Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy.
Department of Animal Medicine, Production and Health, University of Padova, Legnaro (Padova), Italy.
PLoS Negl Trop Dis. 2020 Aug 10;14(8):e0008519. doi: 10.1371/journal.pntd.0008519. eCollection 2020 Aug.
Cystic echinococcosis (CE) is a neglected zoonosis caused by infection with the cestode Echinococcus granulosus sensu lato. We carried out a systematic literature review on E. granulosus s.l. human and animal (cattle, sheep, dog) infection in European Mediterranean and Balkan countries in 2000-2019, to provide a picture of its recent epidemiology in this endemic area. MEDLINE, EMBASE, Scopus, Google Scholar and Open Grey databases were searched. Included cases were: i) for humans, data from hospital records and imaging studies; ii) for dogs, data from necropsy and coprological studies; iii) for ruminants, cases based on slaughter inspection. The NUTS (Nomenclature of Territorial Units for Statistics) classification was used to categorize extracted data in epidemiological units, defined as data referred to one NUTS2 (basic region) in one year time. Data were then aggregated to NUTS1 level (major regions), calculating the average incidence value of included epidemiological units. For prevalence studies covering different epidemiological units, the pooled prevalence was estimated. Data were extracted from 79 publications, 25 on human infection (covering 437 epidemiological units), and 54 on animal infection (52 epidemiological units for cattle, 35 for sheep and 25 for dogs). At NUTS1 level, average annual incidence rates of human CE ranged from 0.10-7.74/100,000; pooled prevalence values ranged from 0.003-64.09% in cattle, 0.004-68.73% in sheep, and 0-31.86% in dogs. Southern and insular Italy, central Spain, Romania and Bulgaria reported the highest values. Bovine data showed a more similar pattern to human data compared to sheep and dogs. Limitation of evidence included the paucity of human prevalence studies, data heterogeneity, and the patchy geographical coverage, with lack of data especially for the Balkans. Our results confirm Italy, Spain, and Eastern Europe being the most affected areas, but data are extremely heterogeneous, geographical coverage very patchy, and human prevalence studies extremely scant. Results also highlight the notorious problem of underreporting of E. granulosus s.l. infection in both humans and animals.
包虫病（CE）是一种被忽视的人畜共患寄生虫病，由细粒棘球绦虫感染引起。我们对 2000-2019 年欧洲地中海和巴尔干国家的细粒棘球蚴人兽（牛、羊、犬）感染进行了系统的文献综述，以了解该流行地区的近期流行情况。检索了 MEDLINE、EMBASE、Scopus、Google Scholar 和 Open Grey 数据库。纳入的病例包括：i）人类，来源于医院记录和影像学研究的数据；ii）犬，来源于剖检和粪便检查研究的数据；iii）反刍动物，基于屠宰检查的病例。使用 NUTS（统计地域单位命名法）分类将提取的数据分类为流行病学单位，定义为一年中涉及一个 NUTS2（基本区域）的数据。然后将数据汇总到 NUTS1 水平（主要区域），计算纳入流行病学单位的平均发病率值。对于涵盖不同流行病学单位的患病率研究，估计了合并患病率。从 79 篇文献中提取数据，25 篇关于人类感染（涵盖 437 个流行病学单位），54 篇关于动物感染（牛 52 个流行病学单位，羊 35 个，犬 25 个）。在 NUTS1 水平，人类包虫病的年平均发病率从 0.10-7.74/100,000 不等；牛的合并患病率从 0.003-64.09%不等，绵羊为 0.004-68.73%，犬为 0-31.86%。意大利南部和岛屿、西班牙中部、罗马尼亚和保加利亚报告的数值最高。与绵羊和犬相比，牛的数据与人类数据更相似。证据的局限性包括人类患病率研究的缺乏、数据异质性以及地理覆盖范围的不完整，尤其是巴尔干地区的数据缺乏。我们的结果证实，意大利、西班牙和东欧是受影响最严重的地区，但数据差异很大，地理覆盖范围非常分散，人类患病率研究非常匮乏。结果还突出了人类和动物包虫病感染报告不足的臭名昭著问题。
