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Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

Abstract Human alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs) associated with AE in humans.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28715408
OWN - NLM
STAT- Publisher
DA  - 20170717
LR  - 20170717
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul 17
TI  - Potential risk factors associated with human alveolar echinococcosis: Systematic 
      review and meta-analysis.
PG  - e0005801
LID - 10.1371/journal.pntd.0005801 [doi]
AB  - BACKGROUND: Human alveolar echinococcosis (AE) is a severe zoonotic disease
      caused by the metacestode stage of Echinococcus multilocularis. AE is commonly
      associated with a long incubation period that may last for more than ten years.
      The objective of this systematic literature review was to identify and summarize 
      the current knowledge on statistically relevant potential risk factors (PRFs)
      associated with AE in humans. METHODOLOGY/PRINCIPAL FINDINGS: Six bibliographic
      databases were searched, generating a total of 1,009 publications. Following the 
      removal of duplicate records and the exclusion of papers that failed to meet the 
      criteria of a previously agreed a priori protocol, 23 publications were retained;
      however, 6 of these did not contain data in a format that allowed their inclusion
      in the meta-analysis. The remaining 17 publications (6 case-control and 11
      cross-sectional studies) were meta-analysed to investigate associations between
      AE and PRFs. Pooled odds ratio (OR) were used as a measure of effect and
      separately analysed for case-control and cross-sectional studies. In the
      case-control studies, the following PRFs for human AE showed higher odds of
      outcome: "dog ownership", "cat ownership", "have a kitchen garden", "occupation: 
      farmer", "haymaking in meadows not adjacent to water", "went to forests for
      vocational reasons", "chewed grass" and "hunting / handling foxes". In the
      cross-sectional studies, the following PRFs showed higher odds of outcome: "dog
      ownership", "play with dogs", "gender: female", "age over 20 years", "ethnic
      group: Tibetan", "low income", "source of drinking water other than well or tap",
      "occupation: herding" and "low education". Our meta-analysis confirmed that the
      chance of AE transmission through ingestion of food and water contaminated with
      E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do
      not significantly increase the risk of infection. CONCLUSIONS/SIGNIFICANCE: This 
      systematic review analysed international peer-reviewed articles that have over
      the years contributed to our current understanding of the epidemiology of human
      AE. The identification of potential risk factors may help researchers and
      decision makers improve surveillance and/or preventive measures that aim at
      decreasing human infection with E. multilocularis. More primary studies are
      needed to confirm potential risk factors and their role in the epidemiology of
      human AE.
FAU - Conraths, Franz J
AU  - Conraths FJ
AUID- ORCID: http://orcid.org/0000-0002-7400-9409
AD  - Friedrich-Loeffler-Institut, Institute of Epidemiology, Greifswald-Insel Riems,
      Germany.
FAU - Probst, Carolina
AU  - Probst C
AD  - Friedrich-Loeffler-Institut, Institute of Epidemiology, Greifswald-Insel Riems,
      Germany.
FAU - Possenti, Alessia
AU  - Possenti A
AD  - Department of Infectious Diseases, Istituto Superiore di Sanita (ISS), Rome,
      Italy.
AD  - European Union Reference Laboratory for Parasites (EURLP), ISS, Rome, Italy.
FAU - Boufana, Belgees
AU  - Boufana B
AD  - Department of Infectious Diseases, Istituto Superiore di Sanita (ISS), Rome,
      Italy.
AD  - World Health Organization Collaborating Centre for the epidemiology, detection
      and control of cystic and alveolar echinococcosis (in humans and animals), ISS,
      Rome, Italy.
FAU - Saulle, Rosella
AU  - Saulle R
AD  - Sapienza University of Rome, Department of Public Health and Infectious Diseases,
      Rome, Italy.
FAU - La Torre, Giuseppe
AU  - La Torre G
AD  - Sapienza University of Rome, Department of Public Health and Infectious Diseases,
      Rome, Italy.
FAU - Busani, Luca
AU  - Busani L
AD  - Department of Food Safety and Veterinary Public Health, Istituto Superiore di
      Sanita (ISS), Rome, Italy.
FAU - Casulli, Adriano
AU  - Casulli A
AD  - Department of Infectious Diseases, Istituto Superiore di Sanita (ISS), Rome,
      Italy.
AD  - World Health Organization Collaborating Centre for the epidemiology, detection
      and control of cystic and alveolar echinococcosis (in humans and animals), ISS,
      Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170717
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
EDAT- 2017/07/18 06:00
MHDA- 2017/07/18 06:00
CRDT- 2017/07/18 06:00
PHST- 2017/02/23 [received]
PHST- 2017/07/12 [accepted]
AID - 10.1371/journal.pntd.0005801 [doi]
AID - PNTD-D-17-00270 [pii]
PST - aheadofprint
SO  - PLoS Negl Trop Dis. 2017 Jul 17;11(7):e0005801. doi:
      10.1371/journal.pntd.0005801.