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A Systematic Review of the Literature on Cystic Echinococcosis Frequency Worldwide and Its Associated Clinical Manifestations

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  • Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China

A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence Proportion Ratio: 1.35 [95% Bayesian Credible Interval: 1.16–1.53]) and increased with age. The most common manifestations of hepatic and pulmonary CE were abdominal pain (57.3% [95% confidence interval [CI]: 37.3–76.1%]) and cough (51.3% [95% CI: 35.7–66.7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.

Author Notes

* Address correspondence to Christine M. Budke, Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, 4458 TAMU, College Station, TX 77843-4458. E-mail: cbudke@cvm.tamu.edu

Financial support: The World Health Organization's Foodborne Disease Burden Epidemiology Reference Group (FERG) funded this project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this manuscript.

Authors' addresses: Christine M. Budke and Rachana Bhattarai, Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, E-mails: cbudke@cvm.tamu.edu and rdhungel@cvm.tamu.edu. Hélène Carabin, Patrick C. Ndimubanzi, Hai Nguyen, Elizabeth Rainwater, and Oleksandr Zeziulin, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, E-mails: helene-carabin@ouhsc.edu, patdim@gmail.com, hai.nguyen@okstate.edu, elizabeth-rainwater@ouhsc.edu, and oleksandr-zeziulin@ouhsc.edu. Mary Dickey, Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, E-mail: mary-dickey@ouhsc.edu. Men-Bao Qian, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China, E-mail: ahtlqmb-007@163.com.

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