DerSimonian R, Lard N, 1986. Meta-analysis in clinical trials. Control Clin Trials 7: 177–188.
De Andrade BB, Carabin H, 2011. On the estimation of relative risks via log binomial regression. Revista Brasileira de Biometria 29: 1–15.
Yang YR, Sun T, Li Z, Zhang J, Teng J, Liu X, Liu R, Zhao R, Jones MH, Wang Y, Wen H, Feng X, Zhao Q, Zhao Y, Shi D, Bartholomot B, Vuitton DA, Pleynell D, Giraudoux P, Ito A, Danson MF, Boufana B, Craig PS, Williams GM, McManus DP, 2006. Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China. Bull World Health Organ 84: 714–721.
Yang YR, Ellis M, Sun T, Li Z, Vuitton DA, Bartholomot B, Giraudoux P, Craig PS, Boufana B, Wang Y, Feng X, Wen H, Ito A, McManus DP, 2006. Unique family clustering of human echinococcosis cases in a Chinese family. Am J Trop Med Hyg 74: 487–494.
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Qiu JM, Liu FJ, Schantz PM, Ito A, Delker C, He JG, Zhang Y, Chen XW, 2000. Epidemiological study on human hydatidosis in Tibetan region of Western Sichuan. Chin J Zoonoses 10: 77–80 [article in Chinese].
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Moro PL, Bonifacio N, Gilman RH, Lopera L, Silva B, Takumoto R, Verastegui M, Cabrera L, 1999. Field diagnosis of Echinococcus granulosus infection among intermediate and definitive host in an endemic focus of human cystic echinococcosis. Trans R Soc Trop Med Hyg 93: 611–615.
Macpherson CN, Kachani M, Lyagoubi M, Berrada M, Shepherd M, Fields PF, El Hasnaoui M, 2004. Cystic echinococcosis in the Berber of the Mid Atlas mountains, Morocco: new insights into the natural history of the disease in human. Ann Trop Med Parasitol 98: 481–490.
Elmahdi IE, Ali QM, Magzoub MM, Ibrahim AM, Saad MB, Romig T, 2004. Cystic echinococcosis of livestock and humans in central Sudan. Ann Trop Med Parasitol 98: 473–479.
Frider B, Moguilensky J, Salvitti JC, Odriozola M, Cantoni G, Larrieu E, 2001. Epidemiological surveillance of human hydatidosis by means of ultrasonography: its contribution to the evaluation of control programs. Acta Trop 79: 219–223.
Larrieu E, Del Carpio M, Salvitti JC, Mercapide C, Sustersic J, Panomarenko H, Costa M, Bigatti R, Labanchi J, Herrero E, Cantoni G, Perez A, Odriozola M, 2004. Ultrasonographic diagnosis and medical treatment of human cystic echinococcosis in asymptomatic school carriers: 5 years of follow-up. Acta Trop 91: 5–13.
Del Carpio M, Moguilansky S, Costa M, Panomarenko H, Bianchi G, Bendersky S, Lazcano M, Frider B, Larrieu E, 2000. Diagnosis of human hydatidosis. Predictive value of a rural ultrasonographic survey in an apparently healthy population. Medicina (B Aires) 60: 466–468.
Mata-Miranda P, Osnaya-Palma I, Rodríguez-Prado U, Gutiérrez-Marin A, Tawil M, Hernández-González S, Solano-Ceh M, Villalvaso L, Martínez-Maya JJ, García-de-la-Torre G, Flisser A, 2007. Epidemiologic and ultrasonographic study of echinococcosis in a community in the state of Mexico. Am J Trop Med Hyg 77: 500–503.
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Shambesh MK, Craig PS, Ibrahem MM, Gusbi AM, Echyuish EF, 1997. A high prevalence of cystic hydatid disease in North Africa. Ann Trop Med Parasitol 91: 957–959.
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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.
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.
DerSimonian R, Lard N, 1986. Meta-analysis in clinical trials. Control Clin Trials 7: 177–188.
De Andrade BB, Carabin H, 2011. On the estimation of relative risks via log binomial regression. Revista Brasileira de Biometria 29: 1–15.
Yang YR, Sun T, Li Z, Zhang J, Teng J, Liu X, Liu R, Zhao R, Jones MH, Wang Y, Wen H, Feng X, Zhao Q, Zhao Y, Shi D, Bartholomot B, Vuitton DA, Pleynell D, Giraudoux P, Ito A, Danson MF, Boufana B, Craig PS, Williams GM, McManus DP, 2006. Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China. Bull World Health Organ 84: 714–721.
Yang YR, Ellis M, Sun T, Li Z, Vuitton DA, Bartholomot B, Giraudoux P, Craig PS, Boufana B, Wang Y, Feng X, Wen H, Ito A, McManus DP, 2006. Unique family clustering of human echinococcosis cases in a Chinese family. Am J Trop Med Hyg 74: 487–494.
Wang YH, Rogan MT, Vuitton DA, Wen H, Bartholomot B, Macpherson CN, Zou PF, Ding ZX, Zhou HX, Zhang XF, Luo J, Xiong HB, Fu Y, McVie A, Giraudoux P, Yang WG, Craig PS, 2001. Cystic echinococcosis in semi-nomadic pastoral communities in north-west China. Trans R Soc Trop Med Hyg 95: 153–158.
Zhao Q, Lv YQ, 2003. Investigation on prevalence of human hepatic hydatid disease diagnosed by ultrasound in two counties of Xinjiang. Endemic Dis Bull 18: 41–42 [article in Chinese].
Qiu JM, Liu FJ, Schantz PM, Ito A, Delker C, He JG, Zhang Y, Chen XW, 2000. Epidemiological study on human hydatidosis in Tibetan region of Western Sichuan. Chin J Zoonoses 10: 77–80 [article in Chinese].
Li T, Qiu J, Yang W, Craig PS, Xingwang C, Xiou N, Ito A, Giraudoux P, Wulamu M, Yank W, Schantz PM, 2005. Echinococcosis in Tibetan populations, western Sichuan Province, China. Emerg Infect Dis 11: 1866–1873.
Wang H, Zhang J, Schantz PM, Ito A, Craig PS, Wu X, Han X, 2006. Epidemiologic survey and analysis on echinococcosis in human and animals from 1995 to 2005. Chin J Zoonoses 22: 1129–1134 [article in Chinese].
Schantz PM, Wang H, Qiu J, Liu FJ, Saito E, Emshoff A, Ito A, Roberts JM, Delker C, 2003. Echinococcosis on the Tibetan Plateau: prevalence and risk factors for cystic and alveolar echinococcosis in Tibetan populations in Qinghai Province, China. Parasitology 127: S109–S120.
Ma JY, Ma X, Wu XH, Zhang J, He D, Liu Y, Liu B, Liu P, Liu H, Zhao Y, Cai H, Wang H, 2005. Epidemiological survey on hydatid disease in human in Yushu County. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 23: 452 [article in Chinese].
Wang Y, He T, Wen X, Li T, Waili TT, Zhang W, Zhou H, Zheng H, Wen H, Davaadorj N, Gambolt L, Mukhar T, Rogan MT, Craig PS, 2005. Human cystic echinococcosis in two Mongolian communities in Hobukesar (China) and Bulgan (Mongolia). Trans R Soc Trop Med Hyg 99: 692–698.
Gavidia CM, Gonzalez AE, Zhang W, McManus DP, Lopera L, Ninaquispe B, Garcia HH, Rodríguez S, Verastegui M, Calderon C, Pan WK, Gilman RH, 2008. Diagnosis of cystic echinococcosis, central Peruvian Highlands. Emerg Infect Dis 14: 260–266.
Moro PL, Garcia HH, Gonzales AE, Bonilla JJ, Verastegui M, Gilman RH, 2005. Screening for cystic echinococcosis in an endemic region of Peru using portable ultrasonography and the enzyme-linked immunoelectrotransfer blot (EITB) assay. Parasitol Res 96: 242–246.
Moro PL, McDonald J, Gilman RH, Silva B, Verastegui M, Malqui V, Lescano G, Falcon N, Montes G, Bazalar H, 1997. Epidemiology of Echinococcus granulosus infection in the central Peruvian Andes. Bull World Health Organ 75: 553–561.
Moro PL, Bonifacio N, Gilman RH, Lopera L, Silva B, Takumoto R, Verastegui M, Cabrera L, 1999. Field diagnosis of Echinococcus granulosus infection among intermediate and definitive host in an endemic focus of human cystic echinococcosis. Trans R Soc Trop Med Hyg 93: 611–615.
Macpherson CN, Kachani M, Lyagoubi M, Berrada M, Shepherd M, Fields PF, El Hasnaoui M, 2004. Cystic echinococcosis in the Berber of the Mid Atlas mountains, Morocco: new insights into the natural history of the disease in human. Ann Trop Med Parasitol 98: 481–490.
Elmahdi IE, Ali QM, Magzoub MM, Ibrahim AM, Saad MB, Romig T, 2004. Cystic echinococcosis of livestock and humans in central Sudan. Ann Trop Med Parasitol 98: 473–479.
Frider B, Moguilensky J, Salvitti JC, Odriozola M, Cantoni G, Larrieu E, 2001. Epidemiological surveillance of human hydatidosis by means of ultrasonography: its contribution to the evaluation of control programs. Acta Trop 79: 219–223.
Larrieu E, Del Carpio M, Salvitti JC, Mercapide C, Sustersic J, Panomarenko H, Costa M, Bigatti R, Labanchi J, Herrero E, Cantoni G, Perez A, Odriozola M, 2004. Ultrasonographic diagnosis and medical treatment of human cystic echinococcosis in asymptomatic school carriers: 5 years of follow-up. Acta Trop 91: 5–13.
Del Carpio M, Moguilansky S, Costa M, Panomarenko H, Bianchi G, Bendersky S, Lazcano M, Frider B, Larrieu E, 2000. Diagnosis of human hydatidosis. Predictive value of a rural ultrasonographic survey in an apparently healthy population. Medicina (B Aires) 60: 466–468.
Mata-Miranda P, Osnaya-Palma I, Rodríguez-Prado U, Gutiérrez-Marin A, Tawil M, Hernández-González S, Solano-Ceh M, Villalvaso L, Martínez-Maya JJ, García-de-la-Torre G, Flisser A, 2007. Epidemiologic and ultrasonographic study of echinococcosis in a community in the state of Mexico. Am J Trop Med Hyg 77: 500–503.
Ozkol M, Kilimcioğlu AA, Girginkardeşler N, Balcioğlu IC, Sakru N, Korkmaz M, Ok UZ, 2005. A discrepancy between cystic echinococcosis confirmed by ultrasound and seropositivity in Turkish children. Acta Trop 93: 213–216.
Ok UZ, Ozkol M, Kilimcioglu AA, Dinc G, Bayindir P, Ostan I, Pabuscu Y, Ozcan C, Kormaz M, Coskun S, Yuksel H, Girginkardesler N, 2007. A province-based study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, Turkey. Acta Trop 103: 116–122.
Bchir A, Larouze B, Soltani M, Hamdi A, Bouhaouala H, Ducic S, Bouden L, Ganouni A, Achour H, Gaudebout C, Rousset JJ, Jemmali M, 1991. Echotomographic and serological population-based study of hydatidosis in central Tunisia. Acta Trop 49: 149–153.
Shambesh MA, Macpherson CN, Beesley WN, Gusbi A, Elsonosi T, 1992. Prevalence of human hydatid disease in northwestern Libya: a cross-sectional ultrasound study. Ann Trop Med Parasitol 86: 381–386.
Shambesh MA, Craig PS, Macpherson CN, Rogan MT, Gusbi AM, Echtuish EF, 1999. An extensive ultrasound and serologic study to investigate the prevalence of human cystic echinococcosis in northern Libya. Am J Trop Med Hyg 60: 462–468.
Klungsøyr P, Courtright P, Hendrikson TH, 1993. Hydatid disease in the Hamar of Ethiopia: a public health problem for women. Trans R Soc Trop Med Hyg 87: 254–255.
Shambesh MK, Craig PS, Ibrahem MM, Gusbi AM, Echyuish EF, 1997. A high prevalence of cystic hydatid disease in North Africa. Ann Trop Med Parasitol 91: 957–959.
Carmona C, Perdomo R, Carbo A, Alvarez C, Monti J, Grauert R, Stern D, Perera G, Lloyd S, Bazini R, Gemmell MA, Yarzabal L, 1998. Risk factors associated with human cystic echinococcosis in Florida, Uruguay: results of a mass screening study using ultrasound and serology. Am J Trop Med Hyg 58: 599–605.
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