Department of Livestock, Ministry of Agriculture and Forestry Pushpa Maya Sharma
|
| Co-Investigator(s) |
Jan Hattendorf Swiss Tropical and Public Health Institute, University of Basel, Switzerland Jan Hattendorf
|
| Co-Investigator(s) |
Beatrice Nickel Swiss Tropical and Public Health Institute, University of Basel, Switzerland Beatrice Nickel
|
| Co-Investigator(s) |
Ramon M. Eichenberger Institute of Chemistry and Bitotechnology (ICBT), Zurich University of Applied Sciences Ramon M. Eichenberger
|
Title(s) and abstract
| Scientific title | Understanding Cystic Echinococcosis in Bhutan: Investigating the Clinical, Epidemiological, and Parasitological Characteristics. |
| Public title | Cystic Echinococcosi in Bhutan |
| Background | Cystic echinococcosis is a neglected parasitic disease primarily affecting rural and underprivileged segments of the population. It is caused by the larvae of the Echinococcus granulosus sensu lato complex, with dogs serving as the definitive host and ruminant livestock as intermediate hosts. Humans are involved as accidental dead-end hosts. Dogs infect themselves most often from the consumption of ruminant offal. Ruminants and humans are infected through contact with dog faeces or contaminated food and water. Due to this condition, livestock-rearing communities with poor hygiene and sanitation face substantial socio-economic challenges. The strain on healthcare systems is significant due to complex, costly, and lengthy treatment procedures involving anti-parasitic medication and surgical interventions. |
| Objectives | The project aims to contribute towards reducing the disease burden, improve patient care, and inform policy planning by comprehensively assessing the clinical, epidemiological, and parasitological characteristics of cystic echinococcosis in Bhutan and the wider Himalayan region of South Asia for achieving sustainable disease control. The primary objectives of this doctoral project are to examine the epidemiology of cystic echinococcosis in humans and animals and evaluate its health impact across the Himalayan region in South Asia and Bhutan. The study seeks to assess the disease burden in the endemic communities and explore clinical features, diagnosis, and treatment while comparing existing practices with established WHO guidelines. In addition, a validation of rapid diagnostic test (RDT) and a molecular characterization of the circulating Echinococcus granulosus parasite will be undertaken to contribute towards disease control and elimination efforts. |
| Study Methods | A systematic review and meta-analysis will be carried out to evaluate the prevalence of cystic echinococcosis in both human and animal populations along the Himalayan belt of South Asia. In Bhutan, an initial step involves a retrospective review of hospital records from the past 10 years (2014 – 2023) at hospitals where echinococcosis cases have been reported and treatments including surgeries are performed. A community screening for cystic echinococcosis using ultrasound, supplemented by serological tests, will be conducted in rural areas including semi-nomadic pastoral communities in Bhutan's north-western, north-central, and eastern regions. Finally, genotyping of parasites from CE cysts or liver lesion samples of human and animal origin and dog fecal samples will be carried out to identify and analyze the parasites present in Bhutan. |
| Expected outcomes and use of results | The research aims to achieve several outcomes. Firstly, it seeks to improve our understanding of cystic echinococcosis (CE) prevalence, distribution, and risk factors among human and animal populations in Bhutan and broader South Asia along the Himalayan belt. This data will inform policymakers, healthcare providers, and researchers, helping them develop targeted interventions and better healthcare strategies. Community-based US survey will facilitate early detection and treatment of CE in these rural communities. Results from the community-based survey can guide healthcare planning and resource allocation to ensure the provision of required services, including diagnostic facilities, treatment options, and public health interventions aimed at CE control. Secondly, the study aims to gain better insights into CE patient demographics, treatment approaches, and adherence to World Health Organization (WHO) guidelines in Bhutan. This will enable optimization of clinical management practices and care delivery for CE patients in Bhutan, leading to improved patient outcomes and quality of care. Lastly, the research seeks to deepen our understanding of CE transmission dynamics in Bhutan, through genotyping of parasites from human and animal CE cysts, along with dog fecal samples. This knowledge will be instrumental in developing effective, targeted control measures and interventions to reduce CE transmission rates and enhance public health outcomes in the country. Furthermore, the findings of the study can contribute to the global knowledge base of CE epidemiology and parasitology. |
| Keywords | Cystic echinococcosis, Echinococcus, Bhutan, Ultrasound |
Research Details
| Student research | Yes |
| Institution: Swiss Tropical and Public Health Institute, University of Basel | |
| Academic degree: Ph.D. | |
| Supervisor of the student(s) | |
| Full Name and title: Prof. Dr. Jakob Zinsstag | |
| Email: jakob.zinsstag@swisstph.ch | |
| Start Date | 01-Aug-2024 |
| End Date | 31-Dec-2026 |
| Key Implementing Institution | Swiss Tropical and Public Health Institute |
| Multi-country research | No |
| Nationwide research | Yes, with randomly selected geographical areas |
| Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Infectious Disease |
| Involves human subjects | Yes |
| Other(Clinical Research),Population-Based Survey, Operational Research | |
| Data Collection | Primary and secondary data |
| Proposal reviewed by other Committee | Approved |