Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

Abstract

BackgroundScientific literature on cystic echinococcosis (CE) reporting data on risk factors is limited and to the best of our knowledge, no global evaluation of human CE risk factors has to date been performed. This systematic review (SR) summarizes available data on statistically relevant potential risk factors (PRFs) associated with human CE.Methodology/Principal FindingsDatabase searches identified 1,367 papers, of which thirty-seven were eligible for inclusion. Of these, eight and twenty-nine were case-control and cross-sectional studies, respectively. Among the eligible papers, twenty-one were included in the meta-analyses. Pooled odds ratio (OR) were used as a measure of effect and separately analysed for the two study designs. PRFs derived from case-control studies that were significantly associated with higher odds of outcome were “dog free to roam” (OR 5.23; 95% CI 2.45–11.14), “feeding dogs with viscera” (OR 4.69; 95% CI 3.02–7.29), “slaughter at home” (OR 4.67; 95% CI 2.02–10.78) or at “slaughterhouses” (OR 2.7; 95% CI 1.15–6.3), “dog ownership” (OR 3.54; 95% CI 1.27–9.85), “living in rural areas” (OR 1.83; 95% CI 1.16–2.9) and “low income” (OR 1.68; 95% CI 1.02–2.76). Statistically significant PRFs from cross-sectional studies with higher odds of outcome were “age >16 years” (OR 6.08; 95% CI 4.05–9.13), “living in rural areas” (OR 2.26; 95% CI 1.41–3.61), “being female” (OR 1.38; 95% CI 1.06–1.8) and “dog ownership” (OR 1.37; 95% CI 1.01–1.86).Conclusions/SignificanceLiving in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasitic infection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas.

Human cystic echinococcosis in Morocco: Ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership

“…These results are different from previous work, where dog ownership was generally not associated with CE infection in studies investigating adults or communities, while gender and source of water were consistently associated with CE infection [20–24]. These results, however, are consistent with those reported in the recent systematic review and meta-analysis of potential risk factors associated with CE infection [1]. In the investigated area, “dog ownership” may be not intended in the same strict manner as in Europe.…”

Estudio epidemiológico de hidatidosis comparando los test de ELISA IgE y Western Blot en población de cinco provincias de la Región Lima. 2015

“…Serología para hidatidosis en pobladores de cinco provincias de la región Lima mediante el test ELISA IgE y Western Blot IgGpecto de la población con algún problema de salud que no consultó a un establecimiento de salud). La seroprevalencia general para anticuerpos IgE fue del 6,96%, mientras que para anticuerpos IgG fue del 5,89%, que concuerda con lo encontrado por diversos estudios (16,17,18) . Con respecto a la seropositividad en cada una de las provincias estudiadas de la Región Lima, se pudo observar que prácticamente todos los sueros positivos para anticuerpos IgE e IgG proceden de las provincias de Canta, Yauyos y Huaura, donde se ha observado que las dos primeras provincias mencionadas se caracterizan por ser zonas rurales y tener a la ganadería como actividad económica predominante (16) , lo cual podría explicar los hallazgos al considerarse estas características como potenciales factores de riesgo para la enfermedad (18) .…”

“…Respecto a la seropositividad de las muestras y su relación con los diferentes rangos de edad, se pudo observar que la mayor proporción de seropositivos se encuentra en individuos de la población económicamente activa, que en el caso de las zonas rurales se caracterizan por mayor contacto con ganado y con perros infectados o de suelo contaminados con huevos del parásito (18) .…”

Análisis de la hidatidosis humana en la Región de Coquimbo entre los años 2008 y 2012

“…Las otras comunas con alta incidencia fueron Río Hurtado y Monte Patria en la provincia de Limarí, Paihuano en la provincia del Elqui, y Canela en la provincia de Choapa. Estas son precisamente las comunas con los mayores índices de ruralidad en sus respectivas provincias 19 , característica que se ha identificado como factor de riesgo para la hidatidosis 20 .…”