ISSN : 2146-3123
E-ISSN : 2146-3131

Human Parasitic Diseases in Bulgaria 2013-2014
Iskra Rainova1, Rumen Harizanov1, Iskren Kaftandjiev1, Nina Tsvetkova1, Ognyan Mikov1, Eleonora Kaneva1
1National Centre of Infectious and Parasitic Diseases, Department of Parasitology and Tropical Medicine, Sofia, Bulgaria
DOI : 10.4274/balkanmedj.2017.0167
Background: In Bulgaria, more than 20 autochthonous human parasitic infections have been described and some of them are widespread. Over 50 imported protozoan and helminthic infections represent diagnostic and therapeutic challenge and pose epidemiological risk due to the possibility of local transmission. 
Aims: To establish the distribution of autochthonous and imported parasitic diseases among the population of the country and to evaluate their significance for the public health system. 
Study design: Retrospective epidemiological analysis of the prevalence of human parasitic diseases in Bulgaria over the two-year period: 2013 - 2014. 
Methods: We used the annual reports by Regional Health Inspectorates and data from the National Reference Laboratory at the National Centre of Infectious and Parasitic Diseases on all individuals infected with parasitic diseases in the country. Prevalence was calculated for parasitic diseases with few or absent clinical manifestations (oligosymptomatic or asymptomatic infections), and incidence per 100 000 was calculated for diseases with overt clinical picture or requiring hospitalization and specialized medical interventions (i.e. surgery). 
Results: During the research period parasitological studies were conducted on 1 441 244 persons, and parasitic infections were diagnosed in 22 039 individuals. Distribution of various parasitic pathogens among the population displayed statistically significant differences with higher prevalence for some intestinal parasites (enterobiasis 0.81%, giardiasis 0.34%, blastocystosis 0.22%). For certain zoonotic diseases such as cystic echinococcosis (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 incidence recorded in the European Union. 
Conclusion:Parasitic diseases still pose a problem with social and medical significance for the country. It is essential to provide constantly the public health system with improved efficiency to deal with autochthonous and imported parasitic diseases. Attention should be directed to some imported vector-borne parasitic diseases (e.g. malaria and cutaneous leishmaniasis) for which the country is potentially endemic.
Keywords : parasitic diseases; prevalence; incidence; disease transmission
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