Osservatorio Epidemiologico Veterinario Regionale, Cagliari, Italy.
Dipartimento di Scienze Cliniche e Biologiche, Università degli studi di Torino, Torino, Italy.
PLoS One. 2019 Apr 1;14(4):e0214224. doi: 10.1371/journal.pone.0214224. eCollection 2019.
Cystic echinococcosis (CE) is a complex zoonosis with domestic and sylvatic life-cycles, involving different intermediate and definitive host species. Many previous studies have highlighted the lack of a surveillance system for CE, its persistence in Italy, and endemicity in several Italian regions. Because of the absence of a uniform surveillance program for both humans and animals, disease occurrence is widely underestimated. This study aimed to estimate the prevalence of ovine CE in Italy. Survey data on the prevalence of Echinococcus granulosus complex infections in Italian sheep farms from 2010 to 2015 were obtained in collaboration with Regional Veterinary Epidemiology Observatories (OEVRs). Bayesian analysis was performed to estimate the true CE farm prevalence. The prior true CE prevalence was estimated using data from Sardinia. Second, Bayesian modelling of the observed prevalence in different regions and the true prevalence estimation from the first step were used to ultimately estimate the prevalence of ovine CE in Italy. We obtained survey data from 10 OEVRs, covering 14 Italian regions. We observed that the risk of CE infection decreased over the years, and it was strictly correlated with the density of susceptible species. Using Sardinia as prior distribution, where the disease farm prevalence was approximately 19% (95% CI, 18.82-20.02), we estimated that the highest endemic CE farm prevalence was in Basilicata with a value of 12% (95% BCI: 7.49-18.9%) and in Piemonte 7.64%(95% BCI: 4.12-13.04%). Our results provide spatially relevant data crucial for guiding CE control in Italy. Precise information on disease occurrence location would aid in the identification of priority areas for disease control implementation by the authorities. The current underestimation of CE occurrence should urge the Italian and European governments to become aware of the public health importance of CE and implement targeted interventions for high-risk areas.
泡型包虫病 (CE) 是一种具有复杂的家畜和野生动物生活周期的人畜共患病，涉及不同的中间宿主和终末宿主物种。许多先前的研究强调了 CE 缺乏监测系统、其在意大利的持续存在以及几个意大利地区的地方性。由于缺乏针对人类和动物的统一监测计划，疾病的发生被广泛低估。本研究旨在估计意大利绵羊 CE 的流行率。通过与地区兽医流行病学观测站 (OEVRs) 合作，获取了 2010 年至 2015 年意大利绵羊养殖场感染细粒棘球蚴复合体的数据。采用贝叶斯分析估计真包虫病农场的流行率。使用来自撒丁岛的数据来估计先验的真实 CE 流行率。其次，使用不同地区的观察流行率和第一步的真实流行率估计进行贝叶斯建模，最终估计意大利绵羊 CE 的流行率。我们从 10 个 OEVR 获得了调查数据，涵盖了 14 个意大利地区。我们发现，CE 感染的风险随着时间的推移而降低，并且与易感染物种的密度密切相关。使用撒丁岛作为先验分布，其中疾病农场的流行率约为 19%（95%CI，18.82-20.02），我们估计，在巴西利卡塔，CE 流行率最高，为 12%（95%BCI：7.49-18.9%），皮埃蒙特为 7.64%（95%BCI：4.12-13.04%）。我们的研究结果提供了具有重要空间相关性的数据，这对于指导意大利的 CE 控制至关重要。关于疾病发生地点的准确信息将有助于当局确定疾病控制实施的优先领域。CE 发生的当前低估应促使意大利和欧洲政府意识到 CE 的公共卫生重要性，并针对高风险地区实施有针对性的干预措施。
